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Ophthalmologic Findings in Fetal Alcohol Spectrum Disorders – A Cohort Study From Childhood to Adulthood

  • Emelie Gyllencreutz
    Correspondence
    Inquiries to Emelie Gyllencreutz, Department of Ophthalmology, Skaraborgs Hospital Skövde, Lövängsvägen 1, 541 42 Skövde, Sweden
    Affiliations
    Department of Ophthalmology, Skaraborg Hospital, Skövde, Sweden

    Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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  • Eva Aring
    Affiliations
    Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

    Department of Ophthalmology, Sahlgrenska University Hospital, Mölndal, Sweden
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  • Valdemar Landgren
    Affiliations
    Department of Psychiatry, Skaraborg Hospital, Skövde, Sweden

    Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
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  • Leif Svensson
    Affiliations
    Department of Pediatrics, Skaraborg Hospital, Mariestad, Sweden
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  • Magnus Landgren
    Affiliations
    Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden

    Department of Pediatrics, Skaraborg Hospital, Mariestad, Sweden
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  • Marita Andersson Grönlund
    Affiliations
    Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

    Department of Ophthalmology, Sahlgrenska University Hospital, Mölndal, Sweden
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Published:January 09, 2020DOI:https://doi.org/10.1016/j.ajo.2019.12.016

      Purpose

      To investigate whether ophthalmologic 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 in right/left eye (OD/OS) 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 OD/OS 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 (≥1 D) was the most common refractive error, in 13 (40%) and 14 (47%) subjects, respectively. Defective stereoacuity (>60 arc second) was noted in 20 subjects (67%) in childhood and 22 (73%) in adulthood. Heterotropia occurred in 12 subjects (40%) in childhood and 13 (43%) in adulthood. Increased tortuosity of the retinal vessels was found in 8 (27%) subjects in childhood vs 11 (37%) in adulthood. Optic nerve hypoplasia was recorded in 3 children and in 4 young adults.

      Conclusions

      Ophthalmologic 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 ophthalmologic examination is an important part of the evaluation of FASD in childhood as well as in young adulthood.
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