Mercuri E, Haataja L, Guzzetta A, Anker S, Cowan F, Rutherford M, Andrew R, Braddick O, Cioni G, Dubowitz L, Atkinson J
Visual Development Unit, University College, London.
Arch Dis Child Fetal Neonatal Ed. 1999 Mar;80(2):F99-104. doi: 10.1136/fn.80.2.f99.
To determine if there is any association between the findings of visual assessment performed at the age of 5 months and neurodevelopmental outcome at the age of 2 years in children who have sustained hypoxic-ischaemic insults.
Twenty nine term infants with hypoxic-ischaemic encephalopathy and/or brain lesions on neonatal magnetic resonance imaging (MRI) were prospectively evaluated. At 5 months of age all the infants had their visual function assessed using the Atkinson Battery of Child Development for Examining Functional Vision, which includes the assessments of optokinetic nystagmus (OKN), acuity, visual fields, fixation shift and phase and orientation reversal visual evoked potentials. At 2 years of age the children had a structured neurological evaluation and a Griffiths developmental assessment.
There was good correlation between the extent of the early detected visual impairment and both neuromotor and global development. Children with more than three out of five abnormal visual tests at 5 months of age tended to have abnormal neurological examination results and abnormal developmental quotients. Children with three or fewer abnormalities tended to have developmental quotients in the normal range; the level of their performance, however, was still related to the number of visual tests passed.
Individual visual tests can provide important prognostic information. While abnormal OKN and acuity were always associated with abnormal outcome, normal results on visual evoked potentials and fixation shift tended to be associated with normal outcome.
确定在患有缺氧缺血性损伤的儿童中，5个月大时进行的视力评估结果与2岁时的神经发育结局之间是否存在关联。
对29名足月新生儿进行前瞻性评估，这些新生儿患有缺氧缺血性脑病和/或在新生儿磁共振成像（MRI）上有脑损伤。在5个月大时，所有婴儿都使用阿特金森儿童发育视力功能检查量表对其视觉功能进行评估，该量表包括视动性眼震（OKN）、视力、视野、注视转移以及相位和方向反转视觉诱发电位的评估。在2岁时，对儿童进行结构化神经学评估和格里菲斯发育评估。
早期检测到的视力损害程度与神经运动和整体发育之间存在良好的相关性。在5个月大时，五项视觉测试中有三项以上异常的儿童往往神经学检查结果异常且发育商异常。异常项数为三项或更少的儿童发育商往往在正常范围内；然而，他们的表现水平仍与通过的视觉测试数量有关。
单项视觉测试可以提供重要的预后信息。虽然异常的视动性眼震和视力总是与异常结局相关，但视觉诱发电位和注视转移的正常结果往往与正常结局相关。
