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Visual evoked potentials and visual prognosis following perinatal asphyxia
D L McCulloch1, M J Taylor, H E Whyte
1Department of Ophthalmology, Hospital for Sick Children, Toronto, Canada.
Insights
Early postnatal visual evoked potentials strongly predict long-term vision in children with perinatal asphyxia. Abnormal or absent early results indicate a high risk of visual impairment or blindness.
Area of Science:
- Neuroscience
- Ophthalmology
- Pediatrics
Background:
- Perinatal asphyxia is a significant risk factor for adverse neurodevelopmental outcomes in term infants.
- Visual impairment is a potential complication following perinatal asphyxia, impacting long-term development.
- Early identification of visual prognosis is crucial for timely intervention.
Purpose of the Study:
- To evaluate visual function in children with a history of perinatal asphyxia.
- To determine the prognostic value of early postnatal visual assessments for long-term visual outcomes.
- To identify predictors of visual impairment in this population.
Main Methods:
- Longitudinal study of 25 term infants with perinatal asphyxia, assessed between 2.5 and 4.5 years.
- Early postnatal assessments (first week) included electroretinograms and visual evoked potentials.
- Follow-up included clinical eye exams, flash and pattern visual evoked potentials, and threshold measurements.
Main Results:
- Nineteen children had normal visual function; three were visually impaired, and three were blind.
- Early postnatal visual evoked potentials showed a strong association with long-term visual outcome (P < .0001).
- Neurologic status, Apgar scores, and arterial pH were poor predictors of visual outcome.
Conclusions:
- Early postnatal visual evoked potentials are reliable predictors of long-term visual function in children with perinatal asphyxia.
- Visual impairment risk is concentrated in survivors with neurodevelopmental deficits.
- Routine early visual assessments can aid in predicting and managing visual outcomes.
Abstract:
Twenty-five children born at term with perinatal asphyxia were studied at age 2.5 to 4.5 years to evaluate visual function and to determine the prognostic value of postnatal assessments of visual outcome. Postnatal assessments included several visual evoked potentials and electroretinograms in the first week of life. Follow-up assessments included flash and pattern visual evoked potentials, visual evoked potential threshold measurements, and clinical eye examinations. Nineteen children had normal visual function, three were visually impaired, and three remained blind. A strong association was found between normal, abnormal, or absent visual evoked potentials in the early postnatal period and long-term visual outcome (P less than .0001). Other perinatal indicators of asphyxia, including neurologic status, Apgar scores, and arterial pH values, were poor predictors of visual outcome. The risk of visual impairment was limited to those survivors with neurodevelopmental deficits.