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Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats
Published on: November 20, 2015
Neuro-ophthalmic manifestations of prematurity
Preeti Patil Chhablani1, Ramesh Kekunnaya
1Department of Pediatric Ophthalmology and Neuro-ophthalmology, Jasti V Ramanamma Children's Eye Care Center, L. V. Prasad Eye Institute, KAR Campus, Banjara Hills, Hyderabad, India.
Insights
Premature infants face increased risks of vision loss from conditions like retinopathy of prematurity and cortical visual impairment (CVI). Early diagnosis and rehabilitation are crucial for managing these complex visual challenges.
Area of Science:
- Ophthalmology
- Neonatology
- Developmental Pediatrics
Background:
- Rising preterm birth rates and improved survival increase the incidence of prematurity-related complications.
- Infants born preterm are susceptible to visual impairments beyond retinopathy of prematurity, including those from hypoxic ischemic encephalopathy and metabolic issues.
Purpose of the Study:
- To review the spectrum of ocular and visual pathway complications in preterm infants.
- To highlight the challenges in evaluating and managing visual deficits in this population.
- To emphasize the importance of early diagnosis and intervention.
Main Methods:
- Review of current literature on visual complications in preterm infants.
- Discussion of anterior and posterior visual pathway involvement.
- Analysis of associated ocular motor and functional vision deficits.
Main Results:
- Prematurity can lead to optic atrophy, optic nerve hypoplasia, and cortical visual impairment (CVI).
- Ocular associations include strabismus, nystagmus, and abnormal ocular motor function.
- CVI presents with visual field defects, photophobia, processing, and color vision deficits.
Conclusions:
- Visual impairment in preterm infants is multifactorial, affecting both anterior and posterior visual pathways.
- Management is complex due to co-existing systemic disabilities.
- Early diagnosis and rehabilitation therapy are vital for improving outcomes in children with visual impairment due to prematurity.
Abstract:
Increasing rates of preterm births coupled with better survival of these infants have resulted in higher prevalence of systemic and ocular complications associated with prematurity. In addition to retinopathy of prematurity, infants who are born preterm may suffer from severe visual impairment as a result of hypoxic ischemic encephalopathy, hypoglycemia, and other metabolic imbalances. The effect of these processes on the anterior visual pathway may result in optic atrophy, optic nerve hypoplasia or optic disc cupping and affection of the posterior visual pathway leads to cortical visual impairment (CVI). Other ocular associations include strabismus, nystagmus, and ocular motor abnormalities such as tonic down gaze and defective saccades and pursuits. Cortical and subcortical involvement also manifests as defects in functional vision and these have not yet been completely understood. Children with CVI may have visual field defects, photophobia, defective visual processing, and deficient color vision. Since most of these children also suffer from additional systemic disabilities, evaluation, and management remains a challenge. However, early diagnosis and initiation of rehabilitation therapy can prove to be of significant benefit in these children.
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