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Brain MRI findings and their association with visual impairment in young adolescents born very preterm
Annette Karimi1,2, Sirkku Setänen3,4, Eva Larsson5
1Department of Surgical Sciences, Neuroradiology, Uppsala University, Uppsala, Sweden. annette.geeb.karimi@akademiska.se.
Insights
Children born very preterm show more white matter lesions and lower white matter volume at age 12. These brain differences are linked to poorer visual acuity and contrast sensitivity, impacting the posterior visual pathway.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Ophthalmology
Background:
- Very preterm birth (VPT) is a known risk factor for neonatal white matter injury.
- Long-term impacts of VPT on brain structure and visual outcomes into adolescence are not well understood.
Purpose of the Study:
- To assess brain MRI findings in 12-year-old children born very preterm compared to controls.
- To investigate the association between these brain findings and ophthalmological outcomes.
Main Methods:
- A cohort of 47 very preterm children (gestational age <32 weeks) and 22 full-term controls (>37 weeks) were evaluated at 12 years.
- Brain MRI and ophthalmological assessments (visual acuity, contrast sensitivity) were performed.
Main Results:
- Very preterm children exhibited increased Evans index and posterior ventricle index on MRI.
- Focal white matter lesions were more prevalent in the very preterm group (32% vs 5%).
- Larger posterior ventricle index and reduced peritrigonal white matter thickness correlated with impaired visual acuity and contrast sensitivity.
Conclusions:
- Children born very preterm have persistent white matter abnormalities at 12 years.
- These structural brain differences are associated with visual pathway disturbances and reduced visual function.
Purpose:
Very preterm birth increases risk for neonatal white matter injury, but there is limited data on to what extent this persists into adolescence and how this relates to ophthalmological outcomes. The aim of this study was to assess brain MRI findings in 12-year-old children born very preterm compared to controls and their association with concurrent ophthalmological outcomes.
Methods:
We included 47 children born very preterm and 22 full-term controls (gestational age <32 and >37 weeks, respectively). Brain MRI findings were studied in association with concurrent ophthalmological outcomes at 12-year follow-up.
Results:
Evans index (0.27 vs 0.25, p<0.001) and a proposed "posterior ventricle index" (0.47 vs 0.45, p=0.018) were increased in children born very preterm. Higher gestational age associated with larger corpus callosum area (β=10.7, 95%CI 0.59-20.8). Focal white matter lesions were observed in 15 (32%) of very preterm children and in 1 (5%) of full-term controls. Increased posterior ventricle index increased risk for visual acuity ≤1.0 (OR=1.07×1011, 95%CI=7.78-1.48×1021) and contrast sensitivity <0.5 (OR=2.6×1027, 95%CI=1.9×108-3.5×1046). Decreased peritrigonal white matter thickness associated with impaired visual acuity (β=0.04, 95%CI 0.002-0.07).
Conclusion:
More white matter lesions and evidence of lower white matter volume were found in children born very preterm compared with full-term controls at 12-year follow-up. The association between larger posterior ventricle index and reduced visual acuity and contrast sensitivity suggests disturbances of the posterior visual pathway due to diffuse white matter lesions.
