Original Article
Cortical Visual Function in Preterm Infants in the First Year

https://doi.org/10.1016/j.jpeds.2009.10.042Get rights and content

Objective

To assess visual function in low-risk preterm infants at 3, 5, and 12 months corrected age to determine whether the maturation of visual function in the first year is similar to that reported in term-born infants.

Study design

Seventy-five low-risk infants (25.0-30.9 weeks gestation) underwent ophthalmological examinations and a battery of tests (fix and follow, visual fields, acuity, attention at distance, and fixation shift) designed to assess various aspects of visual function at 3, 5, and 12 months corrected age.

Results

The results were comparable with normative data from term-born infants in all tests but fixation shift, suggesting that maturation of most aspects of visual function is not significantly affected by preterm birth. In contrast, >25% of preterm infants failed the fixation shift test at 3 months, with a higher percentage of failing at 5 and 12 months.

Conclusions

There is a specific profile of early visual behavior in low-risk preterm infants, with a high percentage of infants failing a test that specifically assesses visual attention and provides a measure of cortical processing.

Section snippets

Methods

Infants were recruited from the neonatal intensive care unit at Gemelli Hospital in Rome, Italy, from June 2004 to June 2006. Informed parental consent for the study was obtained for all infants.

Infants were consecutively enrolled when they were born between 25.0 and 30.9 (<31) weeks gestational age (GA) as determined from the results of first trimester ultrasound scans or when their cranial ultrasound scanning results were normal or only showed transient flares or germinal layer hemorrhages

Results

Eighty-two infants fulfilled the inclusion criteria; 75 infants with a mean GA of 28.8 ± 1.2 weeks (range, 25-30 weeks), with a mean birth weight of 1174 ± 246 g (range, 490-1700 g) were assessed at 3 (median, 3.1 ± 0.2), 5 (median, 5.2 ± 0.3), and 12 (median, 12.2 ± 0.6) months corrected age. The infants had a normal results on a neurodevelopmental assessment at 12 months. The remaining 7 infants missed 1 of the 3 assessments and were not be included in the study. The infants were subdivided

Discussion

In our preterm cohort, nearly all the aspects of vision that we assessed at 3, 5, and 12 months corrected age were within the normal reference range for term-born infants assessed at the same post-term age. More specifically, the ability to fix and follow, acuity, visual fields, and attention at distance had consistently normal results (>85%), suggesting that the maturation of these aspects of vision was not affected by preterm birth. These results are in agreement with earlier studies also

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    Supported by the Mariani Foundation. The authors declare no conflicts of interest.

    Both authors contributed equally.

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