Center for Perinatal Research and Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio.
Stella Maris Infant Laboratory for Early Intervention, Department of Developmental Neuroscience, Stella Maris Scientific Institute, Pisa, Italy; Department of Clinical and Experimental Medicine, University of Pisa, Italy.
Pediatr Neurol. 2017 Nov;76:3-13. doi: 10.1016/j.pediatrneurol.2017.07.011. Epub 2017 Jul 20.
We performed a systematic review and evaluated the level of evidence of vision interventions and assessments for infants at high risk for or with a diagnosis of cerebral palsy from zero to two years of age. Articles were evaluated based on the level of methodologic quality, evidence, and clinical utilization. Thirty publications with vision assessments and five with vision interventions met criteria for inclusion. Assessments included standard care neuroimaging, electrophysiology, and neuro-ophthalmologic examination techniques that are utilized clinically with any preverbal or nonverbal pediatric patient. The overall level of evidence of interventions was strong for neuroprotective interventions such as caffeine and hypothermia but weak for surgery, visual training, or developmental programs. There are few evidence-based interventions and assessments that address cerebral/cortical visual impairment-related needs of infants and toddlers at high risk for or with cerebral palsy. Recommendation guidelines include the use of three types of standard care methodologies and two types of protective interventions.
我们进行了系统评价,并评估了从出生到两岁患有脑瘫高风险或确诊脑瘫的婴儿的视觉干预和评估的证据水平。根据方法学质量、证据和临床应用的水平对文章进行了评估。有 30 篇关于视觉评估的出版物和 5 篇关于视觉干预的出版物符合纳入标准。评估包括标准的神经影像学、电生理学和神经眼科检查技术,这些技术在任何有语言前或无语言的儿科患者中都有临床应用。神经保护干预措施(如咖啡因和低温疗法)的干预措施的整体证据水平较高,但手术、视觉训练或发育计划的证据水平较弱。很少有基于证据的干预措施和评估可以满足有脑瘫高风险或确诊脑瘫的婴儿和幼儿的与大脑/皮质视觉损伤相关的需求。建议指南包括使用三种类型的标准护理方法和两种类型的保护干预措施。