Neonatal Unit, Royal Hospital for Sick Children, , Glasgow, UK.
Br J Ophthalmol. 2014 Feb;98(2):238-45. doi: 10.1136/bjophthalmol-2013-303967. Epub 2013 Nov 18.
Flash visual evoked potentials (VEPs) were abnormal in a cohort of 100 neonates exposed to maintenance methadone in utero. This prospective cohort study now describes clinical visual and electrophysiological outcomes at 6 months.
Visual assessment included modified Atkinson test battery; strabismus, nystagmus, reduced visual acuity, delayed visual maturation or refractive error (>3 dioptres) defined a fail. Pattern-onset VEPs were recorded to 120', 60' and 15' checks.
81 drug-exposed and 26 comparison infants (79% and 52% of the original cohorts) were assessed at a median age of 27 weeks (range 26-30). 90% of drug-exposed infants had been additionally exposed to illicit drugs and 41% to excess alcohol in utero. 40% of the drug-exposed cohort failed clinical visual assessment: the relative risk of abnormal assessment was 5.1 (95% CI 1.3 to 20; p=0.02). Nystagmus was particularly common. VEP peak times were slower and amplitudes smaller in drug-exposed infants, of whom 70% had one or more abnormal VEP parameter. Abnormal visual outcome at 6 months was not associated with the pattern of additional drug exposure or a history of neonatal abstinence.
Abnormal visual electrophysiology in infants born to drug-misusing mothers prescribed maintenance methadone persists to 6 months of age, and is associated with abnormal clinical visual assessment.
在一组 100 名因宫内接受美沙酮维持治疗而暴露于药物的新生儿中，闪光视觉诱发电位（VEPs）异常。这项前瞻性队列研究现在描述了 6 个月时的临床视觉和电生理结果。
视觉评估包括改良的阿特金森测试电池；斜视、眼球震颤、视力降低、视觉成熟延迟或屈光不正（>3 屈光度）定义为失败。记录到 120'、60' 和 15' 检查的图形起始 VEPs。
81 名药物暴露婴儿和 26 名对照婴儿（原始队列的 79%和 52%）在中位数为 27 周（范围 26-30）的年龄进行评估。90%的药物暴露婴儿在宫内还接触过非法药物，41%接触过过量酒精。40%的药物暴露组在临床视觉评估中失败：异常评估的相对风险为 5.1（95%CI 1.3 至 20；p=0.02）。眼球震颤特别常见。药物暴露婴儿的 VEP 峰时间较慢，振幅较小，其中 70%有一个或多个异常 VEP 参数。6 个月时异常视觉结果与额外药物暴露模式或新生儿戒断史无关。
在因母亲滥用药物而接受美沙酮维持治疗的婴儿中，出生时异常的视觉电生理学持续到 6 个月大，并与异常的临床视觉评估相关。
