Visuospatial skills, ocular alignment, and magnetic resonance imaging findings in very low birth weight adolescents

J AAPOS. 2009 Jun;13(3):273-9. doi: 10.1016/j.jaapos.2008.11.008. Epub 2009 Mar 14.


Purpose: To describe ocular alignment and stereoacuity in adolescents with very low birth weight (VLBW) in comparison with a matched control group and to investigate associations with white matter damage of immaturity (WMDI) and visuospatial skills in the VLBW group.

Methods: Fifty-nine 15-year-old VLBW subjects and 55 age- and sex-matched controls with normal birth weight underwent examination, including measurement of ocular alignment using cover test and Maddox rod and cycloplegic refraction. Stereoacuity was assessed with the TNO test, best-corrected visual acuity with a Konstantin Moutakis letter chart, and visuospatial skills with the performance tests, defined as performance intelligence quotient (IQ), in the Wechsler Intelligence Scale for Children (WISC-III). All VLBW subjects underwent magnetic resonance imaging of the brain.

Results: Ocular misalignment was significantly more common in the VLBW group than in the control group (22% compared with 4%; p = 0.004). Exophoria, subnormal stereoacuity, and subnormal performance IQ were significantly more common in the VLBW group than in the control group (p = 0.006, p = 0.011, and p = 0.015, respectively). Ocular misalignment was associated with WMDI (p = 0.035) and subnormal performance IQ (p = 0.020). Of the VLBW subjects with ocular misalignment, 69% had WMDI and/or subnormal performance IQ.

Conclusions: The VLBW adolescents had more visuospatial problems, lower stereoacuity, and more ocular misalignment than the control subjects. Ocular misalignment was associated with visuospatial deficiencies and/or WMDI in the VLBW group and was a better predictor for visuospatial deficits than WMDI.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Anisometropia / etiology
  • Anisometropia / pathology
  • Astigmatism / etiology
  • Astigmatism / pathology
  • Depth Perception*
  • Female
  • Follow-Up Studies
  • Humans
  • Hyperopia / etiology
  • Hyperopia / pathology
  • Infant, Newborn
  • Infant, Very Low Birth Weight*
  • Magnetic Resonance Imaging*
  • Male
  • Refractive Errors / etiology
  • Refractive Errors / pathology
  • Vision Disorders / etiology
  • Vision Disorders / pathology*
  • Visual Acuity
  • Visual Perception*