The Effects of Prematurity on Visual Development

早产对视觉发育的影响

• 批准号: 7273560
• 负责人: WILLIAM V GOOD
• 金额: $ 42.39万
• 依托单位: SMITH-KETTLEWELL EYE RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-15 至 2009-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7273560
• 关键词: Affect; Age; Age-Months; Bilateral; Biological Assay; Blindness; Cerebrum; Child; Complication; Condition; Contrast Sensitivity; Detection; Development; Diffusion Magnetic Resonance Imaging; Early Diagnosis; Effectiveness of Interventions; Electroencephalography; Future; Gestational Age; Goals; Head; Image; Impairment; Infant; Injury; Intervention; Lead; Life; Location; Magnetic Resonance Imaging; Measures; Medical; Methods; Monitor; Morbidity - disease rate; Neonatology; Nervous System Trauma; Newborn Infant; Normal Range; Nurseries; Pathology; Pattern; Premature Infant; Premature aging syndrome; Prematurity of fetus; Prevention; Range; Rate; Rehabilitation therapy; Role; Scanning; Structure; Structure-Activity Relationship; Survival Rate; Testing; Time; Ultrasonography; Vision; Visual evoked cortical potential; Visual impairment; Visual system structure; Week; expectation; improved; insight; intraventricular hemorrhage; nervous system disorder; postnatal; prevent; vision development; visual stimulus; white matter damage

DESCRIPTION (provided by applicant): Nearly one in every eight children is born prematurely in the US, yet very little is known about visual development or patterns of vision damage in this large group of children. The leading cause of bilateral low vision in children in the US is cerebral visual impairment (CVI), usually caused by neurological injury in premature infants. This condition will be potentially preventable or amenable to treatment in the near future as new therapies emerge for the prevention and treatment of neurological disease that result from extreme prematurity. Clearly, better methods to test and assay vision are needed. Otherwise, there will be no accurate way to judge the effects of medical or rehabilitative intervention. In this study, we will measure visual development in healthy, premature infants less than 32 weeks gestational age, and compare this to full term infants. Sweep VEP grating acuity, vernier acuity, and contrast sensitivity measures will be obtained at 6, 9, and 12 months chronological age in the premature group, and at 3, 6, 9, and 12 months chronological age in the fullterm group. In a second aim, we will measure these same three visual functions at 6, 9, and 12 months in infants who suffer an intraventricular hemorrhage (IVH) as a complication of prematurity. Results from this study will provide important information about visual development in normal premature infants, and the manner in which such visual development is perturbed by extreme prematurity and neurological damage (IVH). In a third aim, we will evaluate the role of diffusion tensor imaging (DTI) in identifying infants with vision abnormalities. DTI is performed early in the infant's life, at a time when intervention is most likely to prevent or treat neurological damage. By performing a structure-function analysis, comparing the spectrum of acuity changes in children with the spectrum of changes on their scans, we expect to be able to identify those children who have suffered damage to their visual system. This will allow early detection of vision abnormalities and pave the way for early medical and rehabilitation efforts. A comparison of head ultrasound and DTI findings will demonstrate whether DTI should replace ultrasound for the diagnosis of neurological injury in the newborn nursery.

描述（由申请人提供）：在美国，几乎每八个孩子中的几乎有一个孩子出生，但对于这群大型儿童的视觉发展或视力损害模式知之甚少。美国儿童双侧低视力的主要原因是脑视觉障碍（CVI），通常是由早产婴儿的神经损伤引起的。随着由于极端早产而导致的预防和治疗神经系统疾病的新疗法，这种情况可能是可以预防或适合治疗的。显然，需要更好的测试和测定视觉方法。否则，将没有准确的方法来判断医疗或康复干预的影响。在这项研究中，我们将衡量健康的早产婴儿的视觉发展小于32周的胎龄，并将其与完整的婴儿进行比较。在早产组中，将在6、9和12个月的年代年龄，3、6、6、9和12个月的时间顺序年龄在满月组的年龄在6、9和12个月的年龄上获得扫描VEP光栅的敏锐度，敏锐的敏锐度和对比度敏感性措施。在第二个目标中，我们将在患有脑室室内出血（IVH）的婴儿中，在6、9和12个月的时间衡量这三个视觉功能，作为早产的并发症。这项研究的结果将提供有关正常早产婴儿视觉发展的重要信息，以及这种视觉发展受到极端早产和神经系统损害（IVH）的干扰方式。在第三个目标中，我们将评估扩散张量成像（DTI）在识别视力异常的婴儿中的作用。 DTI是在婴儿生命的早期进行的，当时干预最有可能预防或治疗神经系统损害。通过进行结构功能分析，将儿童敏锐变化的频谱与扫描变化的频谱进行比较，我们希望能够识别那些对其视觉系统损害的儿童。这将允许早期发现视力异常，并为早期的医疗和康复工作铺平道路。头部超声和DTI发现的比较将证明DTI是否应取代新生儿托儿所中神经损伤的超声检查。