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Microstructure changes of occipital white matter are responsible for visual problems in the 3-4-year-old very low
Anna Lesniak1, Izabela Herman-Sucharska2, Małgorzata Klimek3
1Department of Ophthalmology and Ocular Oncology, Jagiellonian University Medical College, Kopernika 25, Cracow, Poland.
Insights
Preterm children with visual pathway abnormalities show lower fractional anisotropy (FA) in occipital white matter. These microstructural changes correlate with visual perception and visual evoked potentials (VEPs), highlighting risks for long-term visual function.
Area of Science:
- Neuroscience
- Ophthalmology
- Developmental Pediatrics
Background:
- Preterm birth is associated with an increased risk of visual impairments.
- Retinopathy of prematurity and visual pathway disturbances are known complications.
- Long-term visual function in preterm children requires further investigation into underlying factors.
Purpose of the Study:
- To identify factors influencing long-term visual function in preterm children.
- To determine the roles of prematurity, retinopathy of prematurity, and visual pathway disturbances.
- To correlate neuroimaging and electrophysiological findings with visual perception.
Main Methods:
- Fifty-eight preterm children (mean birth weight 1016g) were assessed at 48 months.
- Magnetic resonance imaging (MRI) including diffusion tensor imaging (DTI) and fractional anisotropy (FA) was performed.
- Visual evoked potentials (VEPs) and the Developmental Test of Visual Perception (DTVP) were administered.
Main Results:
- Children with abnormal VEPs exhibited lower FA values in the inferior occipital white matter (OWM).
- FA in OWM correlated with VEP latency and amplitude.
- Abnormal VEP group showed lower DTVP scores compared to controls.
- Lower FA of the inferior OWM was identified as an independent risk factor for abnormal VEPs.
Conclusions:
- Significant correlations exist between visual perception, VEPs, and white matter microstructural abnormalities in very low birth weight children.
- FA of the inferior OWM is a key indicator of visual pathway integrity in preterm infants.
- These findings underscore the importance of early neuroimaging and functional assessments for preterm infants.
Purpose:
The main aim of the study was to evaluate which factors affect the long-time visual function in preterm children, whether it is prematurity or retinopathy of prematurity or perhaps disturbances in the visual pathway.
Materials And Methods:
Fifty-eight children with mean birth weight 1016 g (range 520-1500 g) were evaluated at mean age 48 months (range 42-54 months). All children underwent magnetic resonance imaging (MRI) studies, visual evoked potentials (VEPs), and the Developmental Test of Visual Perception (DTVP). The MRI evaluation included diffusion tensor imaging and fractional anisotropy (FA), and colored orientation maps were calculated for each subject. Based on the results of the VEP evaluation, children were divided into two groups: A-abnormal results of VEP (n = 16) and B-normal VEP results (comparison group, n = 42).
Results:
FA values of inferior left and right occipital white matter (OWM) were lower in the group of children with abnormal VEP compared to the comparison group (0.34 ± 0.06 vs. 0.38 ± 0.06; P = 0.047; 0.31 ± 0.04 vs. 0.36 ± 0.06; P = 0.007, respectively). Furthermore, there were correlations between the latency (r = -0.35; P = 0.01) and amplitude (r = 0.31; P = 0.02) and FA in OWM. Children with abnormal VEP had lower DTVP scores as compared with children with normal VEP results (88 ± 18 vs. 95 ± 16 points, P = 0.048). Finally, a multivariate logistic regression revealed that FA of the inferior OWM was the only independent risk factor for the abnormal VEP (P = 0.04).
Conclusion:
Visual perception, VEPs, and white matter microstructural abnormalities in very low birth weight children at the age of 3-4 are significantly correlated.
