White-matter injury is associated with impaired gaze in premature infants.
Periventricular leukomalacia is a risk factor for visual impairment in children born prematurely. The impact of diffuse white-matter injury, as detected on magnetic resonance imaging, on early visual function is unknown. We developed two 5-point visual-gaze scores to analyze the association between this clinical assessment and white-matter injury in 93 premature neonates <34 weeks of gestational age at birth. Older postmenstrual age was associated with higher values of the two gaze scores. Infants with moderate or severe white-matter injury had lower scores than their peers without white-matter injury (0.41 points, 95% confidence interval of 0.13-0.69 for visual fixation score; and 0.70 points, 95% confidence interval of 0.30-1.10 for conjugate score, P < 0.005). Using the results from both scales, a score of >or=9 in an infant examined at >or=36 weeks postmenstrual age predicted normal white matter on magnetic resonance examination, with a sensitivity of 84% and a specificity of 100%. These preliminary findings suggest that white-matter injury affects visual function even before term equivalent postmenstrual age.
Department of Neurology, University of California at San Francisco, San Francisco, California, USA.
Hannah C
HC
Glass
Shinji
S
Fujimoto
Camilla
C
Ceppi-Cozzio
Agnes I
AI
Bartha
Daniel B
DB
Vigneron
A James
AJ
Barkovich
David V
DV
Glidden
Donna M
DM
Ferriero
Steven P
SP
Miller
D000367:Age Factors; D054022:Cerebrum / Q000473:pathology / Q000503:physiopathology*; D004185:Disability Evaluation; D005403:Fixation, Ocular; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007969:Leukomalacia, Periventricular / Q000150:complications / Q000473:pathology / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D009413:Nerve Fibers, Myelinated / Q000473:pathology*; D009460:Neurologic Examination; D015835:Ocular Motility Disorders / Q000209:etiology / Q000473:pathology / Q000503:physiopathology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014795:Visual Pathways / Q000473:pathology / Q000503:physiopathology