Cicatricial Retinopathy Of Prematurity Research Articles

Microstructural changes in the retina in children with retinopathy of prematurity according to optical coherence tomography. Literature review

Retinopathy of prematurity (ROP) is a crucial problem in modern ophthalmology. ROP is a vasoproliferative disease of the eyes in premature infants. Approximately 50,000 children worldwide have become blind because of ROP. The determining indicator in the development of visual acuity is the morphofunctional state of the macula, structural changes of which can lead to disturbances in its functions and, consequently, decreased vision. The present review analyzed available OCT (optical coherence tomography) data on the morphometric and structural state of the retina in children with ROP. Morphometric features of the macular zone in children in the scar period of ROP can be presented by an increase in retinal thickness in the center of the fovea and changes in the profile of the macula by smoothness or absence of foveal depression. These are more pronounced in children after laser coagulation of the retina in the active phase of ROP and in very premature babies. In some cases with increased retinal thickness in the center of the fovea, the presence of internal layers and an increase in the thickness of the outer nuclear layer are noted. Structural features of the macula with favorable outcomes of RP can be expressed by traction displacement of the foveola, photoreceptor layer thinning and pigment epithelium unevenness, intra and epiretinal fibrosis, choriocapillaris layer atrophy, discontinuity of the connection of the outer and internal segments of the photoreceptors and the pigment epithelium–choriocapillaris complex, and central retinoschisis. Furthermore, this review presents mixed results from studies on the impact of structural changes in the macula in cicatricial ROP on visual function.

Хирургическое лечение регматогенной отслойки сетчатки с массивной пролиферативной витреоретинопатией на фоне рубцовой стадии ретинопатии недоношенных. Клинический случай

Purpose. Demonstration of clinical case of surgical treatment of rhegmatogenous retinal detachment (RD) with massive proliferative vitreoretinopathy (PVR) against the background of cicatricial stage of retinopathy of prematurity (ROP). Material and methods. Patient O. was born at gestational age of 28 weeks with a body weight 1600 g. At age of 4 years, patient diagnosed “retinopathy of prematurity stage II, cicatricial period of the right eye. Subatrophy of the left eye”. At age of 12 years, rhegmatogenous subtotal RD, PVR C 1–12 post, developed against the background of the cicatricial stage of ROP in the right eye. 25G vitrectomy with tamponade perfluorinated compound with replacement for silicone, restrictive laser photocoagulation were performed. Results. Complete attachment of the RD was achieved. The silicone was removed after 6 months. Attachment of the retina was noted during 2 years. Visual acuity (VA) was 0.4. RD recurrence happened 2 years later, VA of the right eye – no light perception. 25G vitrectomy with membrane removal and “Pfocalin” tamponade was performed. During staged surgery: “Pfocalin” was removed, laser photocoagulation and silicone tamponade were performed. VA on the 3rd day – 0.1. Intraocular pressure – 14 mm Hg. After 1 month, the VA of the right eye is 0.1. After 6 months, the VA is 0.2, the retina is attach. Conclusions. 1. Rhegmatogenous RD develops with varying degrees of cicatricial ROP. 2. Despite the successful RD surgery against the background of cicatricial ROP, the stability of visual functions and retinal status, in the long-term period, RD recurrence is possible due to development of severe PVR. 3. The decision to terminate silicone tamponade in such cases should be made on an individual basis. 4. Based on the foregoing, long-term monitoring of patients with regressed stages of ROP is required. Keywords: retinopathy of prematurity, retinal detachment, proliferative vitreoretinopathy.

Анатомо-функциональные особенности глаз детей со второй степенью рубцовой ретинопатии недоношенных после лазерной коагуляции сетчатки

Purpose. To evaluate anatomical and functional features of eyes in children with the 2nd stage of cicatricial retinopathy of prematurity (ROP) in long-term period after underwent laser coagulation (LC) of threshold stages of ROP. Material and methods. 18 children with the 2nd stage of cicatricial ROP, who in 2008–2009 underwent LC of retina of threshold stages of ROP (the main group). Selection criterion is absence of traction changes in macular area. In patients aged 8–9 years we studied visual evoked potentials (VEP), performed optical coherence tomography in macular area, and ocular biometry. The control was healthy children of similar age. Results. In the main group we revealed: statistically significant differences in increase of foveal thickness; tendency to reduction of retinal thickness in all segments of macular area; in 89% of cases pathological changes were observed in VEP, despite visually intact optic disc and macula. Conclusion. The features of eyes in children with 2nd stage of cicatricial ROP who underwent LC of retina of threshold stages of ROP, were: increase retinal thickness in fovea, uniform decrease in retinal thickness in other sectors in macular area, more smaller anterior chamber of the eye and narrow anterior chamber angle, than healthy peers. Key words: cicatricial retinopathy of prematurity, retinal thickness, anterior chamber of the eye, visual evoked potentials.

