Visual Impairment in Preterm Children With Periventricular Leukomalacia — Visual, Cognitive and Neuropaediatric Characteristics Related to Cerebral Imaging

Jacobson, Lena; Ek, Ulla; Fernell, Elisabeth; Flodmark, Olof; Broberger, U.

doi:10.1111/j.1469-8749.1996.tb12142.x

Cited by 163 publications

(114 citation statements)

References 27 publications

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“…Sometimes drift movements that can include nystagmus beats and paroxysmal ocular deviations can turn the eyes away from the point of fixation. Instability of fixation, along with saccadic anomalies and the crowding phenomenon (Jacobson 1996), contribute to making reading very difficult for these individuals.…”

Section: Discussionmentioning

confidence: 99%

“…The visual deficit in CVI involves three different aspects: the perceptual (the sheer visual impairment with subnormal visual acuity and visual field defects), the neuropsychological (attention, recognition, and spatial orientation; see Dutton 1996, Jacobson 1996, and the oculomotor aspects. The latter are so severe that not only does it bring about strabismus and nystagmus but other oculomotor mechanisms, such as saccadic movements, pursuit, and vergence, are affected.…”

Section: Discussionmentioning

confidence: 99%

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Oculomotor dysfunction in cerebral visual impairment following perinatal hypoxia

Salati¹,

Borgatti

Giammari

et al. 2002

Develop Med Child Neuro

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The aim of the study was to describe ocular motility in a sample of 56 patients affected by cerebral visual impairment (CVI) of hypoxic‐ischemic origin. The sample consisted of 56 participants (37 males and 19 females), ranging in age from 2 to 16 years. In all cases CVI was associated with MRI‐verified damage of the cerebral visual system. A complete ophthalmologic and neurological assessment was performed. Behaviour of gaze was studied in four conditions: during scanning of the surrounding environment, during fixation, execution of saccades, and pursuing. In addition, strabismus, nystagmus, and paroxysmal ocular deviations were evaluated. Ocular motility was studied by video recording the patients’eye motility during orthoptic examination. Each pattern of ocular motility studied revealed profound alterations in all the individuals examined. Typical features of ocular motility in CVI were: paroxysmal ocular deviations (present in 78%); the presence of variable angle strabismus (86%); and defective coordination of saccades (93%). Exploration of the environment and fixation were also impaired (88% and 84%, respectively). Disorders of initiation and performing saccades, absence of smooth pursuit, vergence abnormalities, nystagmus beats, instability of fixation, and difficulty in the systematic exploration of the environment were observed. These abnormalities characterize lack of gaze coordination found in children with brain damage. An early and detailed evaluation of ocular motility in individuals with CVI is important, especially when rehabilitation intervention is intended.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Oculomotor dysfunction in cerebral visual impairment following perinatal hypoxia

Salati¹,

Borgatti

Giammari

et al. 2002

Develop Med Child Neuro

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“…The prevalence of visual impairment in children with HI injury ranges from 66 to 94%. The visual dysfunctions associated with HI brain injury include strabismus, gaze palsy, nystagmus, optic atrophy, and restriction of the visual field (2,3), defective color vision (4,5), and reduced grating acuity (6). Visual loss associated with brain damage is currently the most common cause of visual impairment in children in developed countries, placing a major burden on ophthalmological and educational services in these countries (2).…”

