Ophthalmic findings in infants of very low birthweight.

Published on Nov 12, 2008in Developmental Medicine & Child Neurology5.449
路 DOI :10.1111/J.1469-8749.1990.TB08461.X
Neil A. Gibson5
Estimated H-index: 5
,
Alistair R. Fielder41
Estimated H-index: 41
+ 1 AuthorsMalcolm I Levene28
Estimated H-index: 28
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Abstract
SUMMARY The ophthalmic findings in 127 very low-birthweight infants seen at a mean corrected age of 7.6 months (range one to 15 months) are presented and related to their neonatal findings on cerebral ultrasound scanning and eye examinations for retinopathy of prematurity. 19 infants (15 per cent) had significant ophthalmic abnormalities, including reduced visual acuity (11), squints (13), disorders of supranuclear eye-movement (three) and retinal abnormalities (eight). A strong association was found between cystic periventricular leukomalacia and ophthalmic morbidity. RESUME Donnees ophtalmologiques chez les nourrissons de tres faible poids de naissance L'article rapporte les donnees ophtalmologiques recueillies chez 127 nourrissons de tres faible poids de naissance examines a l'芒ge corrige moyen de 7,6 mois (entre un et quinze mois), et reliees aux donees neo-natales de l'echographie cerebrale et des examens de l'oeil pour retinopathie de prematurite. 19 nourrissons (15 pour cent) presentaient des anomalies ophtalmologiques caracteristiques, incluant une baisse de l'acuite visuelle (11), un strabisme (13), des troubles des mouvements oculaires supra-nucleaires (trois) et des anomalies retiniennes (huit). Une forte correlation a ete notee entre la leucomalacie kystique periventriculaire et la morbidite ophtalmologique. ZUSAMMENFASSUNG Ophthalmologische Befunde bei Sauglingen mit sehr niedrigem Geburtsgewicht Es werden die ophthalmologischen Befunde von 127 Sauglingen mit sehr niedrigem Geburtsgewicht, die im korrigierten Alter von 7.6 Monaten (Bereich ein bis 15 Monate) untersucht wurden, vorgestellt und mit den Befunden aus der Neonatalperiode (Ultraschall des Kopfes und Augenuntersuchungen auf Retinopathie des Frugeborenen) verglichen. 19 Sauglinge (15 Prozent) hatten signifikante ophthalmologische Befunde: verminderte Sehscharfe (11), Schielen (13), Storungen der supranuklearen Augenbewegungen (drei) und Veranderungen der Retina (acht). Es fand sich eine starke Beziehung zwischen der cystischen periventrikularen Leukomalazie und Augenerkrankungen. RESUMEN Hallazgos oftalmicos en lactantes con muy bajo peso al nacer Se presentan los hallazgos oftalmologicos en 127 lactantes con muy bajo peso al nacer, vistos a una edad corregida media de 7.6 meses (promedio 15 meses) y se retacionan con hallazgos neonatales obtenidos con ultrasonidos y examen ocular en busca de retinopatia por prematuridad. 19 ninos (15 por ciento) tenian anomalias oftalmicas significativas, incluyendo una reduccion en la agudeza visual (11), estrabismos (13), alteraciones en los movimientos oculares supranucleares (tres) y anomalias retinianas (ocho). Se hallo una fuerte asociacion entre la leucomalacia periventricular quistica y la morbilidad of talmica.
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References15
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UMMARY Cysts in the periventricular region of the brain were demonstrated by ultrasound in eight of 102 preterm infants (birthweight <1501g or <34 weeks gestation) during a 14-month period. All eight babies survived, but developed serious neurological problems: five had spastic quadriplegia and three had spastic diplegia. Six had impaired vision and six had delayed speech development, but there was no evidence of impaired hearing. The cysts probably represent the infarcted lesions of periventric...
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#1Mark S. ScherH-Index: 50
#2V. Dobson (University of Pittsburgh)H-Index: 14
Last. Robert D. GuthrieH-Index: 27
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SUMMARY Visual acuity, visual fields and neurological status were assessed in 10 infants with periventricular leukomalacia (PVL), tested at 16, 36, 48 and 72 weeks from the expected date of confinement. Monocular acuity development was normal in eight of the 10 infants, but was below normal in one infant at eight months and in another at 18 months. Over half the infants tested at 16, 36 and 48 weeks had smaller visual fields than those of 95 per cent of healthy preterm infants tested at the same...