Морфометрические особенности глаз детей со второй степенью рубцовой ретинопатии недоношенных

Морфометрические особенности глаз детей со второй степенью рубцовой ретинопатии недоношенных

Features of the Anterior Segment of the Eyeball in Children with 5 Cicatricial Retinopathy of Prematurity According to Ultrasound Biomicroscopy and Optical Coherent Tomography

Purpose: to study the features of the anatomical and topographic relationships of the eye’s anterior segment structures in children with stage 5 ROP in the cicatricial period with the method of ultrasound biomicroscopy and optical coherent tomography of the anterior segment and to evaluate the possibility of using the data to optimize the surgical treatment of ROP.Patients and methods. For the period 2015–2018 in the Kaluga branch of the Fyodorov Eye Microsurgery, 68 children (118 eyes) with 5 cicatricial ROP stages were examined and treated. Gestational age at birth varied from 24 to 31 weeks, body weight at birth — from 630 to 1600 grams. Age at the time of the survey ranged from 5 to 15 months. All children underwent the complex diagnostic examination, which included biometrics, tonometry, ultrasound ophthalmoscanning in B-mode, as well as UBM and OCT of the anterior segment of the eyeball. The extent of fixation of retrolental opacities to the posterior lens capsule, the presence of cystic cavities and retinal folds at the periphery, traction detachment of the ciliary body were determined. OCT of the eye anterior segment was performed in the presence of iridocorneal contact in order to clarify its length. As a result, a comprehensive detailed assessment made it possible to clarify or reject the characteristics identified by UBM, as well as determine the phasing and develop an individual plan of the operation in each case.Conclusion. The use of complex diagnostic examinations, including UBM and OCT of the eye anterior segment in patients with 5 cicatricial PH stages, allows to optimize the tactics of surgical treatment in the advanced stages of the disease.

Эписклеральное круговое пломбирование в лечении отслойки сетчатки в рубцовой фазе ретинопатии недоношенных

Purpose . Determination of the clinical indicates and the effectiveness of episcleral circular buckling in the treatment for late retinal detachment at cicatricial retinopathy of prematurity (ROP). Material and methods . 12 patients (14 eyes) having cicatricial ROP were examined. The age of patients was from 8 months until 14 years. The spontaneous regression of ROP was diagnosed for four cases (two children having 2nd stage of ROP and two children having 3rd stage of ROP). The regression for 3 children occurred after transpupillary retinal laser coagulation (RLC) had been performed in the active period (one during 2nd stage of ROP, two – during 3rd stage of ROP). Three children had the regression after early lens sparing vitrectomy. Among these children, two children underwent surgical treatment due to progressing of the pathological process after RLC. Episcleral circular buckling was performed for all patients (12 children, 14 eyes). It was performed for the single sighted eye in three patients. The surgery was performed for both eyes simultaneously in two patients. The observation period ranged from 1.5 to 2.5 years. The silicone buckle was dissected any cases. Results . The tractions managed to be stopped through three months in all cases. A complete anatomical attachment of retina was achieved in 11 eyes. The detachment did not spread at three cases. The recurrence of retinal detachment happened in the remote postoperative period in two cases (in terms of 9 and 17 months). The proliferative process activated in first case. In second case the progression of axial myopia happened with increasing of the anteroposterior size of the eye. The silicone tamponade vitrectomy needed to be performed in both cases. Conclusions . 1. Cicatricial retinopathy of prematurity is characterized by the risk of developing late complications, at any degree of residual changes in active ROP. The adequate organization and continuity in the process of dynamic observation of children affected ROP and the conducted treatment timely are required. 2. Episcleral circular buckling is effective method of a surgical treatment provided the detection of early complications of cicatricial ROP timely. It lets achieve the positive anatomical and functional results and save visual functions.

