Related Experiment Videos
Patterns of visual impairment associated with lesions of the preterm infant brain
M G Pike1, G Holmstrom, L S de Vries
1Hospital for Sick Children, Headington, Oxford, UK.
Insights
Preterm cerebral insults in infants can cause various visual problems. Neonatal imaging does not reliably predict the type or severity of visual deficits, necessitating individual assessments.
Area of Science:
- Neonatal neurology
- Pediatric ophthalmology
- Neuroimaging
Background:
- Cerebral lesions in preterm infants can impact neurodevelopment.
- Visual function is a critical aspect of development that may be affected by early brain injury.
Purpose of the Study:
- To examine visual function in children with preterm cerebral lesions.
- To correlate visual function with neonatal cranial ultrasound and follow-up MRI and neurodevelopmental status.
Main Methods:
- Evaluated visual function in 42 children with cerebral lesions acquired before 35 weeks gestational age.
- Correlated findings with neonatal cranial ultrasound, follow-up MRI, and neurodevelopmental assessments.
Main Results:
- 37/37 children with abnormal neonatal ultrasound scans showed visual impairment.
- 1/5 children with normal neonatal ultrasound scans also had visual deficits.
- MRI evidence of visual pathway damage correlated with impaired acuity but was not always present.
- Normal visual acuity did not rule out other visual functional deficits.
Conclusions:
- Preterm cerebral insults can lead to diverse visual difficulties.
- Neonatal imaging (ultrasound, MRI) cannot predict the pattern or severity of visual dysfunction.
- Individualized, comprehensive assessment of multiple visual functions is essential for affected children.
Abstract:
The visual function of 42 children with haemorrhagic and/or ischaemic cerebral lesions acquired before a gestational age of 35 weeks was examined and related to cranial ultrasound in the neonatal period and to MRI and neurodevelopmental status at follow-up. All 37 children with abnormal ultrasound scans and one of the five with normal ultrasound scans showed impairment of one or more aspects of visual function. While impaired acuity was more frequent among infants with MRI evidence of visual pathway damage, this was not an invariable finding. Normal or near-normal visual acuity did not preclude the presence of other functional visual deficits. The authors conclude that preterm cerebral insults may produce a variety of visual difficulties, the pattern and severity of which cannot be predicted on imaging. Each child therefore requires individual assessment of multiple aspects of visual function.