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Archives of Disease in Childhood. Fetal and Neonatal Edition logoLink to Archives of Disease in Childhood. Fetal and Neonatal Edition
. 1999 Mar;80(2):F99–F104. doi: 10.1136/fn.80.2.f99

Visual function in term infants with hypoxic-ischaemic insults: correlation with neurodevelopment at 2 years of age

E Mercuri, L Haataja, A Guzzetta, S Anker, F Cowan, M Rutherford, R Andrew, O Braddick, G Cioni, L Dubowitz, J Atkinson
PMCID: PMC1720900  PMID: 10325784

Abstract

AIMS—To determine if there is any association between the findings of visual assessment performed at the age of 5 months and neurodevelopmental outcome at the age of 2 years in children who have sustained hypoxic-ischaemic insults.
METHODS—Twenty nine term infants with hypoxic-ischaemic encephalopathy and/or brain lesions on neonatal magnetic resonance imaging (MRI) were prospectively evaluated. At 5 months of age all the infants had their visual function assessed using the Atkinson Battery of Child Development for Examining Functional Vision, which includes the assessments of optokinetic nystagmus (OKN), acuity, visual fields, fixation shift and phase and orientation reversal visual evoked potentials. At 2 years of age the children had a structured neurological evaluation and a Griffiths developmental assessment.
RESULTS—There was good correlation between the extent of the early detected visual impairment and both neuromotor and global development. Children with more than three out of five abnormal visual tests at 5 months of age tended to have abnormal neurological examination results and abnormal developmental quotients. Children with three or fewer abnormalities tended to have developmental quotients in the normal range; the level of their performance, however, was still related to the number of visual tests passed.
CONCLUSIONS—Individual visual tests can provide important prognostic information. While abnormal OKN and acuity were always associated with abnormal outcome, normal results on visual evoked potentials and fixation shift tended to be associated with normal outcome.