Анатомо-функциональные особенности глаз у детей со второй степенью рубцовой ретинопатии недоношенных

«Российская офтальмология онлайн» - электронное информационное издание, создается с 1 марта 2010 года под эгидой Российского общества офтальмологов. Основная задача проекта - научно-информационная поддержка специалистов в области офтальмологии.

Association of pseudo-exotropia with true esotropia in cicatricial retinopathy of prematurity.

Association of pseudo-exotropia with true esotropia in cicatricial retinopathy of prematurity.

Results of long-term observation of extremely premature babies with retinopathy

To study the long-term clinical and functional outcomes of retinopathy in extremely premature infants. The study included 42 patients (84 eyes) with retinopathy of prematurity (ROP) at the age of 9-18 years. All patients underwent comprehensive ophthalmological examination, including morphometric (OCT), functional (ERG) and psycho-physical (computer perimetry) methods. A high occurrence of low vision (67%) was revealed in extremely premature children with ROP during school years and adolescence, which depended on the severity of active ROP and the formation of pronounced residual changes in the fundus during the cicatricial phase of the disease, a high occurrence of refractive errors (92%), including high degree myopia (46%), late complications that develop with ROP of any degree (68%), impaired retinal electrogenesis - due to both ROP and deep morphological and functional immaturity of the retina. Patients with any degree of cicatricial ROP born in the early stages of gestation and with extremely low body weight need regular complex ophthalmologic examination and lifelong follow-up.

Anatomic features of anterior chamber angle in children with glaucoma depending on the degree of the cicatricial retinopathy of prematurity

Introduction. The retinopathy of prematurity (ROP) is a leading condition in the nosological structure of ophthalmic pathology in preterm children. A number of researchers note the increase in frequency of glaucoma development in such patients, considerably worsening the prognosis of the disease. At the same time, features of ocular hydrostatics and hydrodynamics taking into account the immaturity of the eye are studied insufficiently.
 The purpose of the study was to estimate the anterior chamber angle anatomy in preterm children with glaucoma depending on the cicatricial ROP severity.
 Materials and methods. The study group included 45 preterm children (87 eyes) aged from 6 months to 18 years with glaucoma on the background of cicatricial ROP. The control group consisted of 27 full-term children (54 eyes) with congenital glaucoma. As an addition to traditional ophthalmologic examination, iridocorneal goniography using a pediatric retinal camera was performed.
 Results. In children of the study group, anomalies of anterior chamber angle anatomic structure were diagnosed in the absolute majority of cases 97.7% of cases (85 eyes) and depended on the cicatricial ROP severity: at degrees 1-3 they were similar to those in congenital glaucoma in full-term children; at degrees 4-5 glaucoma was of secondary nature and developed as a result of a combination of dysgenesis signs in the anterior chamber angle.
 Conclusion. Cicatricial ROP of any degree is a high risk factor for the development of secondary glaucoma.

Эписклеральное пломбирование в лечении поздних отслоек сетчатки при рубцовой ретинопатии недоношенных

Эписклеральное пломбирование в лечении поздних отслоек сетчатки при рубцовой ретинопатии недоношенных

Results of surgery for late sequelae of cicatricial retinopathy of prematurity.

Purpose:To report anatomical and functional results of vitreoretinal surgery in our case series of late cicatricial retinopathy of prematurity (ROP) patients with subtotal retinal detachment.Methods:This is a retrospective, consecutive case series. Eleven eyes of 10 patients presented with partial tractional retinal detachment secondary to late cicatricial ROP (cicatricial stage 4B) who underwent vitreoretinal surgery were retrospectively reviewed. Anatomical and functional outcomes were evaluated.Results:The mean gestational age at birth was 28.6 (26–32) weeks. The mean age at surgery was 79 (4–213) months. Patients were followed up for 21.7 (6–40) months. Six eyes (55%) had lens-sparing vitrectomy and five eyes (45%) had lensectomy + vitrectomy. Anatomical success was achieved in 10 eyes (91%). Improvement in visual acuity was noted in nine eyes (82%).Conclusion:Eye grows but fibrotic tissue does not grow with age, and during this period retinal traction may get worse. Relieving these tractions may lead to good anatomical and visual outcomes in selected late cicatricial ROP cases.

