Neuroradiographic, endocrinologic, and ophthalmic correlates of adverse developmental outcomes in children with optic nerve hypoplasia: a prospective study.
BACKGROUND
Developmental delay has been reported to occur with optic nerve hypoplasia, a leading cause of pediatric blindness, but has not been systematically examined for its prevalence and correlation with associated pathologies of optic nerve hypoplasia.


OBJECTIVE
The purpose of this study was to determine the developmental outcomes of children with optic nerve hypoplasia and the correlation of development with neuroradiographic, endocrinologic, and ophthalmic findings.


METHODS
We conducted a prospective analysis of 73 subjects diagnosed with optic nerve hypoplasia at <36 months of age for developmental outcomes at 5 years of age. Subjects underwent neuroradiographic imaging, endocrinologic testing and examination, and ophthalmologic examination; developmental outcomes were assessed by using the Battelle Developmental Inventory.


RESULTS
At 5 years of age, developmental delay was present in 71% of subjects with optic nerve hypoplasia. Of patients with unilateral (18%) and bilateral optic nerve hypoplasia, 39% and 78%, respectively, experienced developmental delay. Corpus callosum hypoplasia and hypothyroidism were significantly associated with poor outcome in all of the developmental domains and an increased risk of delay. Absence of the septum pellucidum was not associated with adverse development. Six subjects had neither a neuroradiographic nor an endocrinologic abnormality, and of those, 4 were developmentally delayed.


CONCLUSIONS
These prospective data confirm the significant association of developmental delay with optic nerve hypoplasia and identify corpus callosum hypoplasia and hypothyroidism as strong correlates. A diagnosis of optic nerve hypoplasia warrants neuroradiographic and endocrinologic testing for risk factors of delay and developmental assessments for early intervention planning.
Garcia-Filion
Pamela
P
Division of Pediatric Ophthalmology, Department of Ophthalmology, University of Southern California Keck School of Medicine and Childrens Hospital Los Angeles, Los Angeles, California, USA. pgarciafilion@chla.usc.edu
Epport
Karen
K
Nelson
Marvin
M
Azen
Colleen
C
Geffner
Mitchell E
ME
Fink
Cassandra
C
Borchert
Mark
M
D000015:Abnormalities, Multiple / Q000175:diagnosis / Q000453:epidemiology; D017677:Age Distribution; D061085:Agenesis of Corpus Callosum; D001766:Blindness / Q000453:epidemiology / Q000209:etiology*; D002675:Child, Preschool; D016001:Confidence Intervals; D002658:Developmental Disabilities / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D004704:Endocrinology; D005124:Eye Abnormalities / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007018:Hypopituitarism / Q000175:diagnosis* / Q000453:epidemiology; D007037:Hypothyroidism / Q000175:diagnosis* / Q000453:epidemiology; D015994:Incidence; D007223:Infant; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009485:Neuroradiography; D009900:Optic Nerve / Q000002:abnormalities*; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D017678:Sex Distribution