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  • 1.
    Austeng, Dordi
    et al.
    Uppsala University.
    Blennow, Mats
    Karolinska University Hospital .
    Ewald, Uwe
    Uppsala University.
    Fellman, Vineta
    Lund University.
    Fritz, Thomas
    Sahlgrens University Hospital.
    Hellstrom-Westas, Lena
    Uppsala University.
    Hellstrom, Ann
    University Gothenburg.
    Holmgren, Per Åke
    Umea University Hospital.
    Holmstrom, Gerd
    Uppsala University.
    Jakobsson, Peter
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Jeppsson, Annika
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Johansson, Kent
    Umeå University.
    Kallen, Karin
    Lund University.
    Lagercrantz, Hugo
    Astrid Lindgren Childrens Hospital.
    Laurini, Ricardo
    Bodo Central Hospital.
    Lindberg, Eva
    University of Örebro.
    Lundqvist, Anita
    Lund University.
    Marsal, Karel
    Lund University.
    Nilstun, Tore
    Lund University.
    Norden-Lindeberg, Solveig
    Uppsala University.
    Norman, Mikael
    Karolinska Institute.
    Olhager, Elisabeth
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Pediatrik. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Barn- och ungdomskliniken i Linköping.
    Oestlund, Ingrid
    University of Örebro.
    Serenius, Fredrik
    Umeå University Hospital.
    Simic, Marija
    Karolinska University Hospital .
    Sjors, Gunnar
    Uppsala University.
    Stigson, Lennart
    Sahlgrens University Hospital.
    Stjernqvist, Karin
    Lund University.
    Stromberg, Bo
    Uppsala University.
    Tornqvist, Kristina
    Lund University.
    Wennergren, Margareta
    Sahlgrens University Hospital.
    Wallin, Agneta
    Karolinska University.
    Westgren, Magnus
    Karolinska University Hospital.
    Incidence of and risk factors for neonatal morbidity after active perinatal care: extremely preterm infants study in Sweden (EXPRESS)2010Ingår i: ACTA PAEDIATRICA, ISSN 0803-5253, Vol. 99, nr 7, s. 978-992Artikel i tidskrift (Refereegranskat)
    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.

  • 2.
    Austeng, Dordi
    et al.
    Uppsala University Hospital.
    Kallen, Karin B M
    Lund University.
    Ewald, Uwe W
    Uppsala University Hospital.
    Jakobsson, Peter
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmiatrik. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Holmstrom, Gerd E
    Uppsala University Hospital.
    Incidence of Retinopathy of Prematurity in Infants Born Before 27 Weeks Gestation in Sweden2009Ingår i: ARCHIVES OF OPHTHALMOLOGY, ISSN 0003-9950, Vol. 127, nr 10, s. 1315-1319Artikel i tidskrift (Refereegranskat)
    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.

  • 3.
    Austeng, Dordi
    et al.
    Uppsala University.
    Kallen, Karin B M
    Lund University.
    Hellstrom, Ann
    University of Gothenburg.
    Jakobsson, Peter
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmiatrik. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Johansson, Kent
    Norrlands University Hospital.
    Tornqvist, Kristina
    Lund University Hospital.
    Wallin, Agneta
    St Eriks Eye Hospital.
    Holmstrom, Gerd E
    Uppsala University.
    Screening for Retinopathy of Prematurity in Infants Born Before 27 Weeks Gestation in Sweden2011Ingår i: ARCHIVES OF OPHTHALMOLOGY, ISSN 0003-9950, Vol. 129, nr 2, s. 167-172Artikel i tidskrift (Refereegranskat)
    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.

  • 4.
    Austeng, Dordi
    et al.
    Uppsala University, Sweden University of Trondheim Hospital, Norway .
    Kallen, Karin
    Lund University, Sweden .
    Hellstrom, Ann
    University of Gothenburg, Sweden .
    Jakobsson, Peter
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neurovetenskap. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Ögonkliniken US/LiM.
    Lundgren, Pia
    Umeå University, Sweden .
    Tornqvist, Kristina
    University of Lund Hospital, Sweden .
    Wallin, Agneta
    St Eriks Eye Hospital, Sweden .
    Holmstrom, Gerd
    Uppsala University, Sweden .
    Regional differences in screening for retinopathy of prematurity in infants born before 27 weeks of gestation in Sweden - the EXPRESS study2014Ingår i: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 92, nr 4, s. 311-315Artikel i tidskrift (Refereegranskat)
    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.