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Selected References

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  1. Atkinson J. Human visual development over the first 6 months of life. A review and a hypothesis. Hum Neurobiol. 1984;3(2):61–74. [PubMed] [Google Scholar]
  2. Cioni G., Fazzi B., Ipata A. E., Canapicchi R., van Hof-van Duin J. Correlation between cerebral visual impairment and magnetic resonance imaging in children with neonatal encephalopathy. Dev Med Child Neurol. 1996 Feb;38(2):120–132. doi: 10.1111/j.1469-8749.1996.tb12083.x. [DOI] [PubMed] [Google Scholar]
  3. Eken P., de Vries L. S., van der Graaf Y., Meiners L. C., van Nieuwenhuizen O. Haemorrhagic-ischaemic lesions of the neonatal brain: correlation between cerebral visual impairment, neurodevelopmental outcome and MRI in infancy. Dev Med Child Neurol. 1995 Jan;37(1):41–55. doi: 10.1111/j.1469-8749.1995.tb11931.x. [DOI] [PubMed] [Google Scholar]
  4. Eken P., van Nieuwenhuizen O., van der Graaf Y., Schalij-Delfos N. E., de Vries L. S. Relation between neonatal cranial ultrasound abnormalities and cerebral visual impairment in infancy. Dev Med Child Neurol. 1994 Jan;36(1):3–15. doi: 10.1111/j.1469-8749.1994.tb11760.x. [DOI] [PubMed] [Google Scholar]
  5. Gambi D., Rossini P. M., Albertini G., Sollazzo D., Torrioli M. G., Polidori G. C. Follow-up of visual evoked potential in full-term and pre-term control newborns and in subjects who suffered from perinatal respiratory distress. Electroencephalogr Clin Neurophysiol. 1980 May;48(5):509–516. doi: 10.1016/0013-4694(80)90286-2. [DOI] [PubMed] [Google Scholar]
  6. Hertz B. G., Rosenberg J., Sjö O., Warburg M. Acuity card testing of patients with cerebral visual impairment. Dev Med Child Neurol. 1988 Oct;30(5):632–637. doi: 10.1111/j.1469-8749.1988.tb04801.x. [DOI] [PubMed] [Google Scholar]
  7. Häkkinen V. K., Ignatius J., Koskinen M., Koivikko M. J., Ikonen R. S., Janas M. Visual evoked potentials in high-risk infants. Neuropediatrics. 1987 May;18(2):70–74. doi: 10.1055/s-2008-1052455. [DOI] [PubMed] [Google Scholar]
  8. Ipata A. E., Cioni G., Bottai P., Fazzi B., Canapicchi R., Van Hof-Van Duin J. Acuity card testing in children with cerebral palsy related to magnetic resonance images, mental levels and motor abilities. Brain Dev. 1994 May-Jun;16(3):195–203. doi: 10.1016/0387-7604(94)90069-8. [DOI] [PubMed] [Google Scholar]
  9. Lambert S. R., Hoyt C. S., Jan J. E., Barkovich J., Flodmark O. Visual recovery from hypoxic cortical blindness during childhood. Computed tomographic and magnetic resonance imaging predictors. Arch Ophthalmol. 1987 Oct;105(10):1371–1377. doi: 10.1001/archopht.1987.01060100073030. [DOI] [PubMed] [Google Scholar]
  10. Lanzi G., Fazzi E., Uggetti C., Cavallini A., Danova S., Egitto M. G., Ginevra O. F., Salati R., Bianchi P. E. Cerebral visual impairment in periventricular leukomalacia. Neuropediatrics. 1998 Jun;29(3):145–150. doi: 10.1055/s-2007-973551. [DOI] [PubMed] [Google Scholar]
  11. Mercuri E., Atkinson J., Braddick O., Anker S., Cowan F., Pennock J., Rutherford M. A., Dubowitz L. M. The aetiology of delayed visual maturation: short review and personal findings in relation to magnetic resonance imaging. Eur J Paediatr Neurol. 1997;1(1):31–34. doi: 10.1016/s1090-3798(97)80007-4. [DOI] [PubMed] [Google Scholar]
  12. Mercuri E., Atkinson J., Braddick O., Anker S., Cowan F., Rutherford M., Pennock J., Dubowitz L. Basal ganglia damage and impaired visual function in the newborn infant. Arch Dis Child Fetal Neonatal Ed. 1997 Sep;77(2):F111–F114. doi: 10.1136/fn.77.2.f111. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Mercuri E., Atkinson J., Braddick O., Anker S., Cowan F., Rutherford M., Pennock J., Dubowitz L. Visual function in full-term infants with hypoxic-ischaemic encephalopathy. Neuropediatrics. 1997 Jun;28(3):155–161. doi: 10.1055/s-2007-973693. [DOI] [PubMed] [Google Scholar]
  14. Mercuri E., Atkinson J., Braddick O., Anker S., Nokes L., Cowan F., Rutherford M., Pennock J., Dubowitz L. Visual function and perinatal focal cerebral infarction. Arch Dis Child Fetal Neonatal Ed. 1996 Sep;75(2):F76–F81. doi: 10.1136/fn.75.2.f76. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Mercuri E., Braddick O., Atkinson J., Cowan F., Anker S., Andrew R., Wattam-Bell J., Rutherford M., Counsell S., Dubowitz L. Orientation-reversal and phase-reversal visual evoked potentials in full-term infants with brain lesions: a longitudinal study. Neuropediatrics. 1998 Aug;29(4):169–174. doi: 10.1055/s-2007-973556. [DOI] [PubMed] [Google Scholar]
  16. Van Hof-van Duin J., Mohn G. Visual defects in children after cerebral hypoxia. Behav Brain Res. 1984 Nov;14(2):147–155. doi: 10.1016/0166-4328(84)90183-9. [DOI] [PubMed] [Google Scholar]
  17. Vohr B. R., Garcia-Coll C., Mayfield S., Brann B., Shaul P., Oh W. Neurologic and developmental status related to the evolution of visual-motor abnormalities from birth to 2 years of age in preterm infants with intraventricular hemorrhage. J Pediatr. 1989 Aug;115(2):296–302. doi: 10.1016/s0022-3476(89)80089-7. [DOI] [PubMed] [Google Scholar]
  18. Weisglas-Kuperus N., Heersema D. J., Baerts W., Fetter W. P., Smrkovsky M., van Hof-van Duin J., Sauer P. J. Visual functions in relation with neonatal cerebral ultrasound, neurology and cognitive development in very-low-birthweight children. Neuropediatrics. 1993 Jun;24(3):149–154. doi: 10.1055/s-2008-1071533. [DOI] [PubMed] [Google Scholar]
  19. Whiting S., Jan J. E., Wong P. K., Flodmark O., Farrell K., McCormick A. Q. Permanent cortical visual impairment in children. Dev Med Child Neurol. 1985 Dec;27(6):730–739. doi: 10.1111/j.1469-8749.1985.tb03796.x. [DOI] [PubMed] [Google Scholar]
  20. Wong V. C. Cortical blindness in children: a study of etiology and prognosis. Pediatr Neurol. 1991 May-Jun;7(3):178–185. doi: 10.1016/0887-8994(91)90081-u. [DOI] [PubMed] [Google Scholar]
  21. van Nieuwenhuizen O., Willemse J. Neuro-imaging of cerebral visual disturbances in children. Neuropediatrics. 1988 Feb;19(1):3–6. doi: 10.1055/s-2008-1052392. [DOI] [PubMed] [Google Scholar]

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