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Development of the optic radiations and visual function after premature birth
Michela Groppo1, Daniela Ricci2, Laura Bassi1
1Centre for the Developing Brain, Imperial College, London, United Kingdom; NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milano, Italy.
Insights
Visual impairment in preterm infants is linked to optic radiation development. Abnormalities in fractional anisotropy (FA) during the late preterm period impact visual function, suggesting interventions after 30 weeks may help.
Area of Science:
- Neuroscience
- Developmental Biology
- Medical Imaging
Background:
- Preterm infants often show visual impairment linked to optic radiation microstructural development.
- Reduced fractional anisotropy (FA) measured by Diffusion Tensor Imaging (DTI) at term equivalent age (TEA) indicates impaired development.
Purpose of the Study:
- To test the hypothesis that optic radiation microstructural abnormalities develop during the late preterm period.
- To investigate the relationship between fractional anisotropy (FA) and visual function in preterm infants.
Main Methods:
- Diffusion Tensor Imaging (DTI) was performed on 53 preterm infants.
- Infants were scanned at a median post-menstrual age (PMA) of 30 weeks, with 22 infants scanned twice.
Main Results:
- FA in the optic radiation at TEA correlated with visual function, PMA at birth, and PMA at scan.
- FA increased significantly between scans in infants studied longitudinally (32 to 40 weeks PMA).
- Visual function was predicted by the rate of FA increase and FA at later scans, not early neonatal scans.
Conclusions:
- Microstructural maturation of the optic radiation during the late preterm period is crucial for normal visual function.
- Interventions initiated after 30 weeks post-menstrual age may mitigate visual impairment in preterm infants.
Introduction:
Visual impairment in preterm infants at term equivalent age (TEA) is associated with impaired microstructural development in the optic radiation, measured as reduced fractional anisotropy (FA) by Diffusion Tensor Imaging (DTI). We tested the hypothesis that these abnormalities develop during the late preterm period.
Methods:
DTI was performed in 53 infants born at a median (range) of 30(+1) (25(+4)-34(+6)) weeks post-menstrual age (PMA), 22 of whom were imaged twice.
Results:
FA in the optic radiation at TEA was related to: visual function (p = .003); PMA at birth (p = .015); and PMA at scan (p = .008); while a significant interaction between PMA at birth and scan (p = .019) revealed an effect of the period of premature extra-uterine life additional to the degree of prematurity. We explored this further in a sub-group of 22 infants who were studied twice. FA increased from mean (95% CI) .174 (.164-.176) on the first image at 32(+5) (29(+5)-36) weeks PMA, to .198 (.190-.206) on the second image at 40(+6) (39(+2)-46) weeks PMA. Visual function was not predicted by FA on the images obtained in the early neonatal period, but was significantly related to the rate of increase in FA between scans (p = .027) and to FA on the second image (p = .015).
Conclusion:
Microstructural maturation during the late preterm period is thus required for normal visual function, suggesting that interventions applied after 30 weeks PMA might reduce impairment in preterm infants.
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