THE REFRACTORY STATUS OF THE CHILDREN BORN PREMATURELY COMPARED WITH THE CHILDREN BORN AT TERM IN PRESCHOOL AGE

CILJEVI ISTRAŽIVANJA: Prikazati refrakcijski status prijevremeno rođene djece i djece rođene na termin u predškolskoj dobi. Utvrditi razlike i specifičnosti u refrakcijskom statusu prijevremeno rođene djece u odnosu na djecu rođenu na termin u predškolskoj dobi. MATERIJAL I METODE: Rad je retrospektivna studija tijekom koje su analizirani podatci o broju pregledane djece sa sumnjom na refrakcijske greške u razdoblju od 01.09.2016 do 30.06.2017. Podatci su prikupljeni u registru Klinike za očne bolesti KBC-a Split. Liječnici primarne zdravstvene zaštite u sklopu sistematskog pregleda pred upis u školu, uputili su 653 djece u dobi od šeste do sedme godine života na pregled oftalmologu. Prijevremeno rođene djece bez retinopatije prematuriteta (ROP – engl. Retinopathy of prematurity) bilo je 243, a na termin rođene djece 410. Prijevremeni porod definiran je kao porod između 33. i 35. tjedna gestacijske dobi. Napravljen je kompletan klinički oftalmološki pregled po standardnoj proceduri u cilju isključenja ili dijagnoze refrakcijskih grešaka. Temeljni kriterij određivanja refrakcijskog statusa djece bila je skijaksopija te su podatci dobiveni tom objektivnom metodom uzeti za statističku obradu podataka. REZULTATI: Unutar skupine prijevremeno rođene djece metodom skijaskopije određene su vrijednosti: 72 (29,5%) djece je imalo vrijednosti sferne dioptrije (Dsph) od -1,0 do 0,0 , 65 (26,5%) od 0,0 do +1,0 Dsph, 63 (26%) od +1,0 do +2,0 Dsph, 43 (18%) od +2,0 do +3,0 Dsph, 55 (22,5%) djece je imalo vrijednosti cilindrične dioptrije (Dcyl) od 0,50 do 1,0 , 85 (34%) od 1,0 do 2,0 Dcyl, 103 (42,5%) od 2,0 do 3,0 Dcyl. Unutar skupine djece rođene na termin metodom skijaskopije određene su vrijednosti: 27 (7%) djece je imalo vrijednosti od -1,0 do 0,0 Dsph, 127 (31%) od 0,0 do +1,0 Dsph, 199 (48%) od +1,0 do +2,0 Dsph, 57 (14%) od +2,0 do +3,0 Dsph, 212 (51,5%) djece je imalo vrijednosti od 0,50 do 1,0 Dcyl, 150 (36,5%) od 1,0 do 2,0 Dcyl, 48 (12%) od 2,0 do 3,0 Dcyl. ZAKLJUČCI: Unutar skupine prijevremeno rođene djece u predškolskoj dobi najčešće je dijagnosticirana miopija i astigmatizam od dvije do tri cilindrične dioptrije. Postoji statistički značajna razlika u refrakcijskom statusu prijevremeno rođene djece i djece rođene na termin u predškolskoj dobi. Miopija i astigmatizam od dvije do tri cilindrične dioptrije se češće javlja u prijevremeno rođene djece u odnosu na djecu rođenu na termin u predškolskoj dobi.OBJECTIVES: The objectives of this research are to demonstrate the refractory status of the children born prematurely compared with the children born at term in preschool age, determine the differences and specifics of the refractory status of the children born prematurely compared with the children born at term in preschool age. MATERIAL AND METHODS: The paper is a retrospective study during which the data on the number of examined children with suspected refractive between 1st September 2016 and 30th June 2017 were analyzed. The data were collected in the register of Department of Ophthalmology, University Hospital of Split. 653 children between the age of six and seven, within the systematic examination prior to enrolment in the school, were supposed to be seen by ophthalmologists through physician referral. It was found out from the medical records that prematurely born children without retinopathy of prematurity (ROP) were 243 whereas the children born at term with the same condition were 410. Premature birth is defined as birth between 33 and 35 weeks of gestational age. A complete clinical ophthalmic examination was performed according to the standard procedure in order to exclude or diagnose refractive errors. The basic criterion for determining the refractory status of children was retinoscopy, and the data obtained by this objective method were taken for statistical data processing. RESULTS: Whitin the group of children born prematurely, the method of retinoscopy was used to determine the following values: 72 (29.5%) children had values from -1.0 to 0.0 dioptres in the sphere (Dsph), 65 (26.5%) from 0.0 to +1.0 Dsph , 63 (26%) from +1.0 to +2.0 Dsph, 43 (18%) from +2.0 to +3.0 Dsph, 55 (22.5%) children had values from 0.50 up to 1.0 dioptres in cylinders (Dcyl), 85 (34%) from 1.0 to 2.0 Dcyl, 103 (42.5%) from 2.0 to 3.0 Dcyl. Within the group of children born at term. the method of retinoscopy was used to determine the following values: 27 (7%) children had values from -1.0 to 0.0 Dsph, 127 (31%) from 0.0 to +1.0 Dsph, 199 (48%) from +1 , 0 to +2.0 Dsph, 57 (14%) from +2.0 to +3.0 Dsph, 212 (51.5%) children had values from 0.50 up to 1.0 Dcyl, 150 (36 , 5%) from 1.0 to 2.0 Dcyl, 48 (12%) from 2.0 to 3.0 Dcyl. CONCLUSIONS: The children born prematurely were most commonly diagnosed with myopia in preschool age and astigmatism from two to three dioptres in cylinders. There is a statistically significant difference in the refractory status of the children born prematurely and children born at term in preschool age. Myopia and astigmatism from two to three dioptres in cylinders is more common to be found in premature born children compared to children born at term in preschool age