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confidence: 99%

Hypoxic–ischemic retinal injury in rat pups

Huang

Hung

et al. 2012

Pediatr Res

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Background: Visual loss associated with brain damage, especially hypoxic-ischemic (hI) encephalopathy, is the most common cause of visual impairment in children in developed countries. We hypothesized that hI insults can cause long-term damage in immature eyes. Methods: In postnatal day 7 rat pups, hI was induced by unilateral common carotid artery ligation followed by hypoxia. Retina damage was assessed by electroretinography (eRG) and cell counting. Neuronal injury and astrogliosis were evaluated by terminal deoxynucleotidyl transferase nick-end labeling, cleaved caspase 3, eD1, and glial fibrillary acidic protein immunostaining. results: We observed rapid and persistently extensive injuries in the ganglia cell layer (GcL), inner plexiform layer, and inner nuclear layer (INL) in ipsilateral retinas after hI injury, corresponding to the marked alteration in eRG. hI insult caused prominent microglial and Műller cell activation in ipsilateral inner retinas. Neuronal death in the GcL and INL after hI injury was mainly apoptotic, involving caspase-dependent pathways. conclusion: Our study demonstrated the first evidence of hI retinal damage at both the pathological and functional level using the Vannucci model in neonatal rats. Because retinal damage is often associated with hI injury, it is important to demonstrate that a particular neuroprotective strategy effectively preserves the retina in addition to the brain.

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“…13,[24][25][26] Our current findings suggest that the white matter injury in very preterm born infants may also be responsible for the impairment in language processing tasks. In addition to the associations with the incidence of cognitive impairment and cerebral palsy, abnormal white matter appearances were associated with the requirement for special assistance at school; this is not surprising given the relationship between a child' s cognitive ability and adaptation to school after very preterm birth.…”

Section: Composite Assessment Of White Matter and Outcomementioning

confidence: 86%

Qualitative Brain MRI at Term and Cognitive Outcomes at 9 Years After Very Preterm Birth

2012

PEDIATRICS

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WHAT'S KNOWN ON THIS SUBJECT:Cross-sectional studies have demonstrated associations between the white matter injury and cognitive impairment in very preterm born children. Longitudinal studies confirmed the relationships between cerebral MRI at term and neurodevelopmental outcomes at up to 2 years old.WHAT THIS STUDY ADDS: White matter injury (but not gray matter injury) on term MRI predicted cognitive impairments of very preterm born infants at 9 years old. Qualitative assessment of white matter signal intensities showed limited predictive values of cognitive impairments. abstract OBJECTIVE: A prospective study was performed to assess the relationship between the appearance of cerebral MRI at term and the cognitive functioning at 9 years old in very preterm born infants.METHODS: Seventy-six very preterm born infants (birth weight ,1500 g or gestational age #32 weeks) obtained cerebral MRI at term-equivalent period, which was assessed by using established composite scores for the white and gray matter; cognitive outcomes at 9 years old were assessed in 60 subjects by using Wechsler Intelligence Scale for Children, Third Edition.RESULTS: Mildly low scores on the different IQ indices (,85) were observed in 23.3% (verbal IQ), 41.7% (performance IQ), and 30.0% (full-scale IQ) of the cohort, whereas moderately low scores (,70) were noted in 3.3% (verbal IQ), 11.7% (performance IQ), and 11.7% (full-scale IQ); cerebral palsy was diagnosed in 10.0%, whereas special assistance at school was required in 56.7%. Abnormal white matter appearances predicted mildly low verbal, performance, and full-scale IQs; moderately low performance and full-scale IQs; cerebral palsy; and the requirement for special assistance at school. Abnormal white matter appearances predicted mild cognitive impairment even after the adjustment for known clinical risk factors. In contrast, abnormal gray matter appearances did not predict any of the outcome measures. CONCLUSIONS:In a cohort of very preterm born infants, abnormal white matter appearance on term MRI showed consistent associations with cognitive impairments at 9 years old, further supporting the benefit of obtaining term MRI for very preterm born infants. Pediatrics 2012;129:e1138-e1147

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Visual Impairment in Preterm Children With Periventricular Leukomalacia — Visual, Cognitive and Neuropaediatric Characteristics Related to Cerebral Imaging

Cited by 163 publications

References 27 publications

Oculomotor dysfunction in cerebral visual impairment following perinatal hypoxia

Oculomotor dysfunction in cerebral visual impairment following perinatal hypoxia

Hypoxic–ischemic retinal injury in rat pups

Qualitative Brain MRI at Term and Cognitive Outcomes at 9 Years After Very Preterm Birth

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