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Delayed visual maturation. A longitudinal clinical and electrophysiological assessment
S R Lambert1, A Kriss, D Taylor
1Department of Ophthalmology, Hospital for Sick Children, London, England.
Insights
Delayed visual maturation in infants is often temporary, with most showing normal visual evoked potentials (VEPs) and electroretinograms (ERGs). Most infants eventually developed visually mediated behavior, suggesting VEPs aid in prognosis.
Area of Science:
- Ophthalmology
- Neuroscience
- Developmental Pediatrics
Background:
- Delayed visual maturation (DVM) is an idiopathic condition presenting as visual inattention in infants.
- Early diagnosis and prognosis are crucial for appropriate intervention.
Purpose of the Study:
- To evaluate the diagnostic and prognostic value of electroretinograms (ERGs) and visual evoked potentials (VEPs) in infants with DVM.
- To characterize the neurophysiological and developmental trajectory of infants diagnosed with DVM.
Main Methods:
- Longitudinal follow-up of nine infants with an initial DVM diagnosis.
- Comparison of ERGs and VEPs (flash and pattern stimulation) with age-matched controls.
- Assessment of visually mediated behavior development and other developmental spheres.
Main Results:
- Eight of nine patients exhibited normal VEPs to both flash and pattern stimulation.
- All infants demonstrated normal ERGs.
- Visually mediated behavior normalized between 3 and 8 months of age in all children (mean 5.5 months).
- Five patients experienced delays in other developmental areas.
Conclusions:
- Normal ERGs and VEPs are characteristic findings in infants with DVM.
- VEPs are valuable tools for establishing a visual prognosis in DVM.
- DVM can be a transient condition, but associated developmental delays may persist.
Abstract:
Delayed visual maturation is an idiopathic condition characterized by visual inattention during infancy. The authors followed longitudinally nine children with an initial diagnosis of delayed visual maturation and compared their electroretinograms (ERGs) and visual evoked potentials with those of age-matched controls. Eight of the nine patients consistently had normal visual evoked potentials to flash and to pattern stimulation. All of the children had normal ERGs. Visually mediated behavior gradually developed in all of these children when they were between 3 and 8 months of age (mean, 5.5 months). Five patients also were delayed in other spheres of development. Visual evoked potentials are helpful in formulating a visual prognosis for children with delayed visual maturation.