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Published on: October 24, 2019
The evolutionary change of flash visual evoked potentials in preterm infants with periventricular leukomalacia
Toru Kato1, Akihisa Okumura, Fumio Hayakawa
1Department of Pediatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho Showa-ku, Nagoya, Aichi 466-8550, Japan. torukato@med.nagoya-u.ac.jp
Insights
Nearly all preterm infants with cystic periventricular leukomalacia (PVL) showed abnormal flash visual evoked potentials (VEPs) within three weeks. However, VEP findings often changed from normal to abnormal early in neonatal life.
Area of Science:
- Neonatal neurology
- Neurophysiology
- Pediatric ophthalmology
Background:
- Cystic periventricular leukomalacia (PVL) is a common brain injury in preterm infants.
- Visual pathway abnormalities are frequent in infants with PVL.
- Flash visual evoked potentials (VEPs) are a non-invasive tool to assess visual pathway function.
Purpose of the Study:
- To prospectively examine flash VEP findings in preterm infants with cystic PVL.
- To document the chronological changes in flash VEPs during the early neonatal period.
Main Methods:
- 14 preterm infants diagnosed with cystic PVL via serial cranial ultrasonography were studied.
- Flash VEPs were recorded at least twice within the first three weeks of life.
Main Results:
- All infants exhibited at least one flash VEP abnormality.
- Absent VEPs were the most common finding (93%), followed by delayed latency and abnormal waveforms.
- While 4 infants had consistently abnormal VEPs, 10 showed transient normal findings that became abnormal within 10 days of birth.
Conclusions:
- Abnormal flash VEPs are highly prevalent in preterm infants with cystic PVL within the first three weeks of life.
- Chronological VEP changes, often progressing from normal to abnormal, were observed during this early neonatal period.
Objective:
The aim of this study was to prospectively investigate flash visual evoked potential (VEP) findings and their chronological changes in preterm infants with cystic periventricular leukomalacia (PVL) during the early neonatal period.
Methods:
The subjects of this study were 14 preterm infants with cystic PVL. The patients underwent serial cranial ultrasonography and diagnosed as having cystic PVL. Flash VEPs were diagnosed at least twice within the first 3 weeks of life.
Results:
All infants had at least one or more flash VEP abnormalities. The most common finding was 'absent VEP', which was seen in 13 infants (93%). 'Delayed latency' was seen in two infants and 'abnormal waveform' was seen in one infant. Concerning the chronological changes, all records were abnormal in 4 infants, and the other 10 had transient normal VEP findings. Among them, flash VEPs changed from normal to abnormal within 10 days after birth in most cases.
Conclusions:
Almost all infants with cystic PVL had abnormal flash VEPs within the first 3 weeks of life, but chronological changes of flash VEP findings were seen during the period.
Significance:
This manuscript may be useful as a reference to the flash VEPs in preterm infants with cystic PVL.
