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Gambardella ML, Pede E, Orazi L, Leone S, Quintiliani M, Amorelli GM, Petrianni M, Galanti M, Amore F, Musto E, Perulli M, Contaldo I, Veredice C, Mercuri EM, Battaglia DI, Ricci D. Visual Function in Children with GNAO1-Related Encephalopathy. Genes (Basel) 2023; 14:genes14030544. [PMID: 36980817 PMCID: PMC10047968 DOI: 10.3390/genes14030544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 02/09/2023] [Accepted: 02/20/2023] [Indexed: 02/24/2023] Open
Abstract
Background: GNAO1-related encephalopathies include a broad spectrum of developmental disorders caused by de novo heterozygous mutations in the GNAO1 gene, encoding the G (o) subunit α of G-proteins. These conditions are characterized by epilepsy, movement disorders and developmental impairment, in combination or as isolated features. Objective: This study aimed at describing the profile of neurovisual competences in children with GNAO1 deficiency to better characterize the phenotype of the disease spectrum. Methods: Four male and three female patients with confirmed genetic diagnosis underwent neurological examination, visual function assessment, and neurovisual and ophthalmological evaluation. Present clinical history of epilepsy and movement disorders, and neuroimaging findings were also evaluated. Results: The assessment revealed two trends in visual development. Some aspects of visual function, such as discrimination and perception of distance, depth and volume, appeared to be impaired at all ages, with no sign of improvement. Other aspects, reliant on temporal lobe competences (ventral stream) and more related to object–face exploration, recognition and environmental control, appeared to be preserved and improved with age. Significance: Visual function is often impaired, with patterns of visual impairment affecting the ventral stream less.
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Affiliation(s)
- Maria Luigia Gambardella
- Pediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Correspondence:
| | - Elisa Pede
- Pediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Lorenzo Orazi
- National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of Visually Impaired, IAPB Italia ONLUS, 00168 Rome, Italy
- Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Simona Leone
- National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of Visually Impaired, IAPB Italia ONLUS, 00168 Rome, Italy
- Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Michela Quintiliani
- Pediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Giulia Maria Amorelli
- National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of Visually Impaired, IAPB Italia ONLUS, 00168 Rome, Italy
- Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Maria Petrianni
- National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of Visually Impaired, IAPB Italia ONLUS, 00168 Rome, Italy
- Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Marta Galanti
- National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of Visually Impaired, IAPB Italia ONLUS, 00168 Rome, Italy
- Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Filippo Amore
- National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of Visually Impaired, IAPB Italia ONLUS, 00168 Rome, Italy
- Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Elisa Musto
- Pediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Marco Perulli
- Pediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Ilaria Contaldo
- Pediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Chiara Veredice
- Pediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Eugenio Maria Mercuri
- Pediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | | | - Daniela Ricci
- Pediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of Visually Impaired, IAPB Italia ONLUS, 00168 Rome, Italy
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Quintiliani M, Ricci D, Petrianni M, Leone S, Orazi L, Amore F, Gambardella ML, Contaldo I, Veredice C, Perulli M, Musto E, Mercuri EM, Battaglia DI. Cortical Visual Impairment in CDKL5 Deficiency Disorder. Front Neurol 2022; 12:805745. [PMID: 35153983 PMCID: PMC8825365 DOI: 10.3389/fneur.2021.805745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 12/10/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND CDKL5 deficiency disorder (CDD) is a developmental encephalopathy caused by pathogenic variants in the gene cyclin-dependent kinase-like 5. Cerebral visual impairment (CVI) is frequent in patients with CDD. In addition to being recognized as a specific feature of the pathology, it has been suggested that visual impairment may correlate with neurodevelopmental outcome and epilepsy severity, but no systematic behavioral visual assessment has been performed. The aim of our study was to evaluate clinical and electrophysiological profile of CVI in patients with CDD, to correlate various aspects of visual function to neurodevelopmental and epileptic features. METHODS The study included all patients with CDD from the National Pathology Registry. All patients underwent neurological examination, a disease-specific functional assessment, structured clinical evaluation of visual functions, including pattern reversal visual evoked potential (VEP), and a detailed monitoring of epileptic features, including video-EEG. RESULTS All the 11 patients recorded in the CDKL5 national registry, 10 females and one male, age range of 1.5 to 24 years (mean 9, SD 7.7, median 6.5), were enrolled. Visual function is impaired in all patients; in particular, visual fields, visual acuity, contrast sensitivity, and stereopsis were consistently abnormal whereas other aspects, such as fixing and tracking, were relatively preserved. Pattern reversal VEP was abnormal in nearly 80% of our patients. No correlation was found among CVI severity, age, level of psychomotor development, EEG abnormalities, and pathology stages even if an overall less abnormal EEG pattern was more often associated with better visual results. CONCLUSION In conclusion, CVI can be considered as a major feature of CDD with a diffuse involvement in several behavioral and electrophysiological aspects. Larger cohorts will help to better clarify the possible prognostic role of EEG severity in predicting both visual and developmental abnormalities.
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Affiliation(s)
- Michela Quintiliani
- Pediatric Neuropsychiatric Unit, Dipartimento di Salute della Donna e del Bambino e Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - Daniela Ricci
- Pediatric Neuropsychiatric Unit, Dipartimento di Salute della Donna e del Bambino e Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
- Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
- National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of Low Vision Patients, IAPB Italia Onlus, Rome, Italy
| | - Maria Petrianni
- National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of Low Vision Patients, IAPB Italia Onlus, Rome, Italy
| | - Simona Leone
- National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of Low Vision Patients, IAPB Italia Onlus, Rome, Italy
| | - Lorenzo Orazi
- National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of Low Vision Patients, IAPB Italia Onlus, Rome, Italy
| | - Filippo Amore
- National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of Low Vision Patients, IAPB Italia Onlus, Rome, Italy
| | - Maria Luigia Gambardella
- Pediatric Neuropsychiatric Unit, Dipartimento di Salute della Donna e del Bambino e Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - Ilaria Contaldo
- Pediatric Neuropsychiatric Unit, Dipartimento di Salute della Donna e del Bambino e Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - Chiara Veredice
- Pediatric Neuropsychiatric Unit, Dipartimento di Salute della Donna e del Bambino e Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - Marco Perulli
- Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Elisa Musto
- Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Eugenio Maria Mercuri
- Pediatric Neuropsychiatric Unit, Dipartimento di Salute della Donna e del Bambino e Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
- Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Domenica Immacolata Battaglia
- Pediatric Neuropsychiatric Unit, Dipartimento di Salute della Donna e del Bambino e Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
- Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
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Xiang Y, Long E, Liu Z, Li X, Lin Z, Zhu Y, Chen C, Lin H. Study to establish visual acuity norms with Teller Acuity Cards II for infants from southern China. Eye (Lond) 2021; 35:2787-2792. [PMID: 33235349 PMCID: PMC8452650 DOI: 10.1038/s41433-020-01314-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 10/28/2020] [Accepted: 11/10/2020] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES To establish the norms of binocular and monocular acuity and interocular acuity differences for southern Chinese infants and compare these norms with the results for northern Chinese infants. METHODS A prospective, comparative, and noninterventional study was conducted from January to August 2018. Teller Acuity Cards II were used to determine the binocular and monocular acuity of infants. The tolerance intervals and limits with a stated proportion and probability were used to evaluate the norms of binocular and monocular acuity and interocular acuity differences. An unpaired t-test was used to compare the obtained norms with the reported northern Chinese norms. RESULTS The tolerance intervals of binocular acuity (mean acuity of 3.73, 7.35, and 12.01 cpd, respectively, at 12, 24, and 36 months), monocular acuity (mean acuity of 2.88, 6.91, and 10.75 cpd, respectively, at 12, 24, and 36 months), and interocular acuity differences (mean difference of 0.92, 2.89, and 3.99 cpd, respectively, at 12, 24, and 36 months) were obtained, exhibiting an increasing trend with age. The binocular visual acuity norms of southern Chinese infants were significantly lower than those in northern China (4.37 vs. 6.9 cpd at 8 months and 7.35 vs. 26 cpd at 24 months) (P = 0.011). CONCLUSIONS Northern and southern Chinese infants exhibited distinct acuity norms and visual development patterns. The establishment of population-specific visual acuity norms is necessary for current populations of infants from different regions.