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#1Margaret Graham (Nottingham City Hospital)H-Index: 2
#2J.Q. Trounce (Nottingham City Hospital)H-Index: 1
Last. N. Rutter (Nottingham City Hospital)H-Index: 1
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Abstract The value of regular cerebral ultrasound scanning in predicting cerebral palsy (CP) was assessed in very low birthweight infants. The infants were scanned before discharge, and their vision and hearing were assessed at age 9 months and neurodevelopment was assessed at 18 months. Ultrasound abnormalities, defined before the study, were periventricular haemorrhage (PVH), "prolonged flare" (echodensity persisting in the periventricular white-matter for more than 2 weeks without cavitating)...
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#1L S de VriesH-Index: 38
#2J. ConnellH-Index: 6
Last. J. M. PennockH-Index: 21
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: Twenty infants, diagnosed by cranial ultrasound as having extensive cystic leukomalacia, had visual evoked responses (VER) and electroencephalograms (EEG) in the neonatal period and MRI scans later in infancy. The early ultrasound findings and results from the electrophysiological tests were correlated with later MRI findings and functional abilities. In infants with periventricular leukomalacia (PVL), the cysts were usually no longer visible by ultrasonography, beyond 40 weeks postmenstrual a...
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Eight children with retinopathy of prematurity (ROP) in whom the corneal diameters were abnormally small in one or both eyes are reported. The mechanisms for microcornea in ROP are discussed. The differential diagnosis of microphthalmos is briefly considered.
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#1J Q TrounceH-Index: 2
#2N RutterH-Index: 2
Last. M I LeveneH-Index: 2
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Two hundred very low birthweight infants were prospectively scanned to ascertain the incidence of periventricular leucomalacia (PVL) and haemorrhage. Before collection of data, clear definitions of ultrasound abnormalities believed to represent PVL and intraventricular haemorrhage were described. These referred to small and moderate intraventricular haemorrhage, paenchymal haemorrhage, and PVL, including prolonged flare (echoes in the periventricular region lasting for two weeks or more and not ...
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#1Lilly Dubowitz (Hammersmith Hospital)H-Index: 49
#2L.S. de Vries (Hammersmith Hospital)H-Index: 47
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Abstract Reasonably normal visual behaviour was observed in premature infants in the neonatal period up to about 48 weeks' postmenstrual age even when there was gross destruction of the cortex in the occipital region. Symmetrical visual evoked responses could be elicited at this time even when asymmetrical lesions of the occipital cortex had been demonstrated on ultrasound scan; the visual evoked response became asymmetrical later, around the age of 2 months. A visual evoked response, albeit of ...
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#1S. A. CalvertH-Index: 2
#2E. M. HoskinsH-Index: 2
Last. S. C. ForsythH-Index: 2
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: The ultrasonographic findings and neurological development of 15 preterm infants, born between August 1981 and July 1984, who developed periventricular leukomalacia (P.V.L.) are described. The incidence of P.V.L. in infants with a birth weight less than 1 500 g was 2.3%. Nine of the 15 infants demonstrated areas of increased echogenicity in the periventricular regions prior to the development of cystic changes. The mean age for the appearance of cysts was 26 days. At follow-up 14 infants showe...
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: Forced-choice preferential looking (FPL) and operant preferential looking (OPL) procedures for testing infant acuity typically require 15-45 min to derive an acuity estimate. This article presents a new acuity assessment technique ("acuity cards") that combines FPL/OPL stimuli with an observer's subjective assessment of an infant's looking behavior. The infant is shown a series of gray cards that contain grating targets of various spatial frequencies. An observer watches the eye movement patte...
: Fifty-three infants with delayed visual maturation (DVM) are presented. These have been classified according to their ocular and systemic features into three groups: DVM as an isolated anomaly, in association with mental retardation, and ocular abnormalities accompanied by DVM. The clinical features are discussed, particularly regarding the time and speed of visual improvement in the three groups. Infants with DVM who experienced difficulties in the perinatal period have an increased risk of d...
