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Jakobsson, Peter
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Hellgren, K. M., Törnqvist, K., Jakobsson, P., Lundgren, P., Carlsson, B., Kallen, K., . . . Holmstrom, G. (2016). Ophthalmologic Outcome of Extremely Preterm Infants at 6.5 Years of Age Extremely Preterm Infants in Sweden Study (EXPRESS). JAMA ophthalmology, 134(5), 555-562
Open this publication in new window or tab >>Ophthalmologic Outcome of Extremely Preterm Infants at 6.5 Years of Age Extremely Preterm Infants in Sweden Study (EXPRESS)
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2016 (English)In: JAMA ophthalmology, ISSN 2168-6165, E-ISSN 2168-6173, Vol. 134, no 5, p. 555-562Article in journal (Refereed) Published
Abstract [en]

IMPORTANCE This follow-up study of extremely preterm (EPT) children (<27 weeks gestational age [GA] at birth) revealed major eye and visual problems in 37.9%(147 of 388) of all EPT infants and in 55.4%(67 of 121) of the most immature subgroups at 6.5 years of age. These major eye and visual problems were strongly associated with treatment-requiring retinopathy of prematurity (ROP). OBJECTIVES To investigate the ophthalmologic outcome of a national cohort of EPT children at 6.5 years of age and to evaluate the impact of prematurity and ROP. DESIGN, SETTING, AND PARTICIPANTS All surviving EPT children born in Sweden between April 1, 2004, and March 31, 2007, were included and compared with a matched term control group, as part of a prospective national follow-up study. MAIN OUTCOMES AND MEASURES Visual acuity, refraction in cycloplegia, and manifest strabismus were evaluated and compared with GA at birth and with treatment-requiring ROP. RESULTS The study cohort comprised 486 participants. The mean (SD) GA of the children who were included was 25 (1) weeks, and 45.7%(222 of 486) were female. At a median age of 6.6 years, 89.3%(434 of 486) of eligible EPT children were assessed and compared with 300 control group children. In the EPT group, 2.1%(9 of 434) were blind, 4.8%(21 of 434) were visually impaired according to the World Health Organization criteria, and 8.8% (38 of 434) were visually impaired according to the study criteria. Strabismus was found in 17.4% (68 of 390) and refractive errors in 29.7%(115 of 387) of the EPT children compared with 0% (0 of 299) and 5.9% (17 of 289), respectively, of the control children (P<.001). Altogether at 6.5 years of age, 37.9%(147 of 388) of the EPT children had some ophthalmologic abnormality compared with 6.2%(18 of 290) of the matched control group (95% CI of the difference, 26.1%-37.2%). When treatment-requiring ROP was adjusted for, no significant association between GA and visual impairment could be detected. For refractive errors, the association with GA remained after adjustment for treatment-requiring ROP (odds ratio, 0.72; 95% CI, 0.58-0.91 for each 1-week increment). CONCLUSIONS AND RELEVANCE In a Swedish national cohort of EPT children at 6.5 years of age, major eye and visual problems were frequently found. Treatment-requiring ROP was a stronger impact factor than GA on visual impairment and strabismus, but not on refractive errors, as a whole. In modern neonatal intensive care settings, ophthalmologic problems continue to account for a high proportion of long-term sequelae of prematurity.

Place, publisher, year, edition, pages
AMER MEDICAL ASSOC, 2016
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-128947 (URN)10.1001/jamaophthalmol.2016.0391 (DOI)000375796100020 ()27010699 (PubMedID)
Note

Funding Agencies|Swedish Research Council [2006-3858, 2009-4250]; Jerring Foundation; Stockholm County Council; Karolinska Institutet; Sigvard & Marianne Bernadotte Research Foundation for Children Eye Care; Bernadotte Foundation for Childrens Eyecare, Inc; Kronprinsessan Margaretas Arbetsnamnd for Synskadade; Ogonfonden; Swedish Society of Medicine; Nordstromer Foundation; Foundation for Visually Impaired in Former Malmohus Ian; Stig and Ragna Gorthon Foundation