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Affiliation(s)
- Yifan Xiang
- grid.12981.330000 0001 2360 039XState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Erping Long
- grid.12981.330000 0001 2360 039XState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Zhenzhen Liu
- grid.12981.330000 0001 2360 039XState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xiaoyan Li
- grid.12981.330000 0001 2360 039XState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Zhuoling Lin
- grid.12981.330000 0001 2360 039XState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yi Zhu
- grid.12981.330000 0001 2360 039XState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China ,grid.26790.3a0000 0004 1936 8606Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, USA
| | - Chuan Chen
- grid.12981.330000 0001 2360 039XState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China ,grid.26790.3a0000 0004 1936 8606Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, USA
| | - Haotian Lin
- grid.12981.330000 0001 2360 039XState Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China ,grid.12981.330000 0001 2360 039XCenter of Precision Medicine, Sun Yat-Sen University, Guangzhou, China
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Groenendaal F, Van Hof-Van Duin J. Visual Deficits and Improvements in Children after Perinatal Hypoxia. JOURNAL OF VISUAL IMPAIRMENT & BLINDNESS 2020. [DOI: 10.1177/0145482x9208600506] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This article reports on a study of the visual development of 38 infants, children, and youths who were neurologically impaired following perinatal hypoxia. All children showed impairments of one or more visual functions, indicating that perinatal hypoxia can have severe detrimental effects on visual development. However, in most patients visual development continued and visual improvements could be demonstrated up to age 16. The implications of these findings and suggestions for treatment are presented.
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Affiliation(s)
- F. Groenendaal
- Department of Physiology, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands
| | - J. Van Hof-Van Duin
- Department of Physiology, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands
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Brown AM, Opoku FO, Stenger MR. Neonatal Contrast Sensitivity and Visual Acuity: Basic Psychophysics. Transl Vis Sci Technol 2018; 7:18. [PMID: 29946492 PMCID: PMC6016435 DOI: 10.1167/tvst.7.3.18] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 03/27/2018] [Indexed: 12/03/2022] Open
Abstract
Purpose This research was prospectively designed to determine whether a 0.083 cycles per degree (cy/deg) (20/7200) square-wave stimulus is a good choice for clinical measurement of newborn infants' contrast sensitivity and whether the contrast sensitivity function (CSF) of the newborn infant is band-pass. The results were retrospectively analyzed to determine whether the method of constant stimuli (MCS) and the descending method of limits (dLIM) yielded similar results. Methods In across-subjects experimental designs, a pilot experiment used MCS (N = 47 visual acuity; N = 38 contrast sensitivity at 0.083 cy/deg), and a main experiment used dLIM (N = 22 visual acuity; N = 22 contrast sensitivity at 0.083 cy/deg; N = 21 at 0.301 cy/deg) to measure visual function in healthy newborn infants. Three candidate CSFs estimated maximum neonatal contrast sensitivity. MCS and dLIM psychometric functions were compared while taking the stimulus presentation protocols into account. Results The band-pass CSF fit the data best, with a peak sensitivity near 0.31 at 0.22 cy/deg. However, the 0.083 cy/deg square-wave stimulus underestimated the best performance of newborn infants by less than 0.15 log10 units. MCS and dLIM data agreed well when the stimulus presentation contingencies were taken into account. Conclusions Newborn contrast sensitivity is well measured using a 0.083 cy/deg square-wave target, regardless of which CSF shape is correct. MCS and dLIM yield wholly comparable results, with no evidence to suggest effects of other factors such as infant inattention or examiner impatience. Translational Relevance These measurements open the way for clinical behavioral measurement of infant visual acuity and contrast sensitivity in the neonatal period.
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Affiliation(s)
- Angela M Brown
- The Ohio State University, College of Optometry, Columbus, OH, USA
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Dotan S, Katzir T. Mind the gap: Increased inter-letter spacing as a means of improving reading performance. J Exp Child Psychol 2018; 174:13-28. [PMID: 29883749 DOI: 10.1016/j.jecp.2018.04.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Revised: 04/18/2018] [Accepted: 04/18/2018] [Indexed: 10/14/2022]
Abstract
Theeffects of text display, specificallywithin-word spacing, on children's reading at different developmental levels has barely been investigated.This study explored the influence of manipulating inter-letter spacing on reading performance (accuracy and rate) of beginner Hebrew readers compared with older readers and of low-achieving readers compared with age-matched high-achieving readers.A computer-based isolated word reading task was performed by 132 first and third graders. Words were displayed under two spacing conditions: standard spacing (100%) and increased spacing (150%). Words were balanced for length and frequency across conditions. Results indicated that increased spacing contributed to reading accuracy without affecting reading rate. Interestingly, all first graders benefitted fromthe spaced condition. Thiseffect was found only in long words but not in short words. Among third graders, only low-achieving readers gained in accuracy fromthespaced condition. Thetheoretical and clinical effects ofthefindings are discussed.
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Affiliation(s)
- Shahar Dotan
- Edmond J. Safra Brain Research Center, Department of Learning Disabilities, University of Haifa, Mount Carmel 31905, Haifa, Israel
| | - Tami Katzir
- Edmond J. Safra Brain Research Center, Department of Learning Disabilities, University of Haifa, Mount Carmel 31905, Haifa, Israel.
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Costa MF, de Cássia Rodrigues Matos França V, Barboni MTS, Ventura DF. Maturation of Binocular, Monocular Grating Acuity and of the Visual Interocular Difference in the First 2 Years of Life. Clin EEG Neurosci 2018; 49:159-170. [PMID: 28844161 DOI: 10.1177/1550059417723804] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The sweep visual evoked potential method (sVEP) is a powerful tool for measurement of visual acuity in infants. Despite the applicability and reliability of the technique in measuring visual functions the understanding of sVEP acuity maturation and how interocular difference of acuity develops in early infancy, as well as the availability of normality ranges, are rare in the literature. We measured binocular and monocular sVEPS acuities in 481 healthy infants aged from birth to 24 months without ophthalmological diseases. Binocular sVEP acuity was significantly higher than monocular visual acuities for almost all ages. Maturation of monocular sVEP acuity showed 2 longer critical periods while binocular acuity showed three maturation periods in the same age range. We found a systematic variation of the mean interocular acuity difference (IAD) range according to age from 1.45 cpd at birth to 0.31 cpd at 24 months. An additional contribution was the determination of sVEP acuity norms for the entire age range. We conclude that binocular and monocular sVEP acuities have distinct growth curves reflecting different maturation profiles for each function. Differences in IAD range shorten according to age and they should be considered in using the sVEP acuity measurements for clinical diagnosis as amblyopia.
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Affiliation(s)
- Marcelo Fernandes Costa
- 1 Laboratório de Psicofisiologia Sensorial, Departamento de Psicologia Experimental, Instituto de Psicologia, Universidade de São Paulo, São Paulo, Brazil.,2 Núcleo de Neurociências e Comportamento e Neurociências Aplicada, Universidade de São Paulo, São Paulo, Brazil
| | | | - Mirella Teles Salgueiro Barboni
- 1 Laboratório de Psicofisiologia Sensorial, Departamento de Psicologia Experimental, Instituto de Psicologia, Universidade de São Paulo, São Paulo, Brazil.,2 Núcleo de Neurociências e Comportamento e Neurociências Aplicada, Universidade de São Paulo, São Paulo, Brazil
| | - Dora Fix Ventura
- 1 Laboratório de Psicofisiologia Sensorial, Departamento de Psicologia Experimental, Instituto de Psicologia, Universidade de São Paulo, São Paulo, Brazil.,2 Núcleo de Neurociências e Comportamento e Neurociências Aplicada, Universidade de São Paulo, São Paulo, Brazil
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Perszyk DR, Ferguson B, Waxman SR. Maturation constrains the effect of exposure in linking language and thought: evidence from healthy preterm infants. Dev Sci 2018; 21:10.1111/desc.12522. [PMID: 28032433 PMCID: PMC5519447 DOI: 10.1111/desc.12522] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 09/20/2016] [Indexed: 01/27/2023]
Abstract
The power of human language rests upon its intricate links to human cognition. By 3 months of age, listening to language supports infants' ability to form object categories, a building block of cognition. Moreover, infants display a systematic shift between 3 and 4 months - a shift from familiarity to novelty preferences - in their expression of this link between language and core cognitive processes. Here, we capitalize on this tightly-timed developmental shift in fullterm infants to assess (a) whether it also appears in preterm infants and (b) whether it reflects infants' maturational status or the duration of their postnatal experience. Healthy late preterm infants (N = 22) participated in an object categorization task while listening to language. Their performance, coupled with that of fullterm infants, reveals that this developmental shift is evident in preterm infants and unfolds on the same maturational timetable as in their fullterm counterparts.
