a cohort study from childhood to adulthood

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DOI: https://doi.org/10.1016/j.ajo.2019.12.016
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Article in Press
Ophthalmological findings in fetal alcohol spectrum
disorders – a cohort study from childhood to adulthood
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Article Info
Abstract Full Text Images References
Highlights
• Few individuals with FASD have a normal ophthalmological status
• Refractive errors, strabismus and fundus abnormalities are common in FASD children
• Most of the ophthalmological characteristics of FASD persist into young adulthood
Abstract
Purpose
To investigate whether ophthalmological findings in children with fetal alcohol spectrum disorders (FASD)
persist into young adulthood.
Design
Prospective cohort study.
Methods
Thirty children (13 female) adopted from eastern Europe to Sweden in the 1990s and diagnosed with FASD by a
multidisciplinary team at the median age of 7.9 years were followed up by the same team 13–18 years later.
Visual acuity (VA), refraction, stereoacuity, strabismus, ocular media and fundus were investigated.
Results
Median VA right/left eye (RE/LE) was 20/32/20/32 (0.2/0.2 logMAR) in childhood and 20/22/20/20 (0.05/0.0
logMAR) in adulthood. Median (range) refraction RE/LE was +0.88/+1.25 (-8.75 to +4.75/-9.38 to +5.25)
spherical equivalent diopter (D) in childhood and -0.25/-0.25 (-12 to +2.75/-13.25 to +2.63) in adulthood.
Astigmatism (≥1D) was the most common refractive error;13 (40%) and 14 (47%), respectively. Defective
stereoacuity (>60”) was noted in 20 (67%) in childhood and 22 (73%) in adulthood. Heterotropia occurred in 12
(40%) in childhood and 13 (43%) in adulthood. Increased tortuosity of the retinal vessels was found in eight
(27%) participants in childhood versus eleven (37%) in adulthood. Optic nerve hypoplasia was recorded in three
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children and in four young adults.
Conclusions
Ophthalmological findings such as refractive errors, strabismus and fundus abnormalities are frequent in
children with FASD and persist into early adulthood. The facial features characteristic of FAS diminish with age,
making a dysmorphology evaluation in adulthood less reliable. An ophthalmological examination is an important
part of the evaluation of FASD in childhood as well as in young adulthood.
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