  • 5.
    Finnström, Orvar
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Pediatrik. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Barn- och ungdomskliniken i Linköping.
    Giordano, Luisa
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Pediatrik. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Barn- och ungdomskliniken i Linköping.
    Nelson, Nina
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Pediatrik. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Barn- och ungdomskliniken i Linköping.
    Jakobsson, Peter
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Oftalmologi. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US.
    Komplikationer i nyföddhetsperioden kan ge synhandikapp senare i livet.2004Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 101, nr 34, s. 2560-2562Artikel i tidskrift (Övrigt vetenskapligt)
  • 6.
    Hellgren, Kerstin M.
    et al.
    Astrid Lindgren Childrens Hospital, Sweden.
    Törnqvist, Kristina
    University of Lund Hospital, Sweden.
    Jakobsson, Peter
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Ögonkliniken US/LiM.
    Lundgren, Pia
    Umeå University, Sweden.
    Carlsson, Birgitta
    University of Örebro, Sweden.
    Kallen, Karin
    Lund University, Sweden.
    Serenius, Fredrik
    Uppsala University, Sweden.
    Hellstrom, Ann
    University of Gothenburg, Sweden.
    Holmstrom, Gerd
    University of Uppsala Hospital, Sweden.
    Ophthalmologic Outcome of Extremely Preterm Infants at 6.5 Years of Age Extremely Preterm Infants in Sweden Study (EXPRESS)2016Ingår i: JAMA ophthalmology, ISSN 2168-6165, E-ISSN 2168-6173, Vol. 134, nr 5, s. 555-562Artikel i tidskrift (Refereegranskat)
    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.

  • 7.
    Holmstrom, Gerd E.
    et al.
    University of Uppsala Hospital, Sweden .
    Kallen, Karin
    Lund University, Sweden .
    Hellstrom, Ann
    University of Gothenburg, Sweden .
    Jakobsson, Peter
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neurovetenskap. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Ögonkliniken US/LiM.
    Serenius, Fredrik
    Uppsala University, Sweden Umeå University, Sweden .
    Stjernqvist, Karin
    Lund University, Sweden .
    Tornqvist, Kristina
    University of Lund Hospital, Sweden .
    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 Study2014Ingår i: JAMA OPHTHALMOLOGY, ISSN 2168-6165, Vol. 132, nr 2, s. 182-189Artikel i tidskrift (Refereegranskat)
    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.

  • 8.
    Holmstrom, Gerd
    et al.
    University of Uppsala Hospital, Sweden.
    Hellstrom, Ann
    University of Gothenburg, Sweden.
    Jakobsson, Peter
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Ögonkliniken US/LiM.
    Lundgren, Pia
    Umeå University, Sweden.
    Tornqvist, Kristina
    University of Lund Hospital, Sweden.
    Wallin, Agneta
    St Eriks Eye Hospital, Sweden.
    Evaluation of new guidelines for ROP screening in Sweden using SWEDROP - a national quality register2015Ingår i: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 93, nr 3, s. 265-268Artikel i tidskrift (Refereegranskat)
    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.

  • 9.
    Holmström, Gerd E.
    et al.
    Uppsala University Hospital, Sweden.
    Hellström, Ann
    University of Gothenburg, Sweden .
    Jakobsson, Peter
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmiatrik. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Ögonkliniken US/LiM.
    Lundgren, Pia
    Umeå University, Sweden .
    Tornqvist, Kristina
    Lund University Hospital, Sweden .
    Wallin, Agneta
    St Eriks Eye Hospital, Stockholm, Sweden .
    Swedish National Register for Retinopathy of Prematurity (SWEDROP) and the Evaluation of Screening in Sweden2012Ingår i: Archives of ophthalmology (1960), ISSN 0003-9950, Vol. 130, nr 11, s. 1418-1424Artikel i tidskrift (Refereegranskat)
    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.

