Eye Abnormalities in Children with Fetal Alcohol Spectrum Disorders: A Systematic Review

Tsang, Tracey W; Finlay‐Jones, Amy; Perry, Kerrin; Grigg, John; Popova, Svetlana; Cheung, Melissa Mei Yin; Bower, Carol; Tam, Patrick; Jamieson, Robyn V; Elliott, Elizabeth J

doi:10.1080/09286586.2022.2123004

Cited by 9 publications

(9 citation statements)

References 63 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Diagnostic assessment of FASD is challenging and relies on a multidisciplinary evaluation approach due to the heterogenic nature of FASD. Additionally, individuals with FASD have a high prevalence of ophthalmological abnormalities 12–14 19. Implementing a complementary ophthalmological diagnostic tool in the diagnostic workup of FASD is warranted.…”

Section: Discussionmentioning

confidence: 99%

“…Children with FASD have been shown to have a high prevalence of ophthalmological abnormalities in previous studies 12–14. Subnormal visual acuity (VA), optic nerve hypoplasia (ONH), retinal vascular malformations, visual perception problems (VPPs), refractive errors, strabismus, short palpebral fissures, ptosis, epicanthus and abnormally increased intercanthal distance (ICD) are well documented in FASD 3–6 12–19. Thus, an ophthalmological assessment should be an integral part of the FASD diagnostic workup 12 19.…”

Section: Introductionmentioning

confidence: 99%

“…Subnormal visual acuity (VA), optic nerve hypoplasia (ONH), retinal vascular malformations, visual perception problems (VPPs), refractive errors, strabismus, short palpebral fissures, ptosis, epicanthus and abnormally increased intercanthal distance (ICD) are well documented in FASD 3–6 12–19. Thus, an ophthalmological assessment should be an integral part of the FASD diagnostic workup 12 19. An independent structured complementary ophthalmological diagnostic tool could strengthen a suspected FASD diagnosis and simultaneously help detect ophthalmological anomalies early 20.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Visual and ocular findings in children with fetal alcohol spectrum disorders (FASD): validating the FASD Eye Code in a clinical setting

et al. 2023

View full text Add to dashboard Cite

ObjectiveFetal alcohol spectrum disorders (FASD) is an umbrella term covering a spectrum of medical conditions caused by prenatal alcohol exposure. The FASD Eye Code is a new complementary ophthalmological diagnostic tool created to corroborate the complex FASD diagnosis. The aim of this work was to validate the FASD Eye Code by testing it on a second group of children diagnosed with FASD in a clinical setting.Methods and analysisA clinical study was carried out in a group of 21 children (13 males, 8 females, mean age 13.3 years) investigated for suspected FASD and a healthy sex-matched and age-matched control group (n=21). The participants underwent a detailed ophthalmological examination including visual perception problems (VPPs) assessment. Clinical examination results were compiled, and total scores were calculated according to the FASD Eye Code protocol (range 4–16).ResultsThe median total score in the FASD group was 8. Eight individuals in the FASD group and none of the controls obtained a total score of ≥9 corresponding to 38% sensitivity and 100% specificity with an area under the curve of 0.90. A cut-off total score of ≥8 showed 52% sensitivity and 95% specificity. One individual in the FASD group versus 12 controls had a total score of 4, representing normal findings. No significant difference between the two groups regarding VPPs was seen.ConclusionThe FASD Eye Code can be used as a complementary diagnostic tool for FASD to assist in diagnosis and to detect ophthalmological abnormalities in individuals with suspected FASD.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Visual and ocular findings in children with fetal alcohol spectrum disorders (FASD): validating the FASD Eye Code in a clinical setting

et al. 2023

View full text Add to dashboard Cite

show abstract

“…Comorbid conditions with the highest pooled prevalence (50-91%) included abnormal functional studies of the peripheral nervous system and special senses, conduct disorder, receptive and expressive language disorders, and chronic serous otitis media 13 . Other studies report a high prevalence of vision and hearing problems among people with FASD 265,266 . All of these comorbid conditions affect the function and QOL of individuals with FASD and their families (Box 1).…”

