Background: Functional disturbances as well as morphologic changes can be various in regressed retinopathy of prematurity (ROP).

Methods: To investigate the incidence and the degree of such changes, we examined prematurely born infants in the age of 11 to 14 years. Of the 142 prematures (birthweight < or = 2000 g), who were cared for in their first weeks of life in the University Children's Hospital at the Klinikum Mannheim in 1977 to 1979, 48 could be reexamined.

Results: Of 48 infants (mean birth weight 1808 +/- 211 g, gestational age 34.6 +/- 3.1 weeks) six (12.5%; birth weight 1742 +/- 218 g, gestational age 32.2 +/- 2.5) had had acute ROP (stage 2 or 3). When reexamined in school age 10 (21%) of the children had physical deficits. Eight (17%) visited a school for handicapped children. Eight (17%) children had a squint. In 13 out of 96 (14%) eyes visual acuity was reduced to 0.8 or less. Thirteen eyes (14%) were emmetropic, 67 (70%) hyperopic, 16 (17%) myopic and 15 (16%) astigmatic. The intraocular pressure was normal in all eyes (15 +/- 4 mm Hg). The anterior segments did not show findings caused by ROP. The fundus findings in the 12 eyes, in which the diagnosis of acute ROP was established in the first weeks of life, showed in 5 (42%) eyes a slightly reduced angle kappa between the vascular arcades and avascular retina in the temporal fundus periphery in all of the 12 (100%) eyes. In 1 (8%) eye the retinal periphery showed extensive scarring after cryotherapy because of acute ROP. None of the eyes which had had acute ROP showed macular ectopia or retinal folds (amotio falciformis). In 16 of the 84 (19%) eyes, which did not have a history of acute ROP, minor changes of the retinal periphery, the peripheral retinal vessels and the pigment epithelium were present, which were caused by prematurity.

Conclusions: Prematurely born infants examined in school age, who were comparatively mature preterms at birth (mean birth weight 1800 g; mean gestational age 34.6 weeks), did not show a higher risk of refractive errors, i.e. myopia. However, they were at higher risk having squint. The functional disturbances found in the prematurely born infants in this study were not caused by morphologic changes due to ROP.