ERG and OCT Changes In Cicatricial Retinopathy of Prematurity

Purpose: to study changes of ERG and depth of retinal vessels bedding in children with cicatricial ROP. Methods: We examined 58 children (82 eyes) aged from 6 months to 16 years old with cicatricial ROP. We evaluated maximal and flicker ERG, glial and AB-indexes and location of vessels in the retina using OCT. Results: In GCL retinal vessels were only in 12 of 82 eyes (15%). In 29 eyes (35%)they were located in NFL, and in 41 eyes (50%)-extraretinal (on the surface of the retina). There was a relation between the degree of displacement of retinal vessels and presence of extraretinal tissue, as well as a tendency to thinning of the retina in cases with extraretinal localization of the vessels (p <0.01). The incidence of traction retinal detachments and retinoschisis increases with growing degree of the displacement vessels. There was no statistically significant differences in the standard amplitude-time parameters of the ERG, but there was a tendency to growth of glial and AB-indexes with the increasing degree of displacement of the vascular bedding, which corresponds to the nature and frequency of late complications in cicatricial ROP. Conclusion: These parameters can be important criteria of the severity of the process and important tests helping to detect a preclinical negative trend in cicatricial ROP.

Risk Factors and Genetics in Common Comitant Strabismus

Understanding the development of common strabismus is important in locating "at-risk" populations and implementing optimal treatment. This systematic review will bring together reported genetic and environmental risk factors for common strabismus to reveal relationships between risk factors and guide future research. To identify known environmental and genetic risk factors for comitant strabismus reported in the literature. A systematic literature search was performed in Medline, Embase, BioSciences Information Service Previews, Web of Science, and the OMIM database during a 2-week period in July 2011 (including all available years) using the following key words: gene, genetic environmental factor, inheritance, risk factor, esotropia, exotropia, strabismus, squint, convergent strabismus, and divergent strabismus. No language restrictions were placed on the search. Exclusion criteria consisted of associated syndromes, strabismus not the primary outcome, poor study design or quality, and logarithm of the odds score less than 3. A study quality and extraction tool was used. Analysis was performed descriptively because of the variant characteristics of the study designs. Risk factor, twin, pedigree, and genetic studies. Forty-one articles fulfilled the inclusion criteria set out by the study, which highlighted 4 subcategories: risk factor, twin, pedigree, and genetic studies. Significant risk factors for strabismus reported by the studies included low birth weight, cicatricial retinopathy of prematurity, prematurity, smoking throughout pregnancy, anisometropia, hyperopia, and inheritance. Inheritance was further supported by twin and pedigree studies, which revealed the complexity of the inheritance pattern. At present the STBMS1 locus is the only gene location that has been supported; however, others have been reported. Certain subgroups within the population are at higher risk of developing comitant strabismus and should be identified and monitored to allow for earlier detection. It is evident that a strong hereditary link is present particularly in intermittent and accommodative forms; however, further research is required to identify possible links between subtypes of strabismus. Further genetic research could also help to locate additional causative genes to aid the understanding of strabismus development.

Late subsequent ocular morbidity in retinopathy of prematurity patients, with emphasis on visual loss caused by insidious ‘involutive’ pathology: an observational series

This paper discusses late complications in eyes of surviving premature infants typically occurring years into the steady state attained after the initial ophthalmic events associated with preterm birth. The study focuses on insidious visual loss, as well as eventual vitreoretinal and anterior segment disorders. We carried out a retrospective uncontrolled study of a case series (n = 31) of late complications to early ocular changes associated with very preterm delivery. The birth years of our subjects extended back to 1941, but only 15 more recent cases fulfilled contemporary criteria for a diagnosis of retinopathy of prematurity (ROP). Fourteen cases involved vitreoretinal pathology (median observation time 14 years, range 6-46 years) with late detachment and/or vitreous haemorrhage. Twelve cases primarily involved anterior segment pathology (median observation time 37 years, range 7-58 years). Eyes in the latter category often showed features of early arrested growth and anterior traction, which, in four eyes, eventually led to enucleation or exenteration as a result of a blind and painful terminal state. The last five cases (observation periods 22-38 years) were labelled 'miscellaneous'. Among the 31 patients, we identified a subgroup in which insidious visual loss was a common feature (n = 20). Initially, some of these cases showed evidence of cicatricial ROP and low vision from early in life. Others retained useful vision and did not present obvious ocular incidents related to the actual visual acuity decline. Based on a variety of clinical ophthalmic preterm appearances, we propose the hypothesis that, in addition to increased structural vulnerability, a reduced functional reserve may pave the way for further abiotrophy or involution over time. This may manifest as reduced resistance to later ophthalmic events, such as disease or trauma, or simply the impact of age.