  • 10.
    Jakobsson, Peter
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmologi. Linköpings universitet, Hälsouniversitetet.
    Johansson, Björn
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    The effect of spatial frequency and contrast on the latency in the visual evoked potential1992Ingår i: Documenta Ophthalmologica, ISSN 0012-4486, Vol. 79, nr 2, s. 187-194Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The latency in the visual evoked potential was measured at spatial frequencies of 2–12 c/deg in 10 subjects. The contrast levels of the sinuosoidal grating patterns were set at 1.5, 1.75, 2.0, 2.25, 2.5, 2.75 and 3.0 log units above each subject's contrast sensitivity threshold. Two factors were shown to influence the latency: suprathreshold contrast and, to a lesser extent, spatial frequency. The visual evoked potential latencies at contrast sensitivity threshold were extrapolated. These threshold latencies showed considerable variation with spatial frequency and between subjects. Therefore, the visual evoked potential latency cannot be considered a useful tool for estimating the contrast sensitivity function.

  • 11.
    Jakobsson, Peter
    et al.
    Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Oftalmologi. Linköpings universitet, Hälsouniversitetet.
    Kvarnström, Gun
    Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Oftalmologi. Linköpings universitet, Hälsouniversitetet.
    Abrahamsson, Mariann
    Department of Ophthalmology, Vrinnevi Hospital, Norrköping, Sweden.
    Bjernbrink-Hörnblad, Eva
    Department of Ophthalmology, Kalmar Hospital, Kalmar, Sweden.
    Sunnqvist, Birgitta
    Department of Ophthalmology, Ryhov Hospital, Jönköping, Sweden.
    The frequency of amblyopia among visually impaired persons2002Ingår i: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 80, nr 1, s. 44-46Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: To investigate the frequency of amblyopia among visually handicapped patients.

    Methods: The study is a retrospective investigation of all living patients registered in four Visual Rehabilitation Centres in a region in southern Sweden. The area's total population numbered 865,612 persons of whom 11,365 were registered as visually handicapped (with visual acuity ≤ 0.3 in the better eye).

    Results: Amblyopia was the main cause of decreased visual acuity in one eye in 1.72% (195 of 11,365) of the patients. The average age of the patients with amblyopia was 69 years (9−95 years) and 28.2% of these patients were less than 65 years old (the age for retirement in Sweden).

    The median visual acuity in the amblyopic eye among these patients was 0.1. The median visual acuity in the nonamblyopic eye was 0.2. The most common cause of decreased vision in the nonamblyopic eye was macular degeneration (39.5%). Bilateral amblyopia was present in 13 (6.7%) of the amblyopic patients. By comparing this study with earlier studies, we can calculate that about 1.2% of the persons with amblyopia 0.3 or lower will eventually become visually handicapped.

    Conclusion: A small but considerable number of patients who attend the Visual Rehabilitation Centres have amblyopia as a cause of their visual impairment. Since amblyopia can be treated if detected in childhood, later visual rehabilitation of these patients can be avoided or delayed, thereby reducing rehabilition costs for society.

  • 12.
    Johansson, Björn
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Jakobsson, Peter
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Fourier analysis of steady-state visual evoked potentials in subjects with normal and defective stereo vision2000Ingår i: Documenta Ophthalmologica, ISSN 0012-4486, Vol. 101, nr 3, s. 233-246Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The purpose of this work was to study the second harmonic in the steady state pattern visual evoked potential (ssVEP) to various stimulus frequencies in subjects with normal and defective binocularity. ssVEPs were elicited by 4 c/deg sinusoidal gratings, with temporal frequencies ranging from 5 to 20 Hz (exp. 1) and 15 to 27.5 Hz (exp. 2). Responses were Fourier analysed and power and phase of the second harmonic to stimulus frequency were measured. For power, binocular enhancement in a bimodal fashion was found both in normals and in subjects with defective binocularity. The power with binocular stimulation was significantly higher in the normal group in the high frequency domain. Latency, estimated from the phase-frequency function, was longer in the group with defective binocularity, but this was statistically significant only for the high frequency domain. The results suggest that a visual system with normal binocular function can follow a stimulus with high temporal frequency more accurately than a system with disturbed binocularity.