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Affiliation(s)
| | - Brock Ferguson
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Sandra R Waxman
- Department of Psychology, Northwestern University, Evanston, IL, USA
- Institue for Policy Research, Northwestern University, Evanston, IL, USA
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9
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Brown AM, Lindsey DT, Cammenga JG, Giannone PJ, Stenger MR. The contrast sensitivity of the newborn human infant. Invest Ophthalmol Vis Sci 2015; 56:625-32. [PMID: 25564453 DOI: 10.1167/iovs.14-14757] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To measure the binocular contrast sensitivity (CS) of newborn infants using a fixation-and-following card procedure. METHODS The CS of 119 healthy newborn infants was measured using stimuli printed on cards under the descending method of limits (93 infants) and randomized/masked designs (26 infants). One experienced and one novice adult observer tested the infants using vertical square-wave gratings (0.06 and 0.10 cyc/deg; 20/10,000 and 20/6000 nominal Snellen equivalent); the experienced observer also tested using horizontal gratings (0.10 cyc/deg) and using the Method of Constant Stimuli while being kept unaware of the stimulus values. RESULTS The CS of the newborn infant was 2.0 (contrast threshold = 0.497; 95% confidence interval: 0.475-0.524) for vertically oriented gratings and 1.74 (threshold = 0.575; 95% confidence interval: 0.523-0.633) for horizontally oriented gratings (P < 0.0006). The standard deviation of infant CS was comparable to that obtained by others on adults using the Pelli-Robson chart. The two observers showed similar practice effects. Randomization of stimulus order and masking of the adult observer had no effect on CS. CONCLUSIONS The CS of individual newborn human infants can be measured using a fixation-and-following card procedure.
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Affiliation(s)
- Angela M Brown
- College of Optometry, The Ohio State University, Columbus, Ohio, United States
| | - Delwin T Lindsey
- College of Optometry, The Ohio State University, Columbus, Ohio, United States Department of Psychology, The Ohio State University, Mansfield, Columbus, Ohio, United States
| | - Joanna G Cammenga
- College of Optometry, The Ohio State University, Columbus, Ohio, United States
| | - Peter J Giannone
- College of Medicine, The Ohio State University, Columbus, Ohio, United States Kentucky Children's Hospital, University of Kentucky College of Medicine, Lexington, Kentucky, United States
| | - Michael R Stenger
- College of Medicine, The Ohio State University, Columbus, Ohio, United States Nationwide Children's Hospital, Columbus, Ohio, United States
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10
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Martini G, Netto AA, Morcillo AM, Gagliardo HGRG, de Oliveira DF. The LEA Grating Test in assessing detection grating acuity in normal infants less than 4 months of age. J AAPOS 2014; 18:563-6. [PMID: 25459200 DOI: 10.1016/j.jaapos.2014.08.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2013] [Revised: 07/27/2014] [Accepted: 08/07/2014] [Indexed: 11/15/2022]
Abstract
PURPOSE To assess binocular detection grating acuity using the LEA GRATINGS test to establish age-related norms in healthy infants during their first 3 months of life. METHOD In this prospective, longitudinal study of healthy infants with clear red reflex at birth, responses to gratings were measured at 1, 2, and 3 months of age using LEA gratings at a distance of 28 cm. The results were recorded as detection grating acuity values, which were arranged in frequency tables and converted to a one-octave scale for statistical analysis. For the repeated measurements, analysis of variance (ANOVA) was used to compare the detection grating acuity results between ages. RESULTS A total of 133 infants were included. The binocular responses to gratings showed development toward higher mean values and spatial frequencies, ranging from 0.55 ± 0.70 cycles per degree (cpd), or 1.74 ± 0.21 logMAR, in month 1 to 3.11 ± 0.54 cpd, or 0.98 ± 0.16 logMAR, in month 3. Repeated ANOVA indicated differences among grating acuity values in the three age groups. CONCLUSIONS The LEA GRATINGS test allowed assessment of detection grating acuity and its development in a cohort of healthy infants during their first 3 months of life.
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Affiliation(s)
- Giovana Martini
- School of Medical Sciences, University of Campinas FCM-UNICAMP, Campinas, Brazil.
| | - Abimael A Netto
- School of Medical Sciences, University of Campinas FCM-UNICAMP, Campinas, Brazil
| | - André M Morcillo
- School of Medical Sciences, University of Campinas FCM-UNICAMP, Campinas, Brazil
| | | | - Denise F de Oliveira
- School of Medical Sciences, University of Campinas FCM-UNICAMP, Campinas, Brazil
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11
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Peña M, Arias D, Dehaene-Lambertz G. Gaze Following Is Accelerated in Healthy Preterm Infants. Psychol Sci 2014; 25:1884-92. [DOI: 10.1177/0956797614544307] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Gaze following is an essential human communication cue that orients the attention of two interacting people to the same external object. This capability is robustly observed after 7 months of age in full-term infants. Do healthy preterm infants benefit from their early exposure to face-to-face interactions with other humans to acquire this capacity sooner than full-term infants of the same chronological age, despite their immature brains? In two different experiments, we demonstrated that 7-month-old preterm infants performed like 7-month-old full-term infants (with whom they shared the same chronological age) and not like 4-month-old full-term infants (with whom they shared the same postmenstrual age). The duration of exposure to visual experience thus appears to have a greater impact on the development of early gaze following than does postmenstrual age.
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Affiliation(s)
- Marcela Peña
- Laboratorio de Neurociencias Cognitivas, Escuela de Psicología, Pontificia Universidad Católica de Chile
| | - Diana Arias
- Laboratorio de Neurociencias Cognitivas, Escuela de Psicología, Pontificia Universidad Católica de Chile
| | - Ghislaine Dehaene-Lambertz
- Cognitive Neuroimaging Unit, INSERM U992, Gif-sur-Yvette, France
- NeuroSpin Center, DSV/I2BM, Commissariat à l'Energie Atomique, Gif-sur-Yvette, France
- Cognitive Neuroimaging Unit, Université Paris-Sud
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12
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Effects of prematurity on the development of contrast sensitivity: testing the visual experience hypothesis. Vision Res 2013; 82:31-41. [PMID: 23485427 DOI: 10.1016/j.visres.2013.02.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Revised: 01/30/2013] [Accepted: 02/05/2013] [Indexed: 11/24/2022]
Abstract
In order to investigate the effects of visual experience on early visual development, the current study compared contrast sensitivity across infants born with different degrees of moderate-to-late prematurity. Here the logic is that at any given postterm age, the most premature infants will have the oldest postnatal age. Given that postnatal age is a proxy for visual experience, the visual experience hypothesis predicts that infants who are more premature, yet healthy, should have higher sensitivity. Luminance (light/dark) and chromatic (red/green) contrast sensitivities (CS) were measured in 236 healthy infants (born -10 to +2 weeks relative to due date) between 5 and 32 weeks postterm age from due date and 8-38 weeks postnatal from birth date. For chromatic CS, we found clear evidence that infants who were most premature within our sample had the highest sensitivity. Specifically, 4-10 additional weeks of visual experience, by virtue of being born early, enhanced chromatic CS. For luminance CS, similar but weaker results were seen. Here, only infants with an additional 6-10 weeks of visual experience, and only at later age points in development, showed enhanced sensitivity. However, CS in preterm infants was still below that of fullterm infants with equivalent postnatal age. In sum, these results suggest that chromatic CS is influenced more by prematurity (and possibly visual experience) than luminance CS, which has implications for differential development of parvocellular and magnocellular pathways.