Astigmatism in the Early Treatment for Retinopathy of Prematurity Study: Findings to 3 Years of Age

To examine the prevalence of astigmatism (> or =1.00 diopter [D]) and high astigmatism (> or =2.00 D) at 6 and 9 months corrected age and 2 and 3 years postnatal age, in preterm children with birth weight of less than 1251 g in whom high-risk prethreshold retinopathy of prematurity (ROP) developed and who participated in the Early Treatment for Retinopathy of Prematurity (ETROP) Study. Randomized, controlled clinical trial. Four hundred one infants in whom prethreshold ROP developed in one or both eyes and who were randomized after they were determined to have a high risk (> or =15%) of poor structural outcome without treatment using the Risk Management of Retinopathy of Prematurity (RM-ROP2) program. Refractive error was measured by cycloplegic retinoscopy. Eyes with additional retinal, glaucoma, or cataract surgery were excluded. Eyes were randomized to receive laser photocoagulation at high-risk prethreshold ROP (early treated [ET]) or to be conventionally managed (CM), receiving treatment only if threshold ROP developed. Astigmatism and high astigmatism at each visit. Astigmatism was classified as with-the-rule (WTR; 75 degrees -105 degrees ), against-the-rule (ATR; 0 degrees -15 degrees and 165 degrees -180 degrees ), or oblique (OBL; 16 degrees -74 degrees and 106 degrees -164 degrees ). The prevalence of astigmatism in ET and CM eyes was similar at each test age. For both groups, there was an increase in prevalence of astigmatism from approximately 32% at 6 months to approximately 42% by 3 years, mostly occurring between 6 and 9 months. Among eyes that could be refracted, astigmatism was not influenced by zone of acute-phase ROP, presence of plus disease, or retinal residua of ROP. Eyes with astigmatism and high astigmatism most often had WTR astigmatism. By age 3 years, nearly 43% of eyes treated at high-risk prethreshold ROP developed astigmatism of > or =1.00 D and nearly 20% had astigmatism of > or =2.00 D. Presence of astigmatism was not influenced by timing of treatment of acute-phase ROP or by characteristics of acute-phase or cicatricial ROP. These findings reinforce the need for follow-up eye examinations in infants with high-risk prethreshold ROP. The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Refractive surgery for high bilateral myopia in children with neurobehavioral disorders: 1. Clear lens extraction and refractive lens exchange

Introduction: A subpopulation of children with high myopia and neurobehavioral disorders is noncompliant with spectacle wear and ill-suited to correction using contact lenses. We report the results of refractive surgery in a series of these children treated using lensectomy alone (clear lens extraction), or lensectomy with simultaneous implantation of an intraocular lens (refractive lens exchange). Methods: Clinical course and outcome data were collated prospectively in a group of 13 children (mean age 10.4 years, range 1 to 18 years) with neurobehavioral disorders exacerbated by chronic noncompliance with spectacle wear, causing profoundly low functional vision. Myopia in the 26 eyes ranged from −14.25 to −26.00 D (mean −19.1 D). Goal refraction was approximately +1 D. Correction was achieved by lensectomy alone in 10 eyes, and lensectomy with intraocular lens implantation in 16 eyes. Primary posterior capsulectomy/subtotal vitrectomy was performed during the primary procedure in 11 eyes (42%). Mean follow-up was 4.5 years (range 1.3 to 7.5 years). Results: Myopia correction averaged 19.9 D. Eighty-one percent (21 eyes) were corrected to within ±2 D of goal refraction and the remaining 19% (5 eyes) to within ±4 D. Uncorrected acuity improved substantially (ie, an average 2 log units) in all 26 eyes, with commensurate gains in behavior and environmental visual interaction in 88% of children (14/16). Myopic regression averaged −0.16 D/year. Capsular regrowth and/or opacification necessitated vitrector or YAG-laser membranectomy in 12 eyes (46%). Focal retinal detachment (successfully repaired) occurred after eye contusion in one eye (4%) with cicatricial retinopathy of prematurity. Conclusions: Bilateral refractive lensectomy is effective for improving functional vision in neurobehaviorally impaired children who have high myopia (beyond the range of excimer laser correction: see companion publication) and difficulties wearing glasses. Posterior capsule regrowth/opacification is common, necessitating secondary membranectomy. Further study is indicated to determine the long-term safety of this procedure in similar pediatric populations.