Section: Quality Of Lifementioning

confidence: 92%

Fetal alcohol spectrum disorders

Popova

Charness

Burd

et al. 2023

Nat Rev Dis Primers

Self Cite

120

View full text Add to dashboard Cite

Alcohol readily crosses the placenta and may disrupt fetal development. Harm from prenatal alcohol exposure (PAE) is determined by the dose, pattern, timing and duration of exposure, fetal and maternal genetics, maternal nutrition, concurrent substance use, and epigenetic responses. A safe dose of alcohol use during pregnancy has not been established. PAE can cause fetal alcohol spectrum disorders (FASD), which are characterized by neurodevelopmental impairment with or without facial dysmorphology, congenital anomalies and poor growth. FASD are a leading preventable cause of birth defects and developmental disability. The prevalence of FASD in 76 countries is >1% and is high in individuals living in out-of-home care or engaged in justice and mental health systems. The social and economic effects of FASD are profound, but the diagnosis is often missed or delayed and receives little public recognition. Future research should be informed Nature Reviews Disease Primers | (2023) 9:11 2 0123456789();: PrimerFASD occur in all socioeconomic and ethnic groups 15 and are complex, chronic conditions that affect health and family functioning 16 . Individuals with FASD usually require lifelong health care as well as social and vocational support. Some require remedial education and others interact with the justice system. Early diagnosis and a strength-based management approach will optimize health outcomes.FASD are the most common of the potentially preventable conditions associated with birth anomalies and neurodevelopmental problems 13 , and their global effects, including huge social and economic costs, are substantial 17 . For example, in Canada, the annual cost associated with FASD is an estimated ~CAD$ 1.8 billion (CAD$ 1.3 billion to CAD$ 2.3 billion) 17 , which is attributable in part to productivity loss (41%), correction services (29%) and health care (10%). In North America, the lifetime cost of supporting an individual with FASD is estimated at >CAD$ 1 million 18 . Addressing and preventing alcohol use in pregnancy is a public-health imperative.This Primer presents the epidemiology of FASD and the latest understanding of its pathophysiology as well as approaches to diagnosis, screening and prevention. The Primer also describes outcomes across the lifespan, management and quality of life (QOL) of people living with FASD, and highlights important areas for future research and clinical practice. Epidemiology Alcohol use during pregnancyNo safe level of PAE has been established 19 , and international guidelines advise against any amount or type of alcohol use during pregnancy [20][21][22][23] . Nevertheless, ~10% of pregnant women worldwide consume alcohol 24,25 . The highest prevalence of alcohol use during pregnancy is in the WHO European Region (25.2% 24 ; Fig. 1), consistent with the prevalence of heavy alcohol use, heavy episodic drinking and alcohol use disorders in this region 26 . 0123456789();: PrimerIn 40% of the 162 countries evaluated, >25% of women who consumed any alcohol during pregnancy drank at 'bing...

show abstract

“…Ophthalmic complications (Gummel & Ygge, 2013;Reid et al, 2021;Tsang et al, 2022), structural and functional ear complications were associated with FASD (Cheung et al, 2022;Popova et al, 2016), increased infection risk, asthma and skin conditions (Reid et al, 2019(Reid et al, , 2021 were all commonly reported in children with FASD/PAE. First Nations peoples in Canada with FASD (aged 20-42 years) reported complex physical needs such as respiratory diseases, cardiovascular complications, gastrointestinal issues, chronic pain, and dental issues (Flannigan, McMorris, et al, 2022).…”

Section: Physical Health (N = 21 Studies)mentioning

confidence: 99%

Factors to be considered as part of a holistic assessment for fetal alcohol spectrum disorder: A scoping review

Reid,

Kent,

Hewlett

et al. 2023

Alcohol: Clinical and Experimental Research

Self Cite

View full text Add to dashboard Cite

BackgroundA scoping review was undertaken to identify factors outside of current fetal alcohol spectrum disorder (FASD) diagnostic criteria that could be considered as part of a holistic assessment process to enable targeted recommendations and supports to improve outcomes. Evidence will be used to inform the revision of the Australian Guide to the Diagnosis of FASD.MethodsSix electronic databases were searched. Studies were eligible if they included factors outside of the diagnostic criteria that clinicians might need to consider as part of a holistic (i.e., physical, social, mental health and wellbeing) assessment process. Data charting and content analysis was performed for synthesis of results.Results121 studies were included that spanned 12 key areas. This included physical health, sleep, adverse postnatal experiences, substance use/other risk‐taking behaviors, contact with the criminal justice system, mental health, First Nations cultural considerations, transition to adult roles, involvement with the out‐of‐home care system, feeding and eating, strengths/interests/external resources and incontinence.ConclusionsAreas to be considered as part of a holistic assessment and diagnostic process spanned individual, family, and system level factors. The results of the current review provide guidance for clinicians regarding the wide range of factors that may influence long‐term health, development, and wellbeing for individuals with prenatal alcohol exposure and FASD. In practice this guidance can be used to inform an individualized assessment process to facilitate tailored recommendations and supports to best meet the complex needs of those living with FASD and their families.

show abstract

Eye Abnormalities in Children with Fetal Alcohol Spectrum Disorders: A Systematic Review

Cited by 9 publications

References 63 publications

Visual and ocular findings in children with fetal alcohol spectrum disorders (FASD): validating the FASD Eye Code in a clinical setting

Visual and ocular findings in children with fetal alcohol spectrum disorders (FASD): validating the FASD Eye Code in a clinical setting

Fetal alcohol spectrum disorders

Factors to be considered as part of a holistic assessment for fetal alcohol spectrum disorder: A scoping review

Contact Info

Product

Resources

About