Reduced visual resolution acuity and cerebral white matter damage in very-low-birthweight infants
Corresponding Author
John Paul SanGiovanni ScD
National Eye Institute, Division of Epidemiology and Clinical Research, National Institutes of Health, Bethesda, MD;
* Correspondence to first author at National Eye Institute, Division of Epidemiology and Clinical Research, National Institutes of Health Building 31,31 Center Drive MSC 2510, Bethesda, MD 20892–2510, USA. E-mail: [email protected]Search for more papers by this authorElizabeth N Allred MS
Department of Neurology, Neuroepidemiology Unit;
Search for more papers by this authorD Luisa Mayer PhD
Department of Ophthalmology, Children's Hospital (Boston);
Search for more papers by this authorJane E Stewart MD MS
Department of Neonatology, Beth Israel Deaconess Medical Center;
Search for more papers by this authorM Guillermo Herrera MD
Department of Nutrition, Harvard School of Public Health;
Search for more papers by this authorAlan Leviton MD MPH
Department of Neurology, Neuroepidemiology Unit, Children's Hospital (Boston), Boston, USA.
Search for more papers by this authorCorresponding Author
John Paul SanGiovanni ScD
National Eye Institute, Division of Epidemiology and Clinical Research, National Institutes of Health, Bethesda, MD;
* Correspondence to first author at National Eye Institute, Division of Epidemiology and Clinical Research, National Institutes of Health Building 31,31 Center Drive MSC 2510, Bethesda, MD 20892–2510, USA. E-mail: [email protected]Search for more papers by this authorElizabeth N Allred MS
Department of Neurology, Neuroepidemiology Unit;
Search for more papers by this authorD Luisa Mayer PhD
Department of Ophthalmology, Children's Hospital (Boston);
Search for more papers by this authorJane E Stewart MD MS
Department of Neonatology, Beth Israel Deaconess Medical Center;
Search for more papers by this authorM Guillermo Herrera MD
Department of Nutrition, Harvard School of Public Health;
Search for more papers by this authorAlan Leviton MD MPH
Department of Neurology, Neuroepidemiology Unit, Children's Hospital (Boston), Boston, USA.
Search for more papers by this authorAbstract
Neonatal cerebral white matter echolucencies predict visual resolution acuity deficits in very-low-birthweight (VLBW) infants. We examined maternal sociodemographic, lifestyle, intrapartum, infant birth/perinatal, and ocular motor/refractive characteristics to determine whether they accounted for this association in infants who were tested once between postnatal age 25 and 56 weeks (corrected for gestational age at birth). Cranial ultrasound scans were read by consensus to identify echolucency in a population of VLBW infants with no known ocular abnormalities. Visual resolution acuity was measured with the Acuity Card Procedure (ACP) in 14 infants with echolucency and compared with that of 81 VLBW infants born in the same hospitals with normal ultrasound scans. In time-oriented logistic regression models, echolucency remained a consistent predictor of abnormal visual resolution acuity after adjustment for covariates in three developmental periods (pre-, peri-, and postnatal). Odds ratios ranged from 19.3 (95% confidence interval, 4.5 to 82.2;p=0.001) to 10.4 (95% confidence interval, 1.3 to 81.9; p=0.03). Reduced visual resolution acuity in VLBW infants appears to be due to cerebral white matter damage.
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