Refractive Surgery for High Bilateral Myopia in Children with Neurobehavioral Disorders: 1. Clear Lens Extraction and Refractive Lens Exchange

A subpopulation of children with high myopia and neurobehavioral disorders is noncompliant with spectacle wear and ill-suited to correction using contact lenses. We report the results of refractive surgery in a series of these children treated using lensectomy alone (clear lens extraction), or lensectomy with simultaneous implantation of an intraocular lens (refractive lens exchange). Clinical course and outcome data were collated prospectively in a group of 13 children (mean age 10.4 years, range 1 to 18 years) with neurobehavioral disorders exacerbated by chronic noncompliance with spectacle wear, causing profoundly low functional vision. Myopia in the 26 eyes ranged from -14.25 to -26.00 D (mean -19.1 D). Goal refraction was approximately +1 D. Correction was achieved by lensectomy alone in 10 eyes, and lensectomy with intraocular lens implantation in 16 eyes. Primary posterior capsulectomy/subtotal vitrectomy was performed during the primary procedure in 11 eyes (42%). Mean follow-up was 4.5 years (range 1.3 to 7.5 years). Myopia correction averaged 19.9 D. Eighty-one percent (21 eyes) were corrected to within +/-2 D of goal refraction and the remaining 19% (5 eyes) to within +/-4 D. Uncorrected acuity improved substantially (ie, an average 2 log units) in all 26 eyes, with commensurate gains in behavior and environmental visual interaction in 85% [corrected] of children (11/13) [corrected] Myopic regression averaged -0.16 D/year. Capsular regrowth and/or opacification necessitated vitrector or YAG-laser membranectomy in 13 [corrected] eyes (50%) [corrected] Focal retinal detachment (successfully repaired) occurred after eye contusion in one eye (4%) with cicatricial retinopathy of prematurity. Bilateral refractive lensectomy is effective for improving functional vision in neurobehaviorally impaired children who have high myopia (beyond the range of excimer laser correction: see companion publication) and difficulties wearing glasses. Posterior capsule regrowth/opacification is common, necessitating secondary membranectomy. Further study is indicated to determine the long-term safety of this procedure in similar pediatric populations.

Modification of Screening Criteria for Retinopathy of Prematurity in India and Other Middle-Income Countries

To determine the gestational age and birth weight of premature babies who developed vision-threatening severe retinopathy of prematurity. Prospective observational study of babies at risk of blindness due to retinopathy of prematurity. Data pertaining to all babies who underwent laser treatment or surgery for acute retinopathy of prematurity and those who had cicatricial retinopathy of prematurity were prospectively collected. The gestational age and birth weight were evaluated to establish screening criteria. In 120 babies, the mean gestational age was 29.6 weeks (range 26 to 36 weeks). The birth weight of 115 babies ranged from 710 to 2000 g (mean 1254.5 g, SD 280.8). Birth weight was not available for five babies. Only one baby had a gestational age of >35 weeks. Ocular morbidity related to retinopathy of prematurity was seen in bigger and more mature babies. This study provides a scientific basis for establishing screening criteria for retinopathy of prematurity in South India and other middle-income countries.

Comitant strabismus.

A review of the literature on comitant strabismus of the period from April 1999 until April 2000 is presented. A rather new and increasingly important issue is the psychosocial aspect of strabismus. Two studies have demonstrated that strabismus creates a significant negative social prejudice on the patients and that it can significantly reduce an applicant's ability to obtain employment. Subsequently, strabismus surgery can no longer be called "cosmetic". Concerning the timing of surgery in congenital esotropia, it was reported that early surgery does not ensure continued alignment, but frequently requires additional operations. The increased risk of early-onset strabismus in prematurely born children was confirmed by several studies, and the importance of regular ophthalmologic controls of all preterm infants screened for retinopathy of prematurity was stressed. It was reported that risk factors are cicatricial retinopathy of prematurity, refractive error, family history of strabismus, and poor neurodevelopmental outcome, rather than low gestational age and regressed acute retinopathy of prematurity. A number of other aspects of interest concerning exotropia, esotropia, and dissociated vertical deviation are presented in this review.