[Modern possibilities of diagnosing lesions of the visual analyzer in perinatal lesions of the central nervous system in full-term and premature infants]

[Morphological features of an optic nerve in premature infants according to the optical coherence tomography data]

OBJECTIVE

To assess the morphological state of the visual analyzer in premature infants in long-term.

MATERIAL AND METHODS

We examined 40 premature children (74 eyes) aged 10.3±2.92 years (gestational age (GA) 25-34 weeks, birth weight (BW) 690-2700 g). Twenty mature children (40 eyes), aged 10.8±3.05 years, were examined as a control group. The children underwent standard ophthalmologic examination, optical coherence tomography (OCT) and recording of visual evoked potentials (VEP).

RESULTS

The thickness of retinal nerve fiber layer (RNFL) is less in preterm infants than in term infants, regardless of retinopathy of prematurity (ROP) and refraction (p<0.05). Thickness loss has an inverse proportion with the degree of hypoxic-ischemic encephalopathy (HIE) and intraventricular hemorrhage (IVH) (p<0.05). Retinal thickness in fovea is significantly greater in preterm infants and has a direct proportionality with the degree of IVH and the number of days on artificial lung ventilation (p<0.05). Moderate organic changes were detected in conduction pathways in 43.08% of premature infants according to VEP data.

CONCLUSION

The use of OCT and recording of VEP may improve the quality of comprehensive neuro-ophthalmologic diagnosis in preterm infants. The thickness loss of RNFL can be expected in premature infants with HIE and IVH.

[Anatomo-functional state of the central retina in premature infants with intraventricular hemorrhage and retinopathy of prematurity]

OBJECTIVE

Assessment of the anatomo-functional state of the central retina in children with intraventricular hemorrhage (IVH) and retinopathy of prematurity (ROP) in the long-term period.

MATERIAL AND METHODS

We examined 51 patients (102 eyes) born 25-34 weeks' of gestation (birth weight 700-2290 g), aged 8.83±3.5 years, and 18 children (36 eyes) born prematurely aged 10.8±3.2 years. The children underwent standard ophthalmologic examination, optical coherence tomography (OCT) and visual evoked potentials (VEP).

RESULTS

Retinal thickness (RT) and retinal volume (RV) in the fovea of premature infants with PH and/or IVH are significantly higher than in healthy full-term infants, which correlates with lower visual acuity (p<0.05). RT and RV in the fovea has an inverse proportional relationship with gestational age (GA), (p<0.05). According to the results of VEP, moderate organic changes in the conduction tract of the visual analyzer are noted in 45% of premature infants (p<0.05).

CONCLUSION

The process of macula formation is affected by many perinatal and postnatal factors, namely: GA, birth weight, ROP, hypoxic-ischemic CNS diseases, and refractive disorders.