Visual Processing in Adolescents Born Extremely Low Birth Weight and/or Extremely Preterm WHAT’S KNOWN ON THIS SUBJECT: Data available before the 1990s in addition to small studies with clinical populations have shown that ocular growth and development differ between extremely preterm and term-born children. WHAT THIS STUDY ADDS: Contemporary data on long-term visual outcomes indicate that adolescents born extremely low birth weight and/or extremely preterm exhibit more visual sensory and perceptual morbidity than adolescents born at term. abstract BACKGROUND AND OBJECTIVES: Ocular growth and development dif- fers between preterm and term-born infants and may cause long- term negative consequences for visual function, but contemporary data on long-term visual outcomes in representative samples of the highest risk extremely low birth weight (ELBW, ,1000 g birth weight) or extremely preterm (EP, ,28 weeks’ gestation) survivors are lacking. Our objective was to compare visual functioning between ELBW/EP and normal birth weight (NBW, .2499 g birth weight) control adolescents. METHODS: Geographically determined cohort study of 228 consecutive ELBW/EP survivors born in the state of Victoria in 1991 and 1992, and 166 randomly selected NBW controls assessed between 14 and 20 years of age. Visual acuity, stereopsis, convergence, color perception, and visual perception were assessed and contrasted between groups. RESULTS: ELBW/EP subjects had significantly worse visual acuity with habitual correction in both the left and right eyes, and for the best eye (P , .001). The ELBW/EP adolescents also exhibited poorer stereopsis, odds ratio (OR) 3.22 (95% confidence interval [CI] 1.78 to 5.84), and convergence, OR 2.76 (CI 1.32 to 5.75) than controls, and more problems with visual perception, OR 3.09 (CI 1.67 to 5.71) after habitual correction. CONCLUSIONS: Despite advances in medical care improving the sur- vival rate of high-risk ELBW/EP infants, visual morbidity is still relatively high compared with controls in late adolescence. Pediatrics 2013;132: e704–e712 AUTHORS: Carly S. Molloy, PhD, a,b Michelle Wilson-Ching, PhD, a,b Vicki A. Anderson, PhD, a,c Gehan Roberts, MD, b,d Peter J. Anderson, PhD, a,c and Lex W. Doyle, MD, a,b,c for the Victorian Infant Collaborative Study Group a Critical Care and Neurosciences, Murdoch Childrens Research Institute, Melbourne, Australia; b Neonatal Medicine, Royal Women’ s Hospital, Melbourne, Australia; c University of Melbourne; and d The Royal Children’ s Hospital, Melbourne, Australia KEY WORDS extremely low birth weight, extremely preterm, visual acuity, visual processing, visual perception ABBREVIATIONS CI—95% confidence interval ELBW—extremely low birth weight EP—extremely preterm NBW—normal birth weight OR—odds ratio ROP—retinopathy of prematurity TVPS-3—Test of Visual Perceptual Skills, 3rd Edition Dr Molloy conceptualized and designed the study, performed data acquisition, drafted the initial manuscript, performed data analysis and interpretation, and approved the final manuscript as submitted; Dr Wilson-Ching was involved in the conceptualization and design of the study, performed data acquisition and interpretation of data, reviewed and revised the manuscript, and approved the final manuscript as submitted; Dr V. Anderson was involved in the conceptualization and design of the study and interpretation of data, reviewed and revised the manuscript, provided supervision, and approved the final manuscript as submitted; Dr Roberts was involved in the interpretation of data, reviewed and revised the manuscript, provided administrative and technical support, and approved the final manuscript as submitted; and Drs P. Anderson and Doyle were involved in the conceptualization and design of the study and interpretation of data, provided supervision, reviewed and revised the manuscript, provided administrative and technical support, and approved the final manuscript as submitted. www.pediatrics.org/cgi/doi/10.1542/peds.2013-0040 doi:10.1542/peds.2013-0040 Accepted for publication May 31, 2013 Address correspondence to Carly Molloy, PhD, Critical Care and Neurosciences, Murdoch Childrens Research Institute, Flemington Road, Parkville, VIC 3052, Australia. E-mail: carly. molloy@mcri.edu.au (Continued on last page) e704 MOLLOY et al by guest on May 3, 2016 Downloaded from