Prevalence of strabismus, nystagmus and risk factors in children and adolescents born preterm with and without retinopathy of prematurity: results from the Gutenberg Prematurity Study Young

Aims This study assessed the prevalence of strabismus, nystagmus and their risk factors in children born preterm, stratified by gestational age (GA), retinopathy of prematurity (ROP) and ROP treatment. Methods This is a retrospective cohort study with a prospective follow-up in a large cohort of children born preterm and full-term aged 4–17 years. Multivariable logistic regression analyses assessed associations of strabismus and nystagmus with perinatal parameters. Participants were divided into the following groups: controls born at term (GA ≥37 weeks, group 1), children born preterm without ROP and GA 33–36 weeks (group 2), GA 29–32 weeks (group 3), GA ≤28 weeks (group 4), GA ≤32 weeks with untreated ROP (group 5) and GA ≤32 weeks with treated ROP (group 6). Results 949 children (11.21±3.92 years, 495 females) were included. Strabismus was observed in 6% of children in group 1, 10% in group 2, 12% in group 3, 23% in group 4, 20% in group 5 and 68% in group 6. Nystagmus was observed in 0.8%, 0.4%, 1.8%, 2.6%, 5.0% and 47% in the respective groups. Strabismus was associated with earlier GA (OR=1.08; p=0.01), astigmatism (OR=2.48; p=0.02) and hypermetropia (OR=2.09; p=0.04). Esotropia was associated with weeks of prematurity (OR=1.11; p=0.02), anisometropia (OR=3.09; p=0.02) and hypermetropia (OR=4.17; p<0.001). Nystagmus was associated with ROP (OR=7.49; p=0.03), anisometropia (OR=5.17; p=0.04) and myopia (OR=11.09; p<0.001). Conclusions Strabismus in children is linked to preterm birth and refractive error, while nystagmus is more prevalent in children with ROP and children with refractive errors.