Available from: 2016-06-09 Created: 2016-06-07 Last updated: 2017-11-30
Holmstrom, G., Hellstrom, A., Jakobsson, P., Lundgren, P., Tornqvist, K. & Wallin, A. (2015). Evaluation of new guidelines for ROP screening in Sweden using SWEDROP - a national quality register. Acta Ophthalmologica, 93(3), 265-268
Open this publication in new window or tab >>Evaluation of new guidelines for ROP screening in Sweden using SWEDROP - a national quality register
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2015 (English)In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 93, no 3, p. 265-268Article in journal (Refereed) Published
Abstract [en]

PurposeTo investigate whether recent Swedish guidelines for Retinopathy of Prematurity (ROP) screening, that is, a gestational age (GA) at birth of less than31weeks (w), are applicable in a new national cohort of prematurely born infants. MethodsSWEDROP is a national register for ROP, initiated in 2006. The present paper reports on data from the register on various aspects of screening for ROP in infants born between 2010 and 2011 and compares the results with those for a previously published cohort born between 2008 and 2009. ResultsDuring the study period, 1744 infants were screened for ROP. Mean GA was 28.4w (22-31), and mean birth weight was 1239g (382-2615). Screening started at postnatal age (PNA) 5.4w (0.4-13.3) and postmenstrual age (PMA) 33.8 w (24.9-50.1) Mean number of examinations was 5.4 per infant (1-38). Mild (stages 1-2) and severe ( stage 3) ROP was found in 15.4% and 8.7%, respectively. Treatment was performed in 4.2% (73/1744) of the infants, but in none with a GA of 30weeks or more. The first treatment was performed at a mean PNA and PMA of 12.7 w (7.7-25.4) and 37.4 w (32.1-51.4), respectively. ConclusionsRecently introduced new guidelines for ROP screening in Sweden remain applicable. Reassuringly, in infants born between 2010 and 2011, incidence of ROP, frequency and timing of treatment, frequency and timing of examinations and national coverage of ROP screening remained almost identical to those for a previous cohort from 2008 to 2009. The two SWEDROP cohorts provide a basis for discussion among Swedish ophthalmologists and neonatologists on the question of further lowering the upper screening limit with 1week.

Place, publisher, year, edition, pages
Wiley, 2015
Keywords
guidelines; national register; retinopathy of prematurity; screening
National Category
Ophthalmology
Identifiers
urn:nbn:se:liu:diva-117780 (URN)10.1111/aos.12506 (DOI)000353053000027 ()25044161 (PubMedID)
Note

Funding Agencies|Nordstromer Foundation, the Foundation for the Visually Impaired in former Malmohus County; Region Skane

Available from: 2015-05-11 Created: 2015-05-08 Last updated: 2017-12-04
Holmstrom, G. E., Kallen, K., Hellstrom, A., Jakobsson, P., Serenius, F., Stjernqvist, K. & Tornqvist, K. (2014). Ophthalmologic Outcome at 30 Months Corrected Age of a Prospective Swedish Cohort of Children Born Before 27 Weeks of Gestation The Extremely Preterm Infants in Sweden Study. JAMA OPHTHALMOLOGY, 132(2), 182-189
Open this publication in new window or tab >>Ophthalmologic Outcome at 30 Months Corrected Age of a Prospective Swedish Cohort of Children Born Before 27 Weeks of Gestation The Extremely Preterm Infants in Sweden Study
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2014 (English)In: JAMA OPHTHALMOLOGY, ISSN 2168-6165, Vol. 132, no 2, p. 182-189Article in journal (Refereed) Published
Abstract [en]