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13
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Hou C, Norcia AM, Madan A, Tith S, Agarwal R, Good WV. Visual cortical function in very low birth weight infants without retinal or cerebral pathology. Invest Ophthalmol Vis Sci 2011; 52:9091-8. [PMID: 22025567 DOI: 10.1167/iovs.11-7458] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Preterm infants are at high risk of visual and neural developmental deficits. However, the development of visual cortical function in preterm infants with no retinal or neurologic morbidity has not been well defined. To determine whether premature birth itself alters visual cortical function, swept parameter visual evoked potential (sVEP) responses of healthy preterm infants were compared with those of term infants. METHODS Fifty-two term infants and 58 very low birth weight (VLBW) infants without significant retinopathy of prematurity or neurologic morbidities were enrolled. Recruited VLBW infants were between 26 and 33 weeks of gestational age, with birth weights of less than 1500 g. Spatial frequency, contrast, and vernier offset sweep VEP tuning functions were measured at 5 to 7 months' corrected age. Acuity and contrast thresholds were derived by extrapolating the tuning functions to 0 amplitude. These thresholds and suprathreshold response amplitudes were compared between groups. RESULTS Preterm infants showed increased thresholds (indicating decreased sensitivity to visual stimuli) and reductions in amplitudes for all three measures. These changes in cortical responsiveness were larger in the <30 weeks ' gestational age subgroup than in the ≥30 weeks' gestational age subgroup. CONCLUSIONS Preterm infants with VLBW had measurable and significant changes in cortical responsiveness that were correlated with gestational age. These results suggest that premature birth in the absence of identifiable retinal or neurologic abnormalities has a significant effect on visual cortical sensitivity at 5 to 7 months' of corrected age and that gestational age is an important factor in visual development.
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Affiliation(s)
- Chuan Hou
- The Smith-Kettlewell Eye Research Institute, 2318 Fillmore Street, San Francisco, CA, USA
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14
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Braddick O, Atkinson J. Development of human visual function. Vision Res 2011; 51:1588-609. [PMID: 21356229 DOI: 10.1016/j.visres.2011.02.018] [Citation(s) in RCA: 204] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2010] [Revised: 02/21/2011] [Accepted: 02/22/2011] [Indexed: 11/19/2022]
Abstract
By 1985 newly devised behavioral and electrophysiological techniques had been used to track development of infants' acuity, contrast sensitivity and binocularity, and for clinical evaluation of developing visual function. This review focus on advances in the development and assessment of infant vision in the following 25 years. Infants' visual cortical function has been studied through selectivity for orientation, directional motion and binocular disparity, and the control of subcortical oculomotor mechanisms in fixation shifts and optokinetic nystagmus, leading to a model of increasing cortical dominance over subcortical pathways. Neonatal face processing remains a challenge for this model. Recent research has focused on development of integrative processing (hyperacuity, texture segmentation, and sensitivity to global form and motion coherence) in extra-striate visual areas, including signatures of dorsal and ventral stream processing. Asynchronies in development of these two streams may be related to their differential vulnerability in both acquired and genetic disorders. New methods and approaches to clinical disorders are reviewed, in particular the increasing focus on paediatric neurology as well as ophthalmology. Visual measures in early infancy in high-risk children are allowing measures not only of existing deficits in infancy but prediction of later visual and cognitive outcome. Work with early cataract and later recovery from blinding disorders has thrown new light on the plasticity of the visual system and its limitations. The review concludes with a forward look to future opportunities provided by studies of development post infancy, new imaging and eye tracking methods, and sampling infants' visual ecology.
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Affiliation(s)
- Oliver Braddick
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom.
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15
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Chieffo D, Ricci D, Baranello G, Martinelli D, Veredice C, Lettori D, Battaglia D, Dravet C, Mercuri E, Guzzetta F. Early development in Dravet syndrome; visual function impairment precedes cognitive decline. Epilepsy Res 2011; 93:73-9. [DOI: 10.1016/j.eplepsyres.2010.10.015] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2010] [Revised: 10/26/2010] [Accepted: 10/31/2010] [Indexed: 11/25/2022]
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16
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Comparison of electroretinogram between healthy preterm and term infants. Doc Ophthalmol 2010; 121:205-13. [PMID: 20878205 DOI: 10.1007/s10633-010-9248-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2009] [Accepted: 09/08/2010] [Indexed: 10/19/2022]
Abstract
To investigate the retinal development in healthy preterm infants through standard ganzfeld electroretinograms (ERG) and compare the difference of ERG between the healthy preterm and term infants. Forty-nine 49 healthy infants were recruited to this study, including 20 preterm and 29 term infants. All the infants were grouped as follows: term 40 W group (ERG recorded at birth), term 44 W group (ERG recorded at 4 weeks after birth), preterm 35 W group (ERG recorded at birth) and preterm 40 W group (ERG recorded at due date). Standard ganzfeld flash ERG was performed according to the ISCEV standard for the clinical electroretinogram (2008). The ERG amplitudes in the term 44 W group were notably larger than those of the term 40 W group, but there was no significant difference between the two groups for combined-b and cone-b responses. The implicit time of cone-b, combined-a and 30 Hz in term 44 W group was significantly shorter than that in term 40 W group, and there was no significant difference in other ERG responses between the two groups. Amplitude of ERG waves in preterm 35 W group was only 48.7-78.0% of that in term 40 W group, and the difference of all ERG waves between the two groups was statistically significant, but there was no significant difference between the two groups for implicit time of all responses except rod-b. There was no significant difference between the amplitude of ERG waves in term 40 W and preterm 40 W groups; however, implicit time of cone-a and cone-b in term 40 W is significantly longer than that in preterm 40 W group. The ERG amplitudes in the preterm 35 W group were notably smaller than those of the preterm 40 W group, and except cone-a response, the difference between the two groups was statistically significant, while the difference of the implicit time between the two groups was not significant. OPs could not be recorded in some infants. OPs were seen significantly less frequently in the preterm 35 W group than in either the term 40 W group (Fisher exact test, P = 0.006) or the term 44 W group (Fisher exact test, P = 0.02). No other significant inter-group frequency differences were found. The mean amplitude ratio b/a was not significantly different between the four groups (P > 0.05) (analysis of variance). The retina is not fully developed at birth in healthy preterm infants. The preterm ISCEV ERG matures rapidly after birth and by term reaches the degree of maturation found in term born neonates.
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17
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Ramenghi LA, Ricci D, Mercuri E, Groppo M, De Carli A, Ometto A, Fumagalli M, Bassi L, Pisoni S, Cioni G, Mosca F. Visual performance and brain structures in the developing brain of pre-term infants. Early Hum Dev 2010; 86 Suppl 1:73-5. [PMID: 20153942 DOI: 10.1016/j.earlhumdev.2010.01.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The presence of abnormal visual function has been related to overt lesions in the thalami, peritrigonal white matter (such as cavitational-necrotic periventricular leucomalacia) and optic radiations, and also to the extent of occipital cortex involvement. The normal development of visual function seems to depend on the integrity of a network that includes not only optic radiations and the primary visual cortex but also other cortical and subcortical areas, such as the frontal or temporal lobes or basal ganglia, which have been found to play a topical role in the development of vision. Therefore, the complex functions and functional connectivity of the developing brain of premature infants can be studied only with highly sophisticated techniques such as diffusion tensor tractography. The combined use of visual tests and neonatal structural and functional neuroimaging, which have become available for newborn infants, provides a better understanding of the correlation between structure and function from early life. This appears to be particularly relevant considering the essential role of early visual function in cognitive development. The identification of early visual impairment is also important, as it allows for early enrolment in intervention programmes. The association of clinical and functional studies to newer imaging techniques, which are being increasingly used also in neonates, are likely to provide further information on early aspects of vision and the mechanisms underlying brain plasticity, which are still not fully understood. Early exposure to a difficult postnatal environment together with early and unexpected removal from a protective milieu are exclusive and peculiar factors of prematurity that interfere with the normal development of the visual system in pre-term babies. The problem is further compounded by the influence of different perinatal brain lesions affecting the developing brain of premature babies. Nevertheless, in the last few decades, there have been considerable advances in our understanding of the development of vision in pre-term infants during early infancy. This has mainly been due to the development of age-specific tests assessing various aspects of visual function, from ophthalmological examination to more cortical aspects of vision, such as the ability to process orientation or different aspects of visual attention [1-7]. Improvements in understanding very early and specific neurological impairments in neurological functions have been reported in pre-term infants, known to be at risk of developing visual and visual-perceptual impairment. These impairments are due not only to retinopathy, a common finding in premature infants, but also to cerebral (central) visual impairment, secondary to brain lesions affecting the central visual pathway.
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Affiliation(s)
- Luca Antonio Ramenghi
- NICU, Ospedale Maggiore Policlinico, Mangiagalli and Regina Elena, IRCCS, University of Milan, Milan, Italy.
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18
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Ricci D, Cesarini L, Gallini F, Serrao F, Leone D, Baranello G, Cota F, Pane M, Brogna C, De Rose P, Vasco G, Alfieri P, Staccioli S, Romeo DM, Tinelli F, Molle F, Lepore D, Baldascino A, Ramenghi LA, Torrioli MG, Romagnoli C, Cowan F, Atkinson J, Cioni G, Mercuri E. Cortical visual function in preterm infants in the first year. J Pediatr 2010; 156:550-5. [PMID: 20056237 DOI: 10.1016/j.jpeds.2009.10.042] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2009] [Revised: 09/15/2009] [Accepted: 10/30/2009] [Indexed: 10/20/2022]
Abstract
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.
