title: Neural correlates of impaired vision in adolescents born extremely preterm and/or extremely low birthweight.
abstract: BACKGROUND
  Adolescents born extremely preterm (EP; <28 weeks' gestation) and/or extremely low birthweight (ELBW; <1000 g) experience high rates of visual impairments, however the potential neural correlates of visual impairments in EP/ELBW adolescents require further investigation. This study aimed to: 1) compare optic radiation and primary visual cortical structure between EP/ELBW adolescents and normal birthweight controls; 2) investigate associations between perinatal factors and optic radiation and primary visual cortical structure in EP/ELBW adolescents; 3) investigate associations between optic radiation and primary visual cortical structure in EP/ELBW adolescents and the odds of impaired vision.
  
  
  METHODS
  196 EP/ELBW adolescents and 143 controls underwent magnetic resonance imaging at a mean age of 18 years. Optic radiations were delineated using constrained spherical deconvolution based probabilistic tractography. Primary visual cortices were segmented using FreeSurfer software. Diffusion tensor variables and tract volume of the optic radiations, as well as volume, surface area and thickness of the primary visual cortices, were estimated.
  
  
  RESULTS
  Axial, radial and mean diffusivities within the optic radiations, and primary visual cortical thickness, were higher in the EP/ELBW adolescents than controls. Within EP/ELBW adolescents, postnatal corticosteroid exposure was associated with altered optic radiation diffusion values and lower tract volume, while decreasing gestational age at birth was associated with increased primary visual cortical volume, area and thickness. Furthermore, decreasing optic radiation fractional anisotropy and tract volume, and increasing optic radiation diffusivity in EP/ELBW adolescents were associated with increased odds of impaired vision, whereas primary visual cortical measures were not associated with the odds of impaired vision.
  
  
  CONCLUSIONS
  Optic radiation and primary visual cortical structure are altered in EP/ELBW adolescents compared with controls, with the greatest alterations seen in those exposed to postnatal corticosteroids and those born earliest. Structural alterations to the optic radiations may increase the risk of impaired vision in EP/ELBW adolescents.
authors.affiliation: Murdoch Childrens Research Institute, Melbourne, Australia.
authors.forename: Claire E
authors.initials: CE
authors.lastname: Kelly
authors.affiliation: Murdoch Childrens Research Institute, Melbourne, Australia; Royal Women's Hospital, Melbourne, Australia; Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Australia.
authors.forename: Jeanie L Y
authors.initials: JL
authors.lastname: Cheong
authors.affiliation: Murdoch Childrens Research Institute, Melbourne, Australia; Royal Women's Hospital, Melbourne, Australia.
authors.forename: Carly
authors.initials: C
authors.lastname: Molloy
authors.affiliation: Murdoch Childrens Research Institute, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Australia.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Anderson
authors.affiliation: Murdoch Childrens Research Institute, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Australia.
authors.forename: Katherine J
authors.initials: KJ
authors.lastname: Lee
authors.affiliation: Murdoch Childrens Research Institute, Melbourne, Australia; Royal Women's Hospital, Melbourne, Australia; School of Psychological Sciences, The University of Melbourne, Melbourne, Australia.
authors.forename: Alice C
authors.initials: AC
authors.lastname: Burnett
authors.affiliation: Florey Institute of Neuroscience and Mental Health, Melbourne, Australia.
authors.forename: Alan
authors.initials: A
authors.lastname: Connelly
authors.affiliation: Murdoch Childrens Research Institute, Melbourne, Australia; Royal Women's Hospital, Melbourne, Australia; Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Australia.
authors.forename: Lex W
authors.initials: LW
authors.lastname: Doyle
authors.affiliation: Murdoch Childrens Research Institute, Melbourne, Australia; Florey Institute of Neuroscience and Mental Health, Melbourne, Australia.
authors.forename: Deanne K
authors.initials: DK
authors.lastname: Thompson
mesh_terms: D000293:Adolescent; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D008297:Male; D014786:Vision Disorders / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D014793:Visual Cortex / Q000473:pathology / Q000503:physiopathology