IMPORTANCE Follow-up at 30 months corrected age reveals eye and visual problems in one-third of children born extremely prematurely (less than27 weeks gestation). OBJECTIVE To investigate the ophthalmologic outcome of extremely preterm children at 30 months corrected age. DESIGN, SETTING, AND PARTICIPANTS A prospective, population-based follow-up study (Extremely Preterm Infants in Sweden Study [EXPRESS]) was conducted in Sweden. The population included extremely preterm infants (less than27 weeks gestation) born in Sweden between 2004 and 2007, of whom 491 survived until age 2.5 years. Screening for retinopathy of prematurity (ROP) was performed in the neonatal period. At 30 months corrected age, an ophthalmologic assessment was performed in 411 of 491 children (83.7%). MAIN OUTCOMES AND MEASURES Visual acuity, manifest strabismus, and refractive errors were evaluated. RESULTS Visual impairment was identified in 3.1% of the children, and 1.0% were blind. Refractive errors, defined as myopia less than -3 diopters (D), hypermetropia greater than +3 D, astigmatism 2 D or more, and/or anisometropia 2 D or more, were found in 25.6% of the children, and 14.1% had manifest strabismus. There were significant associations between visual impairment and treated ROP (P = .02), cognitive disability (P less than .001), and birth weight (P = .02). Multiple regression analyses revealed significant associations between strabismus and treated ROP (P less than .001), cognitive disability (P less than .01), and cerebral palsy (P = .02). Refractive errors were significantly correlated with severity of ROP (right eye, P less than .001; left eye, P less than .01). Children who had been treated for ROP had the highest frequency (69.0%) of eye and visual abnormalities. CONCLUSIONS AND RELEVANCE One-third of the extremely prematurely born children in this study had some kind of eye or visual problems, such as visual impairment, strabismus, or major refractive error. Despite being born extremely preterm, the present cohort has a similar prevalence of blindness and visual impairment as in previous Swedish cohorts of children born less prematurely.

Place, publisher, year, edition, pages
American Medical Association (AMA), 2014
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-105413 (URN)10.1001/jamaophthalmol.2013.5812 (DOI)000331367600010 ()
Available from: 2014-03-21 Created: 2014-03-21 Last updated: 2014-03-21
Austeng, D., Kallen, K., Hellstrom, A., Jakobsson, P., Lundgren, P., Tornqvist, K., . . . Holmstrom, G. (2014). Regional differences in screening for retinopathy of prematurity in infants born before 27 weeks of gestation in Sweden - the EXPRESS study. Acta Ophthalmologica, 92(4), 311-315
Open this publication in new window or tab >>Regional differences in screening for retinopathy of prematurity in infants born before 27 weeks of gestation in Sweden - the EXPRESS study
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2014 (English)In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 92, no 4, p. 311-315Article in journal (Refereed) Published
Abstract [en]

Purpose: The primary aim was to analyse regional incidences of retinopathy of prematurity (ROP) and frequencies of treatment and their relation to perinatal risk factors during a 3-year period. A secondary aim was to study adherence to the study screening protocol in the different regions. Methods: A population-based study of neonatal morbidity in extremely preterm infants in Sweden (EXPRESS) was performed during 2004-2007. Screening for ROP was to start at postnatal age 5weeks and to continue weekly until the retina was completely vascularized or until regression of ROP. Logistic regression analyses were used for evaluation of differences in incidence of Any ROP, ROP 3 or more and ROP Type 1 between the seven regions of the country. Results: The regional incidence of ROP varied between 54% and 92% for Any ROP, between 25% and 43% for ROP stage 3 or more and between 8% and 23% of infants with ROP Type 1, all of whom were treated. There was no significant difference between the regions regarding ROP Type 1, even when adjusting for known risk factors for ROP. Conclusion: The heterogeneity between the regions regarding the incidence of ROP was reduced with increasing severity of ROP, and there was no heterogeneity regarding frequency of treatment for ROP, which is the most important issue for the children. We cannot exclude observer bias regarding mild ROP and ROP stage 3 in this study.

Place, publisher, year, edition, pages
Wiley, 2014
Keywords
retinopathy of prematurity; population-based; extremely preterm; screening, observer bias
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-107823 (URN)10.1111/aos.12165 (DOI)000336443600012 ()
Available from: 2014-06-23 Created: 2014-06-23 Last updated: 2017-12-05
Holmström, G. E., Hellström, A., Jakobsson, P., Lundgren, P., Tornqvist, K. & Wallin, A. (2012). Swedish National Register for Retinopathy of Prematurity (SWEDROP) and the Evaluation of Screening in Sweden. Archives of ophthalmology (1960), 130(11), 1418-1424
Open this publication in new window or tab >>Swedish National Register for Retinopathy of Prematurity (SWEDROP) and the Evaluation of Screening in Sweden
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2012 (English)In: Archives of ophthalmology (1960), ISSN 0003-9950, Vol. 130, no 11, p. 1418-1424Article in journal (Refereed) Published
Abstract [en]

