Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy.
Neuropediatrics. 2023 Dec;54(6):412-416. doi: 10.1055/s-0043-1771388. Epub 2023 Aug 14.
Methadone is used as a substitute for illicit opioids during pregnancy. However, the real effect of this molecule on visual and neurodevelopmental outcomes of the children exposed is not fully understood, since studies considered subjects born to polydrug-dependent mothers and followed for few months/years. We report the long-term outcomes of two infants with congenital nystagmus solely exposed to methadone in utero. Neurological and neurovisual evaluations were performed every year from the first year of life to 11 years of age. One child was diagnosed with developmental coordination disorder. Both cases presented with ophthalmologic (refractive errors), oculomotor (nystagmus and fixation, smooth pursuit, and saccades dysfunctions), and perceptive problems (reduced visual acuity and contrast sensitivity). While nystagmus and other oculomotor dysfunctions remained stable over time, visual acuity and contrast sensitivity improved; refractive errors worsened and required corrective lenses. Both children showed normal neurodevelopmental and cognitive profile. This report highlights the long-term visual and developmental outcomes of two children exclusively exposed to methadone underlining the possibility of a visual dysfunction and motor coordination disorder. These observations prompt the need to investigate prenatal drug exposure as a cause of congenital nystagmus.
美沙酮在怀孕期间被用作非法阿片类药物的替代品。然而，这种分子对暴露于其中的儿童的视觉和神经发育结果的真正影响尚不完全清楚，因为这些研究考虑了来自多药依赖母亲的受试者，并随访了数月/数年。我们报告了两名仅在子宫内暴露于美沙酮的婴儿的长期结果。从出生后的第一年到 11 岁，每年都进行神经和神经视觉评估。一名儿童被诊断为发育协调障碍。这两个病例都存在眼科问题（屈光不正）、眼球运动问题（眼球震颤和注视、平滑追踪和扫视功能障碍）和知觉问题（视力和对比敏感度降低）。虽然眼球震颤和其他眼球运动障碍随时间保持稳定，但视力和对比敏感度有所改善；屈光不正恶化，需要矫正镜片。两个孩子的神经发育和认知状况都正常。本报告强调了两名仅暴露于美沙酮的儿童的长期视觉和发育结果，突出了视觉功能障碍和运动协调障碍的可能性。这些观察结果促使我们需要研究产前药物暴露是否是先天性眼球震颤的原因。