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Purpose To compare visual dysfunction between very preterm-born (VPB) children with no retinopathy of prematurity (no-ROP) at 6鈥10 years of age and age- and sex-matched full-term-born controls.
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#1Katherine McDonnell (University of Wolverhampton)
#2Anna R. O'Connor (University of Liverpool)H-Index: 18
Aim: Periventricular leukomalacia (PVL) is a type of cerebral white matter damage commonly arising within neonates born prematurely. This review aims to evaluate the literature relating to the long-term ophthalmic outcomes following PVL, focussing on the relationship between neuro-imaging and visual out- come. Methods: A literature review was undertaken between October 2013 and January 2015. Articles were sourced using PubMed, ResearchGate and forward citation searches. Results: PVL is shown to ...
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#1Kyung Tae Kim (CBNU: Chungbuk National University)H-Index: 4
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Purpose: We intended to investigate the clinical features and success rates of surgery in premature children with exotropia. Methods: Twenty-two exotropia children with a gestational age of less than 37 weeks, or a birth weight of less than 2,000 g were included. The children had also been clinically observed for at least six months after surgery for exotropia. This study analyzed the results of their surgery in terms of gestational age, birth weight, ages at the first examination, and surgery, ...
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Cerebral visual impairment (CVI) is the commonest cause of impaired vision in childhood. Prematurely born children are at significant risk of damage to the brain with outcomes including cerebral palsy and low IQ. This study presents the results of an investigation of multiple aspects of visual function in a cohort of 46 prematurely born children (<37 weeks) aged 5.5 years -12.3 years and attending mainstream education, compared with an age-matched cohort of 130 term-born children. Fifteen of the...
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Long-term visual outcomes of laser-treated threshold retinopathy of prematurity: a study of refractive status at 7 years
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#1Murat 脰zdemir (Kahramanmara艧 S眉t莽眉 陌mam University)H-Index: 9
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Purpose To investigate ocular growth and morbidity in both preschool and school-aged children born prematurely without retinopathy of prematurity (ROP).
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#1Hans C. Fledelius (UCPH: University of Copenhagen)H-Index: 29
Refractive findings are reported in a follow-up study comprising 88 children aged 7鈥10 years, who were submitted to regular control for retinopathy of prematurity (ROP) in the first months after their pre-term delivery 1982-84 (mean birthweight 1467 g, mean gestational age 31 weeks). The refractive range was -13 to +6.75 D. In four subjects with fully-blown ROP both eyes were left blind and dysmorphic. Twenty-four had had ROP with regression; myopia of prematurity (MOP) appeared in six (25%). At...
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#1Lena JacobsonH-Index: 22
#2Ulla Ek (Stockholm University)H-Index: 18
Last. U BrobergerH-Index: 3
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SUMMARY Thirteen preterm children, aged 4 to 14 years, with visual impairment due to periventricular leukomalacia (PVL) were evaluated for visual function, intellectual level, cognitive profile and motor function. Their visual impairment was characterized by low acuity, crowding, visual field defects and ocular motility disturbances. Their cognitive profile was uneven, often with considerably higher scores on verbal than on visual-spatial tasks. Nine children had normal intelligence, three had m...
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SUMMARY A prospective follow-up study was conducted of a cohort of 65 at-risk neonates to assess the predictive value of neonatal cranial ultrasound abnormalities for cerebral visual impairment in infancy. Visual function was assessed using the acuity card procedure and behavioural visual responses were tested. Normal visual function was found in controls as well as in infants with small haemorrhages or mild leukomalacia. Infants with large haemorrhages performed poorly at 40 weeks postmenstrual...
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#1P. Eken (Boston Children's Hospital)H-Index: 17
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SUMMARY The relationship between the degree of cerebral visual impairment, established using the acuity card procedure, and the extent of neurological sequelae was assessed in 65 at-risk neonates in a prospective follow-up study. MRI and CT scans were performed in all infants with severe neurological sequelae. 11 of 12 children with an acuity at or below the 10th centile at 18 months developed cerebral palsy: the underlying condition was extensive cystic leukomalacia in all. An acuity above the ...
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