  • 13.
    Johansson, Björn
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmologi. Linköpings universitet, Hälsouniversitetet.
    Jakobsson, Peter
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmologi. Linköpings universitet, Hälsouniversitetet.
    Fourier-analysed steadystate VEPs in pre-school children with and without normal binocularity2006Ingår i: Documenta Ophthalmologica, ISSN 0012-4486, Vol. 112, nr 1, s. 13-22Artikel i tidskrift (Refereegranskat)
    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.

  • 14.
    Johansson, Björn
    et al.
    Linköpings universitet, Institutionen för nervsystem och rörelseorgan. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Jakobsson, Peter
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Luminance and color contrast sensitivity and VEP latency in subjects with normal and defective binocularity1997Ingår i: European Journal of Ophthalmology, ISSN 1724-6016, Vol. 7, s. 82-90Artikel i tidskrift (Refereegranskat)
  • 15.
    Johansson, Björn
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmiatrik. Linköpings universitet, Hälsouniversitetet.
    Jakobsson, Peter
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmiatrik. Linköpings universitet, Hälsouniversitetet.
    VEP latency: a comparison between normal and defective binocularity.1993Ingår i: Clinical Vision Sciences, ISSN 0887-6169, Vol. 8, s. 245-251Artikel i tidskrift (Refereegranskat)
  • 16.
    Kvarnström, Gun
    et al.
    Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Oftalmologi. Linköpings universitet, Hälsouniversitetet.
    Jakobson, Peter
    Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Oftalmologi. Linköpings universitet, Hälsouniversitetet.
    Lennerstrand, Gunnar
    Department of Ophthalmology, Karolinska Institute, Stockholm, Sweden.
    Visual screening of Swedish children: an ophthalmological evaluation2001Ingår i: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 79, nr 3, s. 240-244Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose:This study describes the various ophthalmological conditions detected in the Swedish visual screening program for children.

    Methods: The study was longitudinal and retrospective. All children (3126) born in 1982 in three Swedish municipalities have been followed from birth to ten years of age. Visual acuity was examined at the ages of 4, 5.5, 7 and 10 years. Before the age of 4, a gross examination of the eyes was performed.

    Results: The prevalence of ametropia in the population was 7.7%, the prevalence of strabismus 3.1%, and the prevalence of organic lesions 0.6%. Seven children (0.2%) were visually handicapped (visual acuity ≤0.3 in the better eye). Refractive errors and microtropias were mainly detected at the age of 4, when the first visual acuity test was performed, while manifest strabismus was in many cases detected before this age. With this screening and subsequent diagnosis and treatment, the prevalence of deep amblyopia (visual acuity ≤0.3) has been reduced from 2% to 0.2%. With treatment, 47% of the amblyopic children achieved a visual acuity better than 0.7.

    Conclusion: Visual screening is effective in detecting visual and ocular disorders. Most conditions are discovered before the age of 6. Compared to an unscreened population, the prevalence of amblyopia is greatly reduced.

  • 17.
    Kvarnström, Gun
    et al.
    Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Oftalmologi. Linköpings universitet, Hälsouniversitetet.
    Jakobsson, Peter
    Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Oftalmologi. Linköpings universitet, Hälsouniversitetet.
    Is vision screening in 3-year-old children feasible?: comparison between the Lea Symbol chart and the HVOT (LM) chart2005Ingår i: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 83, nr 1, s. 76-80Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: The aim of this prospective study was to compare visual screening at the age of 3 years with screening at 4 years using two different charts.

    Methods: A total of 478 3-year-old children were tested at four child health care centres (CHCCs). Of these children, 440 were tested again at the age of 4 years. A third group, a control group, consisting of 229 children, was examined only at the age of 4 years. All children were tested with both the HVOT chart and the Lea Symbol chart.

    Results: Testability rates for 3-year-olds were almost the same with the Lea Symbol chart and the HVOT chart (82.8% and 84.8%, respectively). The corresponding rates for the same children tested at 4 years of age were 96.5% and 97.0%, and for the 4-year-olds not previously tested 92.9% and 92.8%. The mean testing time was somewhat shorter for the Lea Symbol chart in all three groups, but the difference was not statistically significant. The difference in the assessment of visual acuity between the two charts was small and less than 1/10th of a line. The positive predictive value was lower at 3 years (58%) than has previously been found at 4 years (74.6%).

