Early visual assessment in preterm infants with and without brain lesions: correlation with visual and neurodevelopmental outcome at 12 months.
BACKGROUND
Several studies have reported the development of various aspects of visual function in infancy and early childhood in both preterm and term-born infants, but only a few studies have focused on the predictive power of neonatal visual findings in infants with brain lesions.


OBJECTIVE
To explore visual findings at term age, and at 3 and 12 months corrected age in preterm infants (gestational age <33 weeks) with and without brain lesions; to compare the assessment at term age and at 12 months; and to assess the relationship between visual findings and neurodevelopmental outcome at 12 months.


METHODS
Cranial ultrasound scans (US) were classified in normal, mild or major abnormalities. One-hundred and forty-five infants were assessed with age specific tests for visual function at term age, and at 3 and 12 months. Neurodevelopmental assessment (Griffiths' Scales) was performed at 12 months.


RESULTS
A good correlation was found between early and late visual assessment and neurodevelopment outcome. Of the 121 infants with normal neonatal visual assessment, 119 were also normal at 12 months and 116 had normal developmental quotient. Of the 24 infants with abnormal neonatal visual assessment, 12 were also abnormal at 12 months. All the false positives had normalised by 3 months. Of the 35 infants with major US abnormalities, 20 had normal and 15 abnormal scores on the neonatal assessment. At 1 year 17 had normal and 18 abnormal scores.


CONCLUSIONS
A normal visual assessment at term age is a good predictor of normal visual and neurodevelopmental outcome at 12 months. An abnormal visual examination in the neonatal period was a less reliable prognostic indicator, infant should be reassessed at 3 months.
Paediatric Neurology Unit, Catholic University, Rome, Italy.
Daniela
D
Ricci
Domenico M
DM
Romeo
Francesca
F
Gallini
Michela
M
Groppo
Laura
L
Cesarini
Silvia
S
Pisoni
Francesca
F
Serrao
Patrizia
P
Papacci
Ilaria
I
Contaldo
Francesca
F
Perrino
Claudia
C
Brogna
Flaviana
F
Bianco
Giovanni
G
Baranello
Annalisa
A
Sacco
Michela
M
Quintiliani
Alessandra
A
Ometto
Salvatore
S
Cilauro
Fabio
F
Mosca
Costantino
C
Romagnoli
Mario G
MG
Romeo
Frances
F
Cowan
Giovanni
G
Cioni
Luca
L
Ramenghi
Eugenio
E
Mercuri
D001921:Brain / Q000502:physiology*; D002657:Child Development / Q000502:physiology*; D015331:Cohort Studies; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D011237:Predictive Value of Tests; D014785:Vision, Ocular / Q000502:physiology*; D014792:Visual Acuity / Q000502:physiology