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Affiliation(s)
- Daniela Ricci
- Paediatric Neurology Unit, Catholic University, Rome, Italy
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19
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Bosworth RG, Dobkins KR. Chromatic and luminance contrast sensitivity in fullterm and preterm infants. J Vis 2009; 9:15.1-16. [PMID: 20055548 DOI: 10.1167/9.13.15] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2009] [Accepted: 11/12/2009] [Indexed: 11/24/2022] Open
Abstract
In order to investigate the contributions of visual experience vs. preprogrammed mechanisms on visual development, the current study compared contrast sensitivity in preterm vs. fullterm infants. If development is tied to time since conception, preterm infants should match the developmental trajectories of fullterm infants when plotted in postterm age. By contrast, if development is influenced by visual experience, preterm and fullterm infants should match when plotted in postnatal age. Luminance (light/dark) and chromatic (red/green) contrast sensitivities (CS) were measured in 25 preterm (born, on average, 6.6 weeks early) and 77 fullterm infants, between 1 and 6 months postterm. In the first few months, luminance CS was found to be predicted by postterm age, suggesting that preprogrammed development is sufficient to account for luminance CS. By contrast, chromatic CS exceeded that predicted by postterm age, which suggests that time since birth confers a benefit on chromatic CS. The preterms' 6.6 weeks of additional time since birth is roughly equivalent to 3.7 weeks of development in chromatic CS. In sum, these results suggest that chromatic CS is more influenced by early postnatal visual experience than luminance CS, which may have implications for development of parvocellular and magnocellular pathways.
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Affiliation(s)
- Rain G Bosworth
- Department of Psychology, University of California, San Diego, La Jolla, CA, USA.
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21
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Adams R, Mercer M, Courage M. Ontogenetic development of visual acuity over the first three postnatal years. Ophthalmic Genet 2009; 25:199-203. [PMID: 15512996 DOI: 10.1080/13816810490498314] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Russell Adams
- Department of Psychology & Pediatrics, Faculties of Science, Memorial University of Newfoundland, St. John's, NF, Canada
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22
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Saunders KJ, Westall CA, Woodhouse JM. Longitudinal Assessment of Monocular Grating Acuity: Predictive Value of Estimates in Infancy. Neuroophthalmology 2009. [DOI: 10.3109/01658109609009655] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Hunnius S, Geuze RH, Zweens MJ, Bos AF. Effects of preterm experience on the developing visual system: a longitudinal study of shifts of attention and gaze in early infancy. Dev Neuropsychol 2008; 33:521-35. [PMID: 18568902 DOI: 10.1080/87565640802101508] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Several studies on visual development support the notion that healthy, low-risk preterm infants benefit from their early exposure to the visual world. It has been suggested, however, that mainly early developing sensory and motor processes are enhanced as a result of visual experience and early exercise, whereas later maturing processes might not. This study investigates whether preterm infants' visual and attentional development is accelerated as a consequence of their early visual experience and whether early and later maturing processes are affected differently. Preterm and full-term infants' performance on a gaze and attention shifting task was examined during the first six months of life. Until about 16 weeks post- term, preterm infants were faster in disengaging and shifting their attention and gaze from a stimulus in their central visual field to the periphery, whereas no difference was found for simple gaze shifts without disengagement. This finding is in contrast to earlier accounts that only early developing mechanisms might be advanced as a result of additional visual experience, whereas later developing cortical processes might depend mainly on preprogrammed maturation processes. However, it is consistent with a number of findings on visual, motor, and speech development, which have indicated accelerated cortical functioning in healthy preterm infants before.
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Affiliation(s)
- Sabine Hunnius
- Department of Developmental and Clinical Psychology, University of Groningen, The Netherlands.
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25
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Ricci D, Romeo DMM, Serrao F, Cesarini L, Gallini F, Cota F, Leone D, Zuppa AA, Romagnoli C, Cowan F, Mercuri E. Application of a neonatal assessment of visual function in a population of low risk full-term newborn. Early Hum Dev 2008; 84:277-80. [PMID: 17996405 DOI: 10.1016/j.earlhumdev.2007.10.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2007] [Revised: 09/29/2007] [Accepted: 10/01/2007] [Indexed: 10/22/2022]
Abstract
BACKGROUND We have previously developed and described a battery of 9 items suitable for assessing different clinical aspects of visual function in newborn infants. AIM OF THE STUDY Application of the test battery to a cohort of low risk term-born infants at 48 and 72 h after birth 1) to define the normative distribution of results for each item and 2) to document any effect of postnatal age. STUDY DESIGN AND SUBJECTS 124 term-born low risk infants were assessed at 48 h; fifty of them were re-assessed 24 h later at 72 h. RESULTS The visual test battery was successfully completed in 110 of the 124 infants assessed at 48 h and in all the 50 infants assessed at 72 h after birth. For 3 of the 9 items (fixation on a black/white target of concentric circles, on a coloured (red/yellow) face and horizontal tracking), the findings were very similar at both ages. For the remaining 6 items the range of findings was wider. There was a statistical difference in the responses obtained at 48 and 72 h for vertical and arc tracking (p<0.05) and the ability to discriminate stripes and attention at distance (p<0.001). CONCLUSION Our results provide information on the visual abilities in a low risk population of term-born infants and the distribution of frequency of their visual responses to our battery of visual tests. These findings may be used as reference data when using our visual test battery in both clinical and research settings.
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Affiliation(s)
- Daniela Ricci
- Paediatric Neurology Unit, Catholic University, Rome, Italy.
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26
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Tinelli F, Pei F, Guzzetta A, Bancale A, Mazzotti S, Baldassi S, Cioni G. The assessment of visual acuity in children with periventricular damage: a comparison of behavioural and electrophysiological techniques. Vision Res 2008; 48:1233-41. [PMID: 18384834 DOI: 10.1016/j.visres.2008.02.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2007] [Revised: 02/11/2008] [Accepted: 02/18/2008] [Indexed: 10/22/2022]
Abstract
It has been controversial whether electrophysiology offers better precision than behavioural techniques in measuring visual acuity in children with brain damage. We investigated the concordance between sweep VEPs and Acuity Cards (AC) in 29 children with periventricular leukomalacia (PVL), the most common type of brain damage in preterm infants. An overall good correlation was shown but with relatively better behavioural acuity values. VEP/AC ratio was significantly correlated to corpus callosum posterior thinning. We propose that this result reflects the efficacy of the compensatory mechanisms following early brain damage which may differentially affect the two methods.
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Affiliation(s)
- F Tinelli
- Division of Child Neurology and Psychiatry, University of Pisa, Italy
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27
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Ricci D, Cesarini L, Groppo M, De Carli A, Gallini F, Serrao F, Fumagalli M, Cowan F, Ramenghi LA, Anker S, Mercuri E, Mosca F. Early assessment of visual function in full term newborns. Early Hum Dev 2008; 84:107-13. [PMID: 17513071 DOI: 10.1016/j.earlhumdev.2007.03.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2007] [Revised: 03/19/2007] [Accepted: 03/24/2007] [Indexed: 11/25/2022]
Abstract
BACKGROUND The assessment of visual function is part of all the neonatal neurological examination but it is often limited to the evaluation of ocular movements and the ability to fix and follow a target. AIM OF THE STUDY To develop a simple battery of test items assessing different aspects of visual function that could be used as early as 48 h after birth. STUDY DESIGN AND SUBJECTS : The final battery, which has been used in 50 full term low risk neonates, includes 9 items assessing ocular motility, both spontaneous and with focus on a visual target, fixation and tracking (horizontal, vertical and in an arc), the ability to discriminate stripes of different spatial frequency, and attention at distance. RESULTS The battery proved easy to perform and did not require long training. The testing did not require a specific setting and was easy to use even for infants in incubators. The equipment is small and cleanable. CONCLUSION Our paper suggests that a simple battery, which can be performed in 5/10 min, can be easily applied and provides useful information on various aspects of early neonatal visual function.
