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How to Obtain Reliable Visual Event-related Potentials in Newborns
Published on: October 24, 2019
Visual evoked potentials and development on children with congenital cataract with surgery after 4 months of age
C Sánchez1, G Romero2, E Ontiveros3
1Departamento de Atención a la Salud, Universidad Autónoma Metropolitana, Unidad Xochimilco, Mexico City, Mexico; Centro de Investigación del Neurodesarrollo, Instituto Nacional de Pediatría, Mexico City, Mexico.
Insights
Congenital cataract (CC) surgery improves visual function and development in children. Visual Evoked Cortical Potentials (VEP) assess recovery, showing extended critical periods for visual development even with late treatment.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Neuroscience
Background:
- Congenital cataract (CC) is a leading cause of childhood blindness, impacting visual development.
- Surgical intervention is crucial but effectiveness varies, especially with delayed diagnosis.
- Visual Evoked Cortical Potentials (VEP) are vital for assessing visual pathway function.
Purpose of the Study:
- To evaluate visual function using VEP in pediatric patients with CC after surgical intervention and lens implantation.
- To assess the impact of surgery on the postoperative neurodevelopment of children with CC.
- To explore the extended critical period for visual recovery in CC cases.
Main Methods:
- Prospective longitudinal study of 53 children with CC.
- Standardized VEP testing to analyze visual pathway responses (N1, P1, N2 waves, P1 amplitude).
- Gesell scales used to evaluate child development post-surgery.
Main Results:
- Most CC patients demonstrated VEP responses post-surgery.
- Children under 12 months showed moderate initial developmental delays that improved postoperatively.
- Greater initial visual impairment correlated with higher postoperative developmental quotients.
Conclusions:
- VEP is a valuable tool for assessing surgical outcomes in CC patients.
- Postoperative developmental delays improved, indicating successful intervention.
- The critical window for visual recovery in CC may be longer than previously thought, suggesting revised surgical criteria, particularly for underserved regions.
Introduction And Objectives:
Congenital cataract (CC) is a pediatric eye condition that causes low vision and blindness. Despite the possible surgical treatment to avoid disability, it produces a fifth of the world's blind children. Visual Evoked Cortical Potentials (VEP) is an essential procedure for clinical practice to evaluate the visual pathway and cortex; however, there are no reports of VEP in CC cases.
Objective:
To explore visual function in CC cases treated by surgical removal and lens implantation older than four months of age and their effect on their postoperative development.
Materials And Methods:
Prospective longitudinal study of 53 CC cases. VEP were done under standard techniques, exploring mono and binocular responses, obtaining waves N1, P1 y N2, and the amplitude of P1. The possible impact on child development was evaluated using Gesell scales.
Results:
All CC cases, except 6 with associated morbidities, had VEP responses. Before 12 months, they had moderate delays but followed the expected ontogenic reductions during postoperative periods. CC cases with more significant initial alteration obtained higher development quotients.
Conclusions:
CC cases had VEP responses and had postoperative reductions according to age. Their preoperative developmental delays improved on postoperative period. VEP is useful for assessing the effect of surgery on child development. Although cases were diagnosed and treated late, considering the positive impact in cases younger than 12 months demonstrated that the recovery critical period window is remarkably more extended than the accepted on academic reports. These findings could modify the surgical criterion for treating CC cases, especially in less developed countries.
