Developmental trajectories of visual orienting functions in children born very or extremely preterm

Preterm birth increases the risk of neurodevelopmental impairments, such as Cerebral Visual Impairment (CVI), which affects visual processing. Assessing visual functions in young children is challenging with traditional methods that often rely on verbal/motor responses. The aim of the study was to investigate the developmental trajectories of Visual Orienting Functions (VOF) in children born very preterm (<32 weeks gestational age) between 2 and 5 years corrected age (CA) using eye tracking.

263 children born preterm underwent eye tracking at 2, 3 and 5 years CA. A subgroup of 49 children underwent all three measurements. Magnetic resonance imaging (MRI) was performed shortly after birth and evaluated for brain damage using a modified Kidokoro scoring protocol. The VOF results to high (cartoon and contrast) and intermediate (form and motion detection) salient visual stimuli of the preterm group were compared to those of term-born age-matched peers.

Approximately 40 % of children born preterm showed normal VOF development to high and intermediate salient stimuli. However, in another 40 % of children born preterm, an increase in delayed visual processing to high-salient stimuli was found at 5 years CA. No significant correlation was found between brain damage on MRI shortly after birth and abnormal VOF at 5 years CA.

The data suggest that routine visual screening using high-salient stimuli can identify VOF delays from 2 years CA onwards in children at risk of brain damage. Early detection of visual processing deficits can enable timely interventions and specialized care for pre-schoolers.