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Affiliation(s)
- Daniela Ricci
- Paediatric Neurology Unit, Catholic University, Rome, Italy
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28
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Abstract
Disorders of visual function are common findings in children with neonatal brain lesions of antenatal and perinatal onset. In the last few years the development of age appropriate batteries for assessing visual function in the first years and the combined use of neuroimaging and neurophysiological techniques have allowed to achieve better understanding of the mechanisms underlying development of vision in low risk infants and in those with brain lesions. We will review the main models of visual development and the tests available to assess visual function in infancy, focusing on the recently described battery of tests for assessing early visual abilities in preterm and full term infants.
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29
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Baranello G, Vasco G, Ricci D, Mercuri E. Visual function in nonsyndromic craniosynostosis: past, present, and future. Childs Nerv Syst 2007; 23:1461-5. [PMID: 17701186 DOI: 10.1007/s00381-007-0435-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2007] [Indexed: 10/23/2022]
Abstract
BACKGROUND Previous studies on visual function in craniosynostosis have mainly focused on ocular movements and ophthalmologic findings. More recently, some studies also included the assessment of more functional and electrophysiological aspects of vision, such as acuity and visual evoked potentials. METHODS We reviewed all the relevant publications on visual findings in infants and children with both syndromic and nonsyndromic craniosynostosis and reported our own recent experience on the presurgical assessment of visual function in infants with single suture nonsyndromic craniosynostosis. RESULTS Most studies report abnormal ophthalmologic findings, mainly strabismus and refractive deficits. Only few recent studies, including ours, have reported the impairment of more functional aspects of vision, such as visual acuity and visual evoked potentials in relation to the various forms of craniosynostoses. DISCUSSION We suggest a few guidelines for further studies, which may help to better elucidate the mechanisms underlying possible visual impairment in the various types of craniosynostosis.
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Ricci D, Vasco G, Baranello G, Salerni A, Amante R, Tamburrini G, Dickmann A, Di Rocco C, Velardi F, Mercuri E. Visual function in infants with non-syndromic craniosynostosis. Dev Med Child Neurol 2007; 49:574-6. [PMID: 17635200 DOI: 10.1111/j.1469-8749.2007.00574.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The aim of this study was to assess various aspects of visual function in children with single-suture, non-syndromic craniosynostosis. Thirty-eight infants (28 males, 10 females; age range 3.5-13mo, mean age 7mo, 11 with plagiocephaly, 12 with trigonocephaly, and 15 with scaphocephaly), were assessed with a battery of tests specifically designed to assess various aspects of visual function in infancy. Thirty-two of the 38 infants had at least one abnormality on one of the aspects of visual function assessed. Abnormal eye movements were found in eight infants of the whole cohort and were mainly found in infants with plagiocephaly (6/11), who also had frequent visual field abnormalities (5/11). In contrast, fixation shift, an aspect of visual function related to the integrity of parietal lobes, was more frequently abnormal in patients with scaphocephaly. Our results suggest that the presence and severity of visual impairment is related to the type of craniosynostosis. Follow-up studies after surgical correction are needed to evaluate the possible beneficial effects of reconstructive surgery on visual function.
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Affiliation(s)
- D Ricci
- Pediatric Neurology Unit, Catholic University, Rome, Italy
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31
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Abstract
Early experience preserves and refines many capabilities that emerge prenatally. Here we describe another role that it plays -- establishing the neural substrate for capabilities that emerge at a much later point in development. The evidence comes from sleeper effects: permanent deficits when early experience was absent in capabilities that normally emerge long after birth. We provide evidence of sleeper effects for three aspects of vision, based on our research with children who were deprived of early visual input by congenital cataracts: contrast sensitivity for mid and high spatial frequencies, holistic face processing, and the ability to recognize the identity of faces based on small differences in the spacing among facial features.
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Affiliation(s)
- Daphne Maurer
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, Canada.
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32
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Maurer D, Mondloch CJ, Lewis TL. Effects of early visual deprivation on perceptual and cognitive development. PROGRESS IN BRAIN RESEARCH 2007; 164:87-104. [PMID: 17920427 DOI: 10.1016/s0079-6123(07)64005-9] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
During early infancy, visual capabilities are quite limited. Nevertheless, patterned visual input during this period is necessary for the later development of normal vision for some, but not all, aspects of visual perception. The evidence comes from studies of children who missed early visual input because it was blocked by dense, central cataracts in both eyes. In this article, we review the effects of bilateral congenital cataracts on two aspects of low-level vision--acuity and contrast sensitivity, and on three aspects of higher-level processing of faces. We end by discussing the implications for understanding the developmental mechanisms underlying normal perceptual and cognitive development.
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Affiliation(s)
- Daphne Maurer
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, L8S 4K1, Canada.
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Abstract
Extremely preterm infants are at risk for neurodevelopmental problems and the visual system is particularly vulnerable. However, development of visual function in preterm infants with little or no retinal or neurologic injury has not been well defined. This study compared development of visual function in preterm infants without severe retinopathy of prematurity (ROP), intraventricular hemorrhage (IVH) or periventricular leukomalacia (PVL) to that of term infants at 5-7 mo corrected age. Twenty-one very low birth weight (VLBW) preterm infants (24-32 wk gestational age, weighing < 1500 g), and 22 healthy term infants were tested at 5-7 mo corrected age. Infants with any IVH/PVL and > Stage II ROP or Plus disease were excluded. Contrast sensitivity, grating acuity, and vernier acuity were measured using swept-parameter visual evoked potentials. Thresholds and maximum amplitudes were compared between groups. VLBW and term infants showed no differences in sensitivity for contrast (67.5 versus 63.8), grating resolution (12.4 versus 12.5 cpd) or vernier acuity (1.2 versus 1.0 arcmin). However, the amplitudes for swept contrast (p < 0.03) and swept vernier offset (p < 0.04) stimuli were higher in VLBW infants. Visual thresholds in VLBW infants without serious retinal or neurologic abnormalities were not significantly different from those of term infants, suggesting that increased visual experience does not influence visual sensitivity. The higher amplitudes in VLBW infants, suggests that visual experience may affect responses to suprathreshold stimuli.
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Affiliation(s)
- Giuseppe Mirabella
- The Smith-Kettlewell Eye Research Institute, San Francisco, CA 94115, USA
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Spierer A, Royzman Z, Kuint J. Visual Acuity in Premature Infants. Ophthalmologica 2004; 218:397-401. [PMID: 15564758 DOI: 10.1159/000080943] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2003] [Accepted: 11/21/2003] [Indexed: 11/19/2022]
Abstract
PURPOSE To measure grating visual acuity in premature infants and compare it with that in full-term infants. METHODS The visual acuity of 73 premature and 73 full-term infants was tested at 6 months of age by the Teller Acuity Card procedure. All premature infants had undergone indirect funduscopy for the detection of retinopathy of prematurity (ROP). Seven infants had developed ROP. The mean gestational age of the premature infants was 33 +/- 1.4 weeks as compared with 39.9 +/- 0.9 weeks in the full-term infants. The mean birth weights of the 2 groups were 1,906 +/- 412 and 3,244 +/- 420 g, respectively. RESULTS Impaired binocular visual acuity was found in 53.4% of the premature infants, but in only 11% of the full-term infants (p < 0.0001). Impaired monocular visual acuity was found in 13.7% of the premature infants as compared with 2.7% of the full-term infants. Within the premature infant group, monocular visual acuity was impaired in 42.9% of those with ROP and in 10.6% of those without ROP (p = 0.0497). Pathological refraction was found in 33.3% of the prematures without ROP and in 14.3% of the prematures with ROP. This difference was not statistically significant. Visual acuity of preterm infants was not different from full-term infants when examined at 6 months of postconceptual age. CONCLUSIONS Both monocular and binocular visual acuities as measured by the Teller Acuity Cards are worse in premature infants than in full-term infants at the same chronological age. Poor visual acuity in premature infants can be attributed mainly to immaturity of the visual system.
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Affiliation(s)
- Abraham Spierer
- Goldschleger Eye Institute, Neonatal Department, Sheba Medical Center, Tel-Hashomer, Israel.
