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Correlation between visual function, neurodevelopmental outcome, and magnetic resonance imaging findings in infants
G Cioni1, B Bertuccelli, A Boldrini
1Stella Maris Scientific Institute, Division of Child Neurology and Psychiatry, Via dei Giacinti 2, I-56018 Calambrone, Pisa, Italy. ciono@inpe.unipi.it
Insights
Visual impairment significantly impacts neurodevelopmental outcomes in children with periventricular leucomalacia. Early assessment of visual function is crucial for predicting developmental trajectories in these infants.
Area of Science:
- Pediatric Neurology
- Developmental Pediatrics
- Ophthalmology
Background:
- Periventricular leucomalacia (PVL) is a common form of white matter injury in preterm infants.
- PVL can lead to significant neurodevelopmental deficits, including motor and cognitive impairments.
- Visual dysfunction is frequently observed in children with PVL, but its precise impact on overall development requires further elucidation.
Purpose of the Study:
- To investigate the relationship between visual function and neurodevelopmental outcomes in children diagnosed with periventricular leucomalacia.
- To determine the predictive value of visual impairment on developmental trajectories at 1 and 3 years of age.
Main Methods:
- A cohort of 29 infants with periventricular leucomalacia, confirmed by brain MRI, underwent comprehensive visual function assessments (visual acuity, visual field, ocular motility, optokinetic nystagmus).
- Infants also received structured neurological examinations and Griffiths developmental assessments at 1 and 3 years.
- Correlation and multivariate analyses were employed to evaluate the relationship between visual function and neurodevelopmental scores.
Main Results:
- Abnormalities in visual function were detected in 21 out of 29 infants (72.4%).
- A significant correlation was observed between the degree of visual impairment (number of abnormal visual tests) and developmental assessment scores at both 1 and 3 years.
- The extent of visual impairment was a stronger predictor of neurodevelopmental scores than motor disability or lesion load on MRI.
Conclusions:
- Visual impairment is a critical determinant of neurodevelopmental outcomes in children with periventricular leucomalacia.
- Ophthalmological evaluation should be an integral part of the neurodevelopmental assessment for infants with PVL.
- Early identification and management of visual deficits may play a vital role in optimizing developmental trajectories for this vulnerable population.
Aim:
To evaluate the correlation between visual function and neurodevelopmental outcome in children with periventricular leucomalacia at 1 and 3 years.
Method:
Visual acuity, visual field, ocular motility, and optokinetic nystagmus were tested in 29 infants with periventricular leucomalacia by brain magnetic resonance imaging. All infants also had a structured neurological examination and a Griffiths developmental assessment.
Results:
21 of the infants showed at least one abnormality of visual function. The degree of visual impairment-that is, the number of visual tests showing abnormal results-correlated well with the results on developmental assessment at both ages.
Conclusion:
Multivariate analysis showed that visual impairment was the most important variable in determining the neurodevelopmental scores of these infants, more than their motor disability and the extent of their lesions on magnetic resonance imaging.