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Updated: Aug 15, 2026
Mouse Models of Periventricular Leukomalacia
Published on: May 19, 2010
Cerebral visual impairment in preterm infants with periventricular leukomalacia
G Cioni1, B Fazzi, M Coluccini
1Stella Maris Scientific Institute, University of Pisa, Italy.
Insights
Neonatal brain lesions, specifically periventricular leukomalacia (PVL), significantly impact infant vision. Severe PVL correlates with high rates of cerebral visual impairment, affecting visual acuity and eye movement.
Area of Science:
- Neuroscience
- Ophthalmology
- Pediatrics
Background:
- Neonatal brain lesions are a primary cause of cerebral visual impairment (CVI) in infants.
- Periventricular leukomalacia (PVL) is a common neonatal brain injury affecting preterm infants.
- Understanding the visual outcomes in infants with PVL is crucial for early intervention.
Purpose of the Study:
- To investigate the visual outcome of preterm infants with varying degrees of periventricular leukomalacia (PVL).
- To correlate neuroimaging findings with visual deficits in infants with PVL.
- To establish the need for visual follow-up in infants diagnosed with PVL.
Main Methods:
- Study included 14 infants with severe cystic PVL, 34 with moderate PVL, and 18 controls.
- Exclusion criteria: significant ocular abnormalities (e.g., retinopathy of prematurity, optic nerve atrophy).
- Visual assessments (acuity, field, eye alignment, fixation, following, optokinetic nystagmus, visual threat) conducted at 1 year corrected age.
- Neuroimaging, particularly MRI, was used to assess brain lesions.
Main Results:
- High incidence of CVI (low visual acuity, oculomotor disorders, reduced visual field) in severe PVL group.
- Less frequent and severe visual defects observed in the moderate PVL group.
- Visual defects were rare in the control group.
- Neuroimaging, especially MRI, correlated with visual outcomes, identifying optic radiation lesions as the main substrate of CVI.
Conclusions:
- Severe PVL is strongly associated with significant cerebral visual impairment in preterm infants.
- Visual defects are less pronounced but present in moderate PVL cases.
- All infants with PVL require consistent visual follow-up for optimal visual and motor rehabilitation and daily care.
Abstract:
Neonatal brain lesions are the main cause of cerebral visual impairment in infancy, i.e., of a visual deficit caused by damage to posterior visual pathways. Visual outcome of preterm infants with periventricular leukomalacia (PVL) was investigated in 14 subjects affected by severe cystic PVL, another 34 with moderate PVL (prolonged periventricular echodensities), and 18 control preterm infants. All cases with significant ocular abnormalities (such as retinopathy of prematurity state III or upwards, optic nerve atrophy, or major refraction problems) were excluded. Visual acuity, visual field, eye alignment, fixation and following, optokinetic nystagmus, and visual threat were tested at 1 year of corrected age. A high incidence of cerebral visual impairment, consisting mainly of low visual acuity, severe oculomotor disorders, and reduced visual field, was found in infants with severe PVL. Visual defects were less frequent and less severe in the moderate PVL group, and very rare in the control group. The results of neuroimaging, and especially of magnetic resonance imaging, correlated with the visual outcome and indicate lesions at the level of optic radiations as the main anatomic substrate of the visual impairment. All infants with PVL need a visual follow-up, from the first months of life, the results of which are important both for visual and motor rehabilitation of these cases and for their daily care.