Objectives: To evaluate screening for retinopathy of prematurity (ROP) in Sweden and to investigate possible modifications of the present screening guidelines. less thanbrgreater than less thanbrgreater thanMethods: Infants in Sweden with a gestational age (GA) of 31 weeks + 6 days or less are screened for ROP. Data from the Swedish national register for ROP (SWEDROP) during 2008 and 2009 were extracted and compared with a national perinatal quality register. less thanbrgreater than less thanbrgreater thanResults: In SWEDROP, there were 1791 infants born before a GA of 32weeks from January 1, 2008, through December 31, 2009. Another 70 infants were registered in the perinatal quality register but not in SWEDROP (drop-out rate, 3.8% [70 of 1861 infants]). Seven infants died before termination of screening. In the final study cohort (1784 infants), 15.6% had mild ROP and 8.5% had severe ROP. Treatment was performed in 4.4% of the infants, none of whom had a GA at birth of more than 28 weeks. Nine infants with a GA of more than 28 weeks at birth developed stage 3 ROP, which regressed spontaneously. The total number of examinations was 9286 (964 in infants with a GA of 31 weeks), and the mean (range) number of examinations of each infant was 5.2 (1-30). less thanbrgreater than less thanbrgreater thanConclusions: The SWEDROP, a quality register for ROP, has a national coverage (ie, participation) of 96%. Data from 2008 to 2009 show that it seems possible to reduce the upper limit for screening in Sweden by 1 week, including only infants with a GA of 30 weeks + 6 days or less. However, such a change should be combined with a strong recommendation to neonatologists to refer also severely ill and more "mature" infants.

Place, publisher, year, edition, pages
Ama American Medical Association, 2012
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-86655 (URN)10.1001/archophthalmol.2012.2357 (DOI)000310986700007 ()
Note

Funding Agencies|Swedish Association of Visually Impaired||Swedish Association of Visually Impaired in former M-Ian||Region Skane||Nordstromer Foundation||

Available from: 2012-12-20 Created: 2012-12-20 Last updated: 2017-12-06
Austeng, D., Kallen, K. B., Hellstrom, A., Jakobsson, P., Johansson, K., Tornqvist, K., . . . Holmstrom, G. E. (2011). Screening for Retinopathy of Prematurity in Infants Born Before 27 Weeks Gestation in Sweden. ARCHIVES OF OPHTHALMOLOGY, 129(2), 167-172
Open this publication in new window or tab >>Screening for Retinopathy of Prematurity in Infants Born Before 27 Weeks Gestation in Sweden
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2011 (English)In: ARCHIVES OF OPHTHALMOLOGY, ISSN 0003-9950, Vol. 129, no 2, p. 167-172Article in journal (Refereed) Published
Abstract [en]

Objective: To analyze screening for retinopathy of prematurity (ROP) during a 3-year period in a national cohort of infants born before 27 weeks gestation. Methods: A national prospective study of neonatal morbidity in extremely preterm infants was performed in Sweden between April 1, 2004, and March 31, 2007. Screening for ROP was to start in the fifth postnatal week and to continue weekly until complete vascularization of the retina or until regression of ROP. Results: The first eye examination was performed no later than the sixth postnatal week in 84.8% of 506 infants, and the last examination was performed at postmenstrual age (PMA) of 38 weeks or later in 96.2% of infants. The mean and median numbers of days between examinations in the total cohort were 8.6 and 7.9 days, respectively (range, 1-27.8 days), and the mean and me-dian numbers of examinations were 12 and 10, respectively. Most infants were treated during a limited period (eg, at PMA of 39 weeks, 75.0% of infants had been treated). Conclusions: The objective of screening for ROP is timely detection of ROP before reaching treatment of criteria, ie, type 1 ROP, according to the Early Treatment for ROP recommendations. In our population of infants born before 27 weeks gestation, the first examination could safely be postponed until PMA of 31 weeks because the onset of ROP stage 3 did not occur before then and criteria for treatment were not reached before PMA of 32 weeks. Gestational age at birth and PMA at the time of examination should be considered when deciding when and where the next examination should be performed.

