Kraemer M, Abrahamsson M, Sjöström A
Department of Ophthalmology, Institute for Clinical Neuroscience, Göteborg University, Sweden.
Doc Ophthalmol. 1999;99(1):21-39. doi: 10.1023/a:1002414803226.
To follow visual development longitudinally in the normal neonate using the flash visual evoked potential (VEP) and to find indications for a relationship between potential development and visual development.
Twenty healthy infants, born at term, were included in the study. Flash and patterned flash VEPs were used. The first VEP was recorded the day of birth or just postnatally, and succeeding recordings were performed the following weeks and months.
The data revealed different types of VEP in the neonatal period suggesting great variability in visual function on the day of birth. In the early development a potential of long latency and duration preceded the development of a more compound potential of shorter latency. The two types of responses seemed to coalesce during early development; the first late response was attenuated and was eventually integrated in the more mature VEP. At approximately five weeks of age changes in the VEP were simultaneous with the development of responsive smiling and another visual behaviour of the infants.
The results showed many similarities between the VEP development in infants and in immature animals. In developing animals geniculo-cortical and extra-geniculate visual afferent pathways evoke two types of VEPs similar to those recorded in the present study. The early responses were also similar to previous recordings from children with lesions in the geniculo-striatal pathway or primary cortex. Our interpretation of the results was that the human VEP also consists of responses evoked by afferents running both in geniculo-cortical and extra-geniculate pathways and that the two types of responses could be separated in the VEP in the neonatal period. These findings are important for our understanding of conditions with a delay in visual maturation, for example intracranial haemorrhages, hydrocephalus, pre/dys-maturity and 'idiopathic' delayed visual maturation.
利用闪光视觉诱发电位（VEP）对正常新生儿的视觉发育进行纵向跟踪，并寻找电位发育与视觉发育之间关系的指征。
本研究纳入了20名足月出生的健康婴儿。使用了闪光和图形闪光VEP。首次VEP记录于出生当天或出生后不久，随后在接下来的几周和几个月进行记录。
数据显示新生儿期存在不同类型的VEP，提示出生当天视觉功能存在很大变异性。在早期发育中，长潜伏期和持续时间的电位先于潜伏期较短的更复合电位的发育。这两种反应类型在早期发育过程中似乎合并；第一个晚期反应减弱，最终整合到更成熟的VEP中。在大约五周龄时，VEP的变化与婴儿反应性微笑和另一种视觉行为的发展同时发生。
结果显示婴儿和未成熟动物的VEP发育有许多相似之处。在发育中的动物中，膝状体-皮质和膝状体外视觉传入通路诱发两种类型的VEP，与本研究中记录的相似。早期反应也与先前对膝状体-纹状体通路或初级皮质受损儿童的记录相似。我们对结果的解释是，人类VEP也由膝状体-皮质和膝状体外通路中传入神经诱发的反应组成，并且这两种反应类型在新生儿期的VEP中可以分离。这些发现对于我们理解视觉成熟延迟的情况很重要，例如颅内出血、脑积水、早产/发育异常和“特发性”视觉成熟延迟。
