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  • Ocular Outcomes of Alcohol Exposure in Utero

    By Lynda Seminara
    Selected By: Richard K. Parrish II, MD
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    Journal Highlights

    American Journal of Ophthalmology, June 2020

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    Alcohol exposure in utero has been linked to growth and learning defi­cits, facial abnormalities, and organ damage. It also can cause eye problems such as optic nerve hypoplasia (ONH) and abnormal retinal configuration, although few studies of fetal alcohol spectrum disorder (FASD) have fully described the ocular aspects of the disorder. Gyllencreutz et al. examined individuals with FASD; they found that refractive errors, strabismus, and fundus abnormalities persisted from childhood through to early adulthood.

    The authors enrolled 30 children who were adopted from Eastern Euro­pean countries by families in Sweden. The children were diagnosed with FASD at a mean age of 7.9 years and examined by a multidisciplinary team between 2000 and 2002. Thirteen to 18 years later, the same team performed follow-up exams; at this point, the patients’ mean age was 22 years.

    Visual acuity (VA) and refractive results were as follows:

    • During childhood, median VA was 20/32 in the right eye and 20/32 in the left (0.2 logMAR for both). Median refraction was +0.88 D in the right eye (range, ‒75 to +4.75) and +1.25 D (range, ‒9.38 to +5.25) in the left.
    • During adulthood, median VA was 20/22 in the right eye and 20/20 in the left (0.05 logMAR in the right and 0.0 in the left). Median refraction was ‒25 D in both eyes (right eye range, ‒12 to +2.75; left eye range, ‒13.25 to +2.63).
    • Thirteen children (40%) and 14 adults (47%) had astigmatism ≥1 D.

    In other results, defective stereoacu­ity (>60 arc second) was apparent in 20 children (67%) and 22 adults (73%); and 12 children (40%) and 13 adults (43%) had heterotropia. Also noted was ONH persistence over time (three chil­dren, four adults) and increased tortu­osity of retinal vessels (eight children, 11 adults). Nine of the 11 adults with increased tortuosity were born preterm and/or were small for their gestational age. (Data were unavailable for the other two.) The findings reinforce the need for ongoing follow-up of patients with FASD.

    The original article can be found here.