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How to Obtain Reliable Visual Event-related Potentials in Newborns
Published on: October 24, 2019
Visual function at 11 years of age in preterm-born children with and without fetal brain sparing
Joke H Kok1, Liesbeth Prick, Elly Merckel
1Emma Children's Hospital AMC, Department of Neonatology H3 229, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. j.h.Kok@amc.uva.nl
Insights
Preterm infants with antenatal brain sparing showed no difference in visual function at age 11. However, neonatal brain abnormalities were linked to later visual impairments in these children.
Area of Science:
- Neonatal neurology
- Pediatric ophthalmology
- Developmental neuroscience
Background:
- Previous research indicated accelerated visual evoked potential maturation in preterm infants with antenatal brain sparing.
- This study investigates long-term visual functioning in this cohort.
Purpose of the Study:
- To assess visual functioning at 11 years of age in preterm infants.
- To compare visual outcomes between infants with and without antenatal brain sparing.
Main Methods:
- Followed 116 preterm infants (<33 weeks gestation) admitted to NICU.
- Assessed 98 infants at 11 years for visual acuity, fields, eye position, binocular function, and visual motor skills.
- Utilized fetal Doppler and neonatal cerebral ultrasound data.
Main Results:
- No significant differences in visual functioning were found between groups with and without brain sparing.
- Abnormal neonatal cerebral ultrasound diagnoses correlated with poorer visual function and lower visual motor scores.
Conclusions:
- Antenatal brain sparing does not impact visual development at late school age.
- Neonatal brain abnormalities are associated with long-term visual deficits in preterm infants.
Objective:
We have demonstrated earlier an accelerated maturation of the visual evoked potential in the first year of life in preterm infants with antenatal brain sparing. We have now assessed visual functioning at 11 years of age in the same cohort and compared the groups with and without brain sparing.
Design/Methods:
One hundred sixteen survivors included in a study on the outcome of preterm infants born at <33 weeks' gestation with and without fetal brain sparing and admitted to the NICU were followed extensively. Ninety-eight infants (85%) were again assessed at 11 years of age. Data were available for fetal Doppler measurements indicating brain sparing, neonatal cerebral ultrasound scanning, and developmental outcome in the first 5 years. Mean birth weight was 1303 g; mean gestational age was 29.8 weeks. The infants were divided into 2 groups with and without brain sparing. Visual functioning was estimated by measuring visual acuity, visual fields, eye position, and binocular function and by visual motor tests.
Results:
Six percent of the children were found to have a visual acuity of <0.8, 12% had strabismus, and 14% to 46% showed abnormal results on the visual motor tests. No statistical differences were found between the 2 groups. However, children with severe cerebral ultrasound diagnoses in the neonatal period were found to have significantly more abnormalities on visual functioning and lower scores on visual motor tests than children without these morbidities.
Conclusions:
Children with fetal brain sparing do not demonstrate a different development of their visual functioning at late school age. However, an abnormal cerebral ultrasound in the neonatal period is associated with impaired visual function in later life.
