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How to Obtain Reliable Visual Event-related Potentials in Newborns
Published on: October 24, 2019
Visual development in very low birth weight infants
Giuseppe Mirabella1, Patricia K Kjaer, Anthony M Norcia
1The Smith-Kettlewell Eye Research Institute, San Francisco, CA 94115, USA.
Insights
Extremely preterm infants without severe brain or eye injury show normal visual function development. Their visual sensitivity is comparable to full-term infants, but their brain responses to visual stimuli are stronger.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Ophthalmology
Background:
- Extremely preterm infants face risks for neurodevelopmental issues, especially affecting the visual system.
- Visual function development in preterm infants with minimal neurological or retinal damage is not well understood.
Purpose of the Study:
- To compare visual function development in very low birth weight (VLBW) preterm infants without significant retinopathy of prematurity (ROP), intraventricular hemorrhage (IVH), or periventricular leukomalacia (PVL) against healthy term infants.
- To assess visual sensitivity and response amplitudes at 5-7 months corrected age.
Main Methods:
- Twenty-one VLBW infants (24-32 weeks gestational age, <1500g) and 22 healthy term infants were evaluated.
- Exclusion criteria included IVH/PVL and ROP Stage II or worse.
- Visual evoked potentials (VEPs) using swept-parameter techniques measured contrast sensitivity, grating acuity, and vernier acuity.
Main Results:
- No significant differences were found in visual thresholds for contrast sensitivity, grating acuity, or vernier acuity between VLBW and term infants.
- VLBW infants exhibited significantly higher amplitudes for swept contrast and swept vernier offset stimuli.
- This suggests visual experience may influence responses to suprathreshold visual stimuli in VLBW infants.
Conclusions:
- Preterm infants without major neurological or retinal complications demonstrate visual sensitivity comparable to term infants.
- Elevated VEP amplitudes in VLBW infants may indicate that visual experience impacts processing of suprathreshold visual information.
- Further research is needed to understand the long-term implications of these findings.
Abstract:
Extremely preterm infants are at risk for neurodevelopmental problems and the visual system is particularly vulnerable. However, development of visual function in preterm infants with little or no retinal or neurologic injury has not been well defined. This study compared development of visual function in preterm infants without severe retinopathy of prematurity (ROP), intraventricular hemorrhage (IVH) or periventricular leukomalacia (PVL) to that of term infants at 5-7 mo corrected age. Twenty-one very low birth weight (VLBW) preterm infants (24-32 wk gestational age, weighing < 1500 g), and 22 healthy term infants were tested at 5-7 mo corrected age. Infants with any IVH/PVL and > Stage II ROP or Plus disease were excluded. Contrast sensitivity, grating acuity, and vernier acuity were measured using swept-parameter visual evoked potentials. Thresholds and maximum amplitudes were compared between groups. VLBW and term infants showed no differences in sensitivity for contrast (67.5 versus 63.8), grating resolution (12.4 versus 12.5 cpd) or vernier acuity (1.2 versus 1.0 arcmin). However, the amplitudes for swept contrast (p < 0.03) and swept vernier offset (p < 0.04) stimuli were higher in VLBW infants. Visual thresholds in VLBW infants without serious retinal or neurologic abnormalities were not significantly different from those of term infants, suggesting that increased visual experience does not influence visual sensitivity. The higher amplitudes in VLBW infants, suggests that visual experience may affect responses to suprathreshold stimuli.
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