    Conclusion: Three-year-old children co-operate well in visual acuity testing. However, the examination time is a little longer and the testability rate is about 10% lower than at 4 years. Both 3-year-old and 4-year-old children can be tested equally well with the HVOT and the Lea Symbol charts.

  • 18.
    Kvarnström, Gun
    et al.
    Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Oftalmologi. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US. Linköpings universitet, Hälsouniversitetet.
    Jakobsson, Peter
    Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Oftalmologi. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US. Linköpings universitet, Hälsouniversitetet.
    Lennerstrand, Gunnar
    Dahlgaard, Jens Jörn
    Preventable vision loss in children: a public health concern?2006Ingår i: American Orthoptic Journal, ISSN 0065-955X, Vol. 56, nr 1, s. 3-6Artikel i tidskrift (Refereegranskat)
    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.

  • 19.
    Lennerstrand, Gunnar
    et al.
    Karolinska Institute, Huddinge University Hospital, Stockholm, Sweden.
    Kvarström, Gun
    Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Oftalmologi. Linköpings universitet, Hälsouniversitetet.
    Jakobsson, Peter
    Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Oftalmologi. Linköpings universitet, Hälsouniversitetet.
    Screening for visual and ocular disorders in children, evaluation of the system in Sweden1998Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 87, nr 11, s. 1173-1179Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study was to evaluate the visual screening system in Sweden. We have made a retrospective investigation of the results of screening for ocular disease and visual impairment of all children born in 1982 in three Swedish communities. The records from screening examinations from 0 to 10 y and from diagnostic follow-up at the departments of ophthalmology that the children were referred to were inspected. The data were used to evaluate the efficiency of the Swedish visual screening system. The study included 3126 children. The attendance rate at the 4-y examination was better than 99%. The sensitivity of the 4- and 5.5-y screening examinations was on the average 92% and the specificity was 97%. The average number of false negative cases at 4 y was 5.6 in 1000 (0.56%). With this screening and subsequent diagnosis and treatment, the prevalence of amblyopia at different levels of visual acuity at the age of 10 y was: 0.06% with visual acuity <0.1,0.9% with visual acuity <0.5 and 1.7% with visual acuity < 0.7. In spite of largely unchanged pressure of amblyogenic factors in the population, the prevalence of deep and moderate amblyopia has been markedly reduced by screening and early treatment.

  • 20. Magnusson, Gunilla
    et al.
    Jakobsson, Peter
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Oftalmologi. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Kugelberg, U
    Lundvall, A
    Maly, E
    Tornqvist, K
    Abrahamsson, M
    Andreasson, B
    Borres, Magnus
    Broberger, U
    Hellström-Westas, L
    Kornfält, R
    Nelson, Nina
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Pediatrik. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Barn.
    Sjöstrand, J
    Thiringer, Klara
    Evaluation of screening procedures for congenital cataracts2003Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 92, nr 12, s. 1468-1473Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: To evaluate the efficacy of two different Swedish screening procedures for early detection of congenital cataracts in comparison with no screening. Methods: Children born between January 1992 and December 1998 in Swedish regions with an established eye-screening routine procedure, diagnosed with congenital cataract, and operated on before 1 y of age, were included in a retrospective study. Age at referral and age at time of the operation were compared between regions using different screening procedures: screening in the maternity wards (Region 1), at the well-baby clinics (Region 2) and one region without any screening (Region 3). Results: Seventy-two children were included in the study. Concerning early diagnosis and surgery, Region 1 differed significantly from Regions 2 and 3, which were more similar and were combined for further analysis. The difference in detected cases was greatest at 21 d of age (55% vs 18%, p < 0.001), but persisted even at 100 d of age (78% vs 64%, p < 0.02). Region 1 screening resulted in more and earlier cases detected than the other two regions (22 vs 15 per 100 000 births). In 72% of all cases, surgery was performed in response to referrals from either the maternity wards (36%), or the well-baby clinics (36%). However, half of the cases from the well-baby clinics were detected too late, i.e. at >100 d. Conclusion: Eye screening in the maternity ward is preferable to well-baby clinic screening and to no screening at all, since it leads to early detection. Screening should also be performed routinely at well-baby clinics within the period when successful treatment is possible.

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