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Magnusson G, Abrahamsson M, Sjöstrand J. Changes in visual acuity from 4 to 12 years of age in children operated for bilateral congenital cataracts. Br J Ophthalmol 2002; 86:1385-9. [PMID: 12446371 PMCID: PMC1771395 DOI: 10.1136/bjo.86.12.1385] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2002] [Indexed: 11/03/2022]
Abstract
AIMS To investigate the long term effects of age at surgery on the development of visual acuity (VA) by measuring VA from preschool age to puberty. Furthermore, to report the VA levels at 12 years of age in a geographically based cohort of operated congenital bilateral cataracts. METHODS All children born in four western counties of Sweden between January 1980 and December 1993 who were diagnosed with congenital cataracts were included in a longitudinal prospective study. The monocular VA of the better eye in 38 subjects was analysed at 4, 7, 10, and 12 years of age, with 20 total and 18 partial cataracts. The mean follow up time was 9.3 years after surgery. RESULTS The final value of VA was 0.4 or above for approximately 50% of the subjects at 12 years of age. Visual acuity improved to a considerable extent after school age, especially in children who underwent surgery between the ages of 7 weeks and 1 year. Results for partial cataracts were favourable compared to those for total cataracts, reaching a mean of approximately 0.5 at age 12. The mean VA in the group of total congenital cataracts operated on before 7 weeks of age achieved higher values of VA at 4 years of age compared to children with total cataracts operated on between 7 weeks and 1 year of age. However, no statistically significant difference in VA results among these groups could be proved. CONCLUSION Visual acuity improves to a considerable extent after school age in children with delayed visual development caused by congenital cataracts. Surgery within 7 weeks results in a more rapid development of VA, initially.
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Drover JR, Earle AE, Courage ML, Adams RJ. Improving the effectiveness of the infant contrast sensitivity card procedure. Optom Vis Sci 2002; 79:52-9. [PMID: 11828899 DOI: 10.1097/00006324-200201000-00013] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Based on results from an earlier prototype, custom software and printing techniques were developed to construct a new card-based test of contrast sensitivity (CS) for nonverbal subjects. Compared with the prototype, the new CS card test contains three improvements: (1) larger, more salient test gratings; (2) higher contrast warm-up cards for each spatial frequency set; and (3) smaller contrast step size between adjacent cards. The success of the new cards was evaluated by testing 3.5- and 12-month-old human infants. Results indicated that the new version of the test required little time to complete (mean, 6.5 min) and provided accurate estimates of visual acuity. Also, group contrast sensitivity functions (CSFs) showed substantial development from 3.5 to 12 months of age. Surprisingly, however, group CSFs obtained with the new cards were lower than those obtained with the prototype, a discrepancy that may be due to differences in space average luminance between the two sets of cards. In all, the new CS card procedure possesses several merits that give it potential as an option for assessing spatial vision in infants, toddlers, and subjects with multiple impairments.
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Affiliation(s)
- James R Drover
- Faculty of Science, Department of Psychology, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
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37
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Atkinson J, Anker S, Rae S, Weeks F, Braddick O, Rennie J. Cortical visual evoked potentials in very low birthweight premature infants. Arch Dis Child Fetal Neonatal Ed 2002; 86:F28-31. [PMID: 11815544 PMCID: PMC1721367 DOI: 10.1136/fn.86.1.f28] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To compare the age of onset of the pattern orientation reversal visual evoked potential (OR-VEP) in a group of very low birthweight (VLBW) premature infants with term infants matched for postconceptual age at testing. The OR-VEP measure is used as an indicator of visual cortical functioning because of the specificity of cortical neurones in showing sensitivity to changes of slant or orientation. DESIGN Results are given for 24 VLBW infants, born at 24-32 weeks gestation weighing less than 1500 g, and 31 infants born at term. The steady state evoked potential to a grating pattern reversing in orientation (between 45 degrees and 135 degrees) at 4 reversals/second and 8 reversals/second was recorded. RESULTS The VLBW infants with normal neonatal ultrasound results (and normal neurological outcome at 3 years of age) showed a significant OR-VEP with a similar postnatal time course to the term infants. Four premature infants, showing appreciable abnormalities on ultrasound examination, did not show normal onset of the OR-VEP, and all had an abnormal neurological outcome. CONCLUSIONS This result can be taken to indicate that the onset of cortical function is similar in healthy preterm infants to term infants. The visual development of the premature infants was neither accelerated nor delayed as a result of their extra visual experience. The OR-VEP can be used as a prognostic indicator of early brain development alongside other neurological measures. It may also be a very early indicator of later neurological outcome.
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Affiliation(s)
- J Atkinson
- Visual Development Unit, Psychology Department, University College London, UK.
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Cassia VM, Simion F, Milani I, Umiltà C. Dominance of global visual properties at birth. ACTA ACUST UNITED AC 2002. [DOI: 10.1037/0096-3445.131.3.398] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abstract
Visual impairment, oculomotor abnormalities, and refractive error are prevalent among children with a history of preterm birth. These conditions may result from exposure of the immature visual system to early visual stimulation, from nutritional deficits that occur following the abrupt loss of placental maternal-to-fetal transfer of essential nutrients, and as secondary effects of systemic disease or complications associated with preterm birth. This chapter provides an overview of the structural and functional maturation of the visual system of the healthy preterm infant and of several forms of visual impairment that are prevalent in the low birth weight population.
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Affiliation(s)
- E E Birch
- University of Texas Southwestern Medical Center, Dallas, USA.
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40
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Maurer D, Lewis TL. Visual acuity: the role of visual input in inducing postnatal change. ACTA ACUST UNITED AC 2001. [DOI: 10.1016/s1566-2772(01)00010-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abstract
Visual acuity was assessed in 28 human infants who had been deprived of all patterned visual input by cataracts in one or both eyes until they were treated at 1 week to 9 months of age. Immediately after treatment, acuity was no better than that of normal newborns. Acuity improved significantly over the next month, with some improvement apparent after as little as 1 hour of visual input. Unlike findings at older ages, the pattern of results was the same for eyes treated for monocular and for binocular deprivation. The results indicate that patterned visual input is necessary for the postnatal improvement of human visual acuity and that the onset of such input initiates rapid functional development.
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Affiliation(s)
- D Maurer
- Department of Ophthalmology, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada.
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Ellemberg D, Lewis TL, Maurer D, Lui CH, Brent HP. Spatial and temporal vision in patients treated for bilateral congenital cataracts. Vision Res 1999; 39:3480-9. [PMID: 10615511 DOI: 10.1016/s0042-6989(99)00078-4] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Using the method of limits, we measured spatial and temporal vision in 13 children who had been deprived of patterned visual input during infancy until they were treated for dense central cataracts in both eyes. Spatial vision was assessed with vertical sine-wave gratings, and temporal vision was assessed with an unpatterned luminance field sinusoidally modulated over time. Under these testing conditions, spatial contrast sensitivity at low and medium spatial frequencies (0.33-2 c deg-1) was within normal limits, but sensitivity at higher spatial frequencies and grating acuity were reduced on average by 1.3 and 0.5 log units, respectively. Temporal vision was affected less severely, with losses in sensitivity only for low temporal frequencies (5 and 10 Hz), which averaged 0.4 log units. Thus, spatial and temporal vision are likely mediated by different neural mechanisms, that are differentially affected by deprivation.
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Affiliation(s)
- D Ellemberg
- Department of Psychology, McMaster University, Hamilton, Ont., Canada
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Abstract
Using the method of limits, we measured the development of spatial and temporal vision beginning at 4 years of age. Participants were adults, and children aged 4, 5, 6, and 7 years (n = 24 per age). Spatial vision was assessed with vertical sine-wave gratings, and temporal vision was assessed with an unpatterned luminance field sinusoidally modulated over time. Under these testing conditions, spatial contrast sensitivity at every frequency increased by at least 0.5 log units between 4 and 7 years of age, at which point it was adult-like. Grating acuity reached adult values at 6 years of age. Temporal vision was more mature: at 4 years of age temporal contrast sensitivity at higher temporal frequencies (20 and 30 Hz) and critical flicker fusion frequency were already adult-like. Sensitivity at lower temporal frequencies (5 and 10 Hz) increased by 0.25 log units after the age of 4 to reach adult levels at age 7. The results suggest that temporal vision matures more rapidly than spatial vision during childhood. Thus, spatial and temporal vision are likely mediated by different underlying neural mechanisms that mature at different rates.
