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Visual outcome at 5 years of newborn infants at risk of cerebral visual impairment
J van Hof-van Duin1, G Cioni, B Bertuccelli
1Faculty of Human Movement Sciences, Free University, Amsterdam, The Netherlands.
Insights
Children with neonatal encephalopathy or perinatal brain lesions often experience visual disorders. Early visual acuity and neuroimaging can predict visual outcomes and correlate with motor and cognitive impairments.
Area of Science:
- Pediatric Neurology
- Developmental Neuroscience
- Ophthalmology
Background:
- Neonatal encephalopathy and perinatal brain lesions can impact long-term neurodevelopment.
- Visual development is a critical component of early childhood development.
- Identifying early indicators of visual impairment is crucial for timely intervention.
Purpose of the Study:
- To assess visual development at 5 years in children with documented neonatal encephalopathy or perinatal brain lesions.
- To determine the correlation between early visual assessments, neuroimaging findings, and later visual function.
- To investigate the relationship between visual, motor, and cognitive development in this cohort.
Main Methods:
- Evaluated 39 children with a history of severe neonatal encephalopathy or perinatal brain lesions.
- Assessed grating acuity in infancy (1-2 years) and comprehensive visual functions at 5 years.
- Utilized neuroimaging (cranial ultrasound, MRI) and neurological/cognitive assessments.
Main Results:
- The majority of children exhibited visual disorders unrelated to ophthalmological issues.
- Early grating acuity (1-2 years) predicted visual outcome in 27/39 children.
- Neonatal cranial ultrasound (26/32) and later MRI (23/27) also showed predictive value for visual outcomes.
- Significant correlations were observed between visual, motor, and cognitive impairments.
Conclusions:
- Children with perinatal brain injuries frequently develop visual impairments.
- Early visual acuity testing and neuroimaging are valuable tools for predicting visual outcomes.
- Visual deficits are associated with broader neurological and cognitive challenges in affected children.
Abstract:
Visual development at 5 years of age was tested in a group of 39 children who had shown severe neonatal encephalopathy or perinatal brain lesions, documented by medical history, cranial ultrasound, or MRI. In all children, grating acuity was tested during the first 2 years of life. The assessment protocol at 5 years included various visual functions (grating and resolution acuity, visual field size, depth perception, optokinetic nystagmus, and ocular motility), and neurological and cognitive development. The majority of the children showed visual disorders of different type and degree, which were not due to ophthalmological abnormalities. Visual defects correlated well with the results of early visual assessment and of neuroimaging. Visual outcome could be predicted by grating acuity at 1 to 2 years in 27 of the 39 children, by neonatal cranial ultrasound in 26 of the 32 cases examined by this technique, and by later MRI in 23 out of 27. Moreover, a significant correlation was found between visual, motor, and cognitive impairment.