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Early visual assessment in preterm infants with and without brain lesions: correlation with visual and
Daniela Ricci1, Domenico M Romeo, Francesca Gallini
1Paediatric Neurology Unit, Catholic University, Rome, Italy.
Insights
A normal infant visual assessment at term age predicts good visual and neurodevelopmental outcomes. Abnormal neonatal visual findings require reassessment at 3 months for reliable prognosis.
Area of Science:
- Neonatal care
- Developmental pediatrics
- Ophthalmology
Background:
- Infant visual development is well-studied, but predictive value of neonatal visual findings in infants with brain lesions is less understood.
- Preterm infants require careful monitoring of visual and neurodevelopmental trajectories.
Purpose of the Study:
- To evaluate visual function in preterm infants (<33 weeks gestation) with and without brain lesions at term, 3, and 12 months corrected age.
- To compare visual assessments between term and 12-month follow-up.
- To correlate visual findings with 12-month neurodevelopmental outcomes.
Main Methods:
- Cranial ultrasound (US) classified brain lesion severity (normal, mild, major).
- 145 preterm infants underwent age-specific visual function tests at term, 3, and 12 months.
- Neurodevelopmental assessment using Griffiths' Scales at 12 months.
Main Results:
- Normal neonatal visual assessment strongly predicted normal 12-month visual and developmental outcomes (119/121 normal).
- Abnormal neonatal visual assessment had lower predictive accuracy (12/24 abnormal at 12 months).
- False positive abnormal neonatal assessments normalized by 3 months; major US abnormalities showed varied visual outcomes at 1 year.
Conclusions:
- Normal term-age visual assessment is a reliable predictor of positive visual and neurodevelopmental outcomes at 12 months.
- Abnormal neonatal visual findings necessitate reassessment at 3 months for improved prognostic accuracy.
- Early visual assessment aids in identifying preterm infants needing closer developmental monitoring.
Background:
Several studies have reported the development of various aspects of visual function in infancy and early childhood in both preterm and term-born infants, but only a few studies have focused on the predictive power of neonatal visual findings in infants with brain lesions.
Aims:
To explore visual findings at term age, and at 3 and 12 months corrected age in preterm infants (gestational age <33 weeks) with and without brain lesions; to compare the assessment at term age and at 12 months; and to assess the relationship between visual findings and neurodevelopmental outcome at 12 months.
Study Design:
Cranial ultrasound scans (US) were classified in normal, mild or major abnormalities. One-hundred and forty-five infants were assessed with age specific tests for visual function at term age, and at 3 and 12 months. Neurodevelopmental assessment (Griffiths' Scales) was performed at 12 months.
Results:
A good correlation was found between early and late visual assessment and neurodevelopment outcome. Of the 121 infants with normal neonatal visual assessment, 119 were also normal at 12 months and 116 had normal developmental quotient. Of the 24 infants with abnormal neonatal visual assessment, 12 were also abnormal at 12 months. All the false positives had normalised by 3 months. Of the 35 infants with major US abnormalities, 20 had normal and 15 abnormal scores on the neonatal assessment. At 1 year 17 had normal and 18 abnormal scores.
Conclusion:
A normal visual assessment at term age is a good predictor of normal visual and neurodevelopmental outcome at 12 months. An abnormal visual examination in the neonatal period was a less reliable prognostic indicator, infant should be reassessed at 3 months.