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Affiliation(s)
- D Ellemberg
- Department of Psychology, McMaster University, Hamilton, Ontario, Canada
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44
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Van den Hout BM, Eken P, Van der Linden D, Wittebol-Post D, Aleman S, Jennekens-Schinkel A, Van der Schouw YT, De Vries LS, Van Nieuwenhuizen O. Visual, cognitive, and neurodevelopmental outcome at 51/2 years in children with perinatal haemorrhagic-ischaemic brain lesions. Dev Med Child Neurol 1998; 40:820-8. [PMID: 9881678 DOI: 10.1111/j.1469-8749.1998.tb12359.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
To determine predictive values of early visual and neurocognitive assessment in children with perinatally acquired haemorrhagic or ischaemic brain lesions selected on the basis of ultrasound, 63 children (37 boys, 26 girls), who had been followed and examined until the age of 18 months, were reexamined at 5 1/2 years. Good correlations between visual and neurodevelopmental assessments at 18 months and at 5 1/2 years were found. When ultrasound abnormalities were combined with early visual and neurocognitive assessment data, good predictive values, especially for the group of children who had grade 2 to 4 leukomalacia, were found for visual acuity and neurodevelopment.
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Affiliation(s)
- B M Van den Hout
- Department of Paediatric Neurology, Wilhelmina Children's Hospital, Utrecht, The Netherlands
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Kennedy KA, Ipson MA, Birch DG, Tyson JE, Anderson JL, Nusinowitz S, West L, Spencer R, Birch EE. Light reduction and the electroretinogram of preterm infants. Arch Dis Child Fetal Neonatal Ed 1997; 76:F168-73. [PMID: 9175946 PMCID: PMC1720640 DOI: 10.1136/fn.76.3.f168] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
AIMS To examine the effects of light on retinal development and function in preterm infants as measured by the electroretinogram (ERG). Secondary outcomes included visual acuity testing, the incidence of retinopathy of prematurity, and general wellbeing, reflected in feeding tolerance, rate of weight gain, and length of hospital stay. METHODS Eligibility criteria for enrollment were birthweight < or = 1250 g and gestational age < or = 31 weeks. Sixty one infants were randomly allocated by 6 hours after birth to a control or treatment group which wore 97% light filtering goggles for a minimum of four weeks or until the infant reached 31 weeks postmenstrual age. RESULTS There were no significant differences between the two groups in the numbers of electroretinograms performed at 36 weeks of postmenstrual age. Although the sample size was not large enough to exclude clinically important differences in secondary outcomes, no significant differences were observed between the groups in visual acuity testing at 4-6 months corrected age, incidence of retinopathy of prematurity, weight gain, or length of stay. CONCLUSION These data support the safety and feasibility of this intervention. A much larger study will be needed to determine whether light reduction to the eyes of very low birthweight infants will reduce the incidence of retinopathy of prematurity or enhance general well-being.
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Affiliation(s)
- K A Kennedy
- Department of Pediatrics, University of Texas Southwestern Medical Center at Dallas 75235, USA
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Hermans AJ, Van Hof-van Duin J, Oudesluys-Murphy AM. Visual outcome of low-birth-weight infants (1500-2500 g) at one year of corrected age. Acta Paediatr 1994; 83:402-7. [PMID: 8025397 DOI: 10.1111/j.1651-2227.1994.tb18128.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Visual functions (grating acuity, visual field size, optokinetic nystagmus and eye alignment) were tested as part of a longitudinal study in 96 low-birth-weight infants (birth weight 1500-2500 g) at one year of corrected age. Except for optokinetic nystagmus, deficit rates of all visual functions were low, and the obtained values comparable with normal age values in full-term infants. Effects of gestational duration, birth weight and intrauterine growth retardation on visual functions could not be demonstrated. Some perinatal risk factors (mechanical ventilation, oxygen treatment for more than one day, the presence of maternal hypertensive disorders) and a less-optimal neurodevelopmental status at one year had a negligible effect on visual field size. The observed deficits are not likely to cause disability. Low-birth-weight infants appeared not to be at risk for developing visual deficits at one year of corrected age.
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Affiliation(s)
- A J Hermans
- Department of Physiology I, Erasmus University Rotterdam, The Netherlands
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Quinn GE, Berlin JA, James M. The Teller acuity card procedure. Three testers in a clinical setting. Ophthalmology 1993; 100:488-94. [PMID: 8479705 DOI: 10.1016/s0161-6420(93)31617-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
PURPOSE The Teller acuity card procedure provides a quantitative measure of grating acuity in infants and young children and has been used in clinical and laboratory settings. The purpose of this study is to address the influence of the individual testers in a clinical setting. The authors report a comparison of acuity results obtained by three well-trained, experienced testers in a busy hospital-based clinical practice. METHODS Three different testers (A, B, C) performed 971 consecutive acuity assessments using the Teller acuity card procedure on 570 patients. The testers used similar techniques and adaptations, depending on clinical need. Diagnostic categories include nystagmus, aphakia, strabismus, glaucoma, retinopathy of prematurity (ROP), ptosis, optic nerve abnormalities, etc. Patients ranged in age from 2 weeks to 17 years (mean +/- standard deviation, 23 +/- 20 months). RESULTS When each patient was represented only once, A tested 144 patients; B, 251; and C, 175. The geometric mean right eye acuity scores of A were 3.00 cycles/degree (cy/deg) (0.34 octaves, standard error [SE]; n = 134); B, 4.05 cy/deg (0.20 octave, SE; n = 225); and C, 3.71 cy/deg (0.30 octave, SE; n = 163). An analysis of covariance showed a significant difference in the mean log scores across testers (P = 0.02 adjusted for both age and diagnosis). Age was a strong predictor of acuity (P = 0.0001), and the interactions between tester and age and tester and diagnosis were not significant. The geometric mean left eye acuity scores for A were 2.86 cy/deg (0.33 octave, SE; n = 132); B, 3.46 cy/deg (0.23 octave, SE; n = 218); and C, 3.32 cy/deg (0.30 octave, SE; n = 160). The differences for left eyes among testers were not significant (P = 0.37 adjusted for age and diagnosis). CONCLUSIONS These results suggest that the tester may influence the acuity results measured by the Teller acuity card procedure in a clinical setting. Evaluation of interobserver reliability in clinical subjects should be a high priority of further work using the Teller acuity card procedure.
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Affiliation(s)
- G E Quinn
- Division of Pediatric Ophthalmology, Children's Hospital of Philadelphia, PA 19104
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49
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Schenk-Rootlieb AJ, van Nieuwenhuizen O, van Zoggel J, van der Graaf Y, Willemse J. Grating-acuity in children. Normal values of visual acuity in children up to 13 years as assessed by the acuity card procedure. OPHTHALMIC PAEDIATRICS AND GENETICS 1992; 13:155-63. [PMID: 1484693 DOI: 10.3109/13816819209046484] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The acuity card procedure proved to be a useful method for assessing visual acuity in children. Normal values of visual acuity measured by this method had already been assessed in children up to four years. To enable application of the test in older children this study obtained values in a group of 396 normal children, aged three months to 13 years. The mean curve as well as the 10th centile was calculated in different age groups. A considerable variation of acuity values causing a 'dip' in the 10th centile was found in the ages 18 to 24 months. A smaller 'dip' was found in the ages 48 to 52 months. This has to be attributed to behavioural properties connected with age. The results obtained in the group of children under four years of age corresponded fairly well with other studies. In schoolchildren a fair agreement could also be found between the data obtained using the acuity card procedure and the data obtained with the Landolt-C rings. Obtaining normal values for the acuity card procedure in children covering a wide age range facilitates recognition of visual handicap in children who are difficult to assess.
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Affiliation(s)
- A J Schenk-Rootlieb
- Department of Child Neurology, Wilhelmina Children's Hospital, Utrecht, The Netherlands
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50
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Vital-Durand F. Acuity card procedures and the linearity of grating resolution development during the first year of human infants. Behav Brain Res 1992; 49:99-106. [PMID: 1388807 DOI: 10.1016/s0166-4328(05)80199-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Since the early times of preferential looking (PL), improvement of procedures to test visual resolution in infants has reached the point where the technique is spreading to clinical practice as it is applicable to a large range of age with a high degree of reliability. Acuity cards allow estimation of bi- and monocular acuity in a few minutes. Data from the literature, obtained with various PL techniques and procedures are compared to explain some incongruities. Procedures for presentation of the cards and criteria for threshold determination can greatly bias the data when they do not take into account the infant's behavioral requirements. To test the linearity of the development of visual resolution, a series of grating acuity measurements was performed on a population of 11 normal infants, regularly tested during their first year of life in optimal conditions. It was observed that: (1) grating acuity develops very regularly during the first year, (2) the two eyes never differ from each other by more than the smallest difference measurable with the equipment used (one half-octave), (3) binocular acuity appears to slightly exceed monocular acuity. These results stress the need for early detection of deviation from the norm and prompt therapeutic action.
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