Place, publisher, year, edition, pages
Ama American Medical Association, 2011
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-66150 (URN)10.1001/archophthalmol.2010.346 (DOI)000287329500008 ()
Available from: 2011-03-04 Created: 2011-03-04 Last updated: 2014-10-23
Austeng, D., Blennow, M., Ewald, U., Fellman, V., Fritz, T., Hellstrom-Westas, L., . . . Westgren, M. (2010). Incidence of and risk factors for neonatal morbidity after active perinatal care: extremely preterm infants study in Sweden (EXPRESS). ACTA PAEDIATRICA, 99(7), 978-992
Open this publication in new window or tab >>Incidence of and risk factors for neonatal morbidity after active perinatal care: extremely preterm infants study in Sweden (EXPRESS)
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2010 (English)In: ACTA PAEDIATRICA, ISSN 0803-5253, Vol. 99, no 7, p. 978-992Article in journal (Refereed) Published
Abstract [en]

Aims: The aim of this study was to determine the incidence of neonatal morbidity in extremely preterm infants and to identify associated risk factors. Methods: Population based study of infants born before 27 gestational weeks and admitted for neonatal intensive care in Sweden during 2004-2007. Results: Of 638 admitted infants, 141 died. Among these, life support was withdrawn in 55 infants because of anticipation of poor long-term outcome. Of 497 surviving infants, 10% developed severe intraventricular haemorrhage (IVH), 5.7% cystic periventricular leucomalacia (cPVL), 41% septicaemia and 5.8% necrotizing enterocolitis (NEC); 61% had patent ductus arteriosus (PDA) and 34% developed retinopathy of prematurity (ROP) stage andgt;= 3. Eighty-five per cent needed mechanical ventilation and 25% developed severe bronchopulmonary dysplasia (BPD). Forty-seven per cent survived to one year of age without any severe IVH, cPVL, severe ROP, severe BPD or NEC. Tocolysis increased and prolonged mechanical ventilation decreased the chances of survival without these morbidities. Maternal smoking and higher gestational duration were associated with lower risk of severe ROP, whereas PDA and poor growth increased this risk. Conclusion: Half of the infants surviving extremely preterm birth suffered from severe neonatal morbidities. Studies on how to reduce these morbidities and on the long-term health of survivors are warranted.

Place, publisher, year, edition, pages
Blackwell Publishing Ltd, 2010
Keywords
Bronchopulmonary dysplasia, Intraventricular haemorrhage, Necrotizing enterocolitis, Patent ductus arteriosus, Retinopathy of prematurity
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-57421 (URN)10.1111/j.1651-2227.2010.01846.x (DOI)000278294800008 ()
Available from: 2010-06-18 Created: 2010-06-18 Last updated: 2010-06-18
Austeng, D., Kallen, K. B., Ewald, U. W., Jakobsson, P. & Holmstrom, G. E. (2009). Incidence of Retinopathy of Prematurity in Infants Born Before 27 Weeks Gestation in Sweden. ARCHIVES OF OPHTHALMOLOGY, 127(10), 1315-1319
Open this publication in new window or tab >>Incidence of Retinopathy of Prematurity in Infants Born Before 27 Weeks Gestation in Sweden
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2009 (English)In: ARCHIVES OF OPHTHALMOLOGY, ISSN 0003-9950, Vol. 127, no 10, p. 1315-1319Article in journal (Refereed) Published
Abstract [en]

Objective: To determine the incidence of retinopathy of prematurity (ROP) in extremely preterm infants born before 27 weeks gestation in Sweden during a 3-year period. Methods: A national, prospective, population-based study was performed in Sweden from April 1, 2004, to March 31, 2007. The ophthalmologic part of the study was separately organized, and screening for ROP was performed beginning postnatal week 5. The criteria for the treatment of ROP agreed with the recommendations of the Early Treatment for Retinopathy of Prematurity Cooperative Group. Results: During the study, 506 of 707 live-born infants survived until the first eye examination. Of these, 368 (72.7%) had ROP: 37.9% had mild ROP and 34.8% had severe ROP. Ninety-nine infants (19.6%) were treated. Gestational age at birth was a stronger predictor of ROP than was birth weight. A log-linear relationship between severe ROP and gestational age at birth was found in the present cohort, and the risk of ROP was reduced by 50% for each week of increase in gestational age at birth. Conclusions: Today, extremely preterm infants are surviving, and this population-based study with ROP as a primary outcome shows a higher incidence of this condition than in previously reported national cohorts.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-51400 (URN)10.1001/archophthalmol.2009.244 (DOI)
Available from: 2009-10-30 Created: 2009-10-30 Last updated: 2014-09-09
Johansson, B. & Jakobsson, P. (2006). Fourier-analysed steadystate VEPs in pre-school children with and without normal binocularity. Documenta Ophthalmologica, 112(1), 13-22
Open this publication in new window or tab >>Fourier-analysed steadystate VEPs in pre-school children with and without normal binocularity
2006 (English)In: Documenta Ophthalmologica, ISSN 0012-4486, Vol. 112, no 1, p. 13-22Article in journal (Refereed) Published
Abstract [en]

Pre-school children aged 4–5 were examined with steady-state VEP in response to a sinusoidal grating pattern with a spatial frequency of 4 c/deg, reversing at rates 5, 10, and 15 Hz. Normal children (n = 10) were compared with subjects lacking stereo perception (n = 6) and with subjects showing significant unilateral amblyopia with visual acuity in the worse eye <0.5 (n = 7). Fast Fourier Transform was used for analysis of the crude steady-state VEP responses. Compared to normals, the subjects lacking stereo perception showed a significantly lower power of the second harmonic in the response evoked by binocular stimulation with gratings reversed at 15 Hz. The amblyopic group showed a significant difference between the dominant and the non-dominant eye regarding the first harmonic power in the responses evoked by gratings reversed at 5 and 10 Hz. These findings are discussed in relation to the magnocellular and parvocellular visual pathways and suggested models for linear and non-linear processing of visual signals.

Keywords
amblyopia, binocularity, Fourier analysis, strabismus, visual evoked potential
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-14098 (URN)10.1007/s10633-005-5889-4 (DOI)
Available from: 2006-10-23 Created: 2006-10-23
Kvarnström, G., Jakobsson, P., Lennerstrand, G. & Dahlgaard, J. J. (2006). Preventable vision loss in children: a public health concern?. American Orthoptic Journal, 56(1), 3-6
Open this publication in new window or tab >>Preventable vision loss in children: a public health concern?
2006 (English)In: American Orthoptic Journal, ISSN 0065-955X, Vol. 56, no 1, p. 3-6Article in journal (Refereed) Published
Abstract [en]

Background and Purpose: Does screening/treatment reduce amblyopia and is it worth doing it?

Materials: All children (3126) born in 1982 have been followed from birth to ten years. The second study was an investigation of four Low Vision Centers to see how many persons become visual handicapped due to amblyopia.

Methods: Up to the age of 4, inspection of the eyes and ocular alignment is performed at the Child Health Care Centers. At the age of 4 years, visual acuity is measured at the centers and at school at the ages of 7 and 10 years. All patients at four Low Vision Centers have been investigated with regard to amblyopia. These patients have not been screened or treated for amblyopia. From these two studies, we compare the costs of screening and no screening.

Results: The prevalence of ametropia in the population was 7.7%, and strabismus 3.1%. The prevalence of deep amblyopia (visual acuity ≤ 0.3) has been reduced from 2% to 0.2%. Results from the four Swedish Low Vision Centers showed that amblyopia was the main cause of decreased visual acuity in one eye in at least 1.72% of the patients. The cost for these people is higher then the cost for screening and treatment.

Conclusion: Visual screening is effective in detecting visual and ocular disorders. The prevalence of amblyopia is greatly reduced with screening. The benefits greatly outweighs the economical disadvantages of screening and treating amblyopic children.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-35994 (URN)10.3368/aoj.56.1.3 (DOI)29268 (Local ID)29268 (Archive number)29268 (OAI)
Note

Presented as part of a Symposium at the Joint Meeting of the American Orthoptic Council, the American Association of Certified Orthoptists, and the American Academy of Ophthalmology, Chicago, Illinois, October 16, 2005.

Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2012-10-30
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