275 - Visual Function and Neurodevelopmental Outcomes in School-Aged Children Born Extremely Preterm: A Population-Based Study

Poster Number: 275
Publication Number: 275.225

Sigrid Hegna Ingvaldsen, Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, NTNU, Trondheim, Sor-Trondelag, Norway; Tor Ivar Hansen, NTNU, Trondheim, Sor-Trondelag, Norway; Asta K. Håberg, norwegian university of science and technology, Trondheim, Sor-Trondelag, Norway; Viggo A. Moholdt, NTNU, Trondheim, AL, United States; Kari Anne I. Evensen, Norwegian University of Science and Technology, Trondheim, Sor-Trondelag, Norway; Olaf Dammann, Tufts U School of Medicine, Boston, MA, United States; Dordi Austeng, Norwegian University of Science and Technology, Trondheim, Sor-Trondelag, Norway; Tora S. Morken, Norwegian University of Science and Technology (NTNU), Trondheim, Sor-Trondelag, Norway

Background: Extremely preterm birth (gestational age (GA) < 28 weeks) is a risk factor for visual impairments, even in the absence of retinopathy of prematurity (ROP), and it is conceivable that such impairments are associated with neurodevelopmental deficits.

Objective: This exploratory study aimed to investigate the visual function and neurodevelopmental outcomes in a population of school-aged children born extremely preterm.

Design/Methods: All children born < 28 weeks in Central-Norway between 2006-2011 (Nf69) that were admitted to the Neonatal Intensive Care Unit in Trondheim, Norway, were invited to participate. Thirty-six children were included (median age= 13, min= 10, max= 16). Visual function was assessed by (1) best-corrected visual acuity (BCVA); and (2) contrast sensitivity (CS) testing spatial frequencies at 3, 6, 12 and 18 cycles per degree (CpD). Neurodevelopmental outcomes were assessed with (1) the Nordic parent questionnaire Five to Fifteen, scoring deficits in learning, executive functions, motor skills, and perception; and (2) the neuropsychological test Memoro, scoring complex reaction time, visual memory, processing speed, and pattern separation. A clinical cranial MRI (T1 mprage, T2 space) of all participants was obtained and assessed by a neuroradiologist using standardized criteria.

Results: Participants with a history of ROP (19.4%) had lower scores than those with no ROP in 3 of 4 spatial frequencies (CpD6: p=.048; CpD12: p=.009; CpD18: p=.001). BCVA, CS, and neurodevelopmental scores tended to be lower with lower GA (see Table 1 and Table 2 ). Correlation analyses suggested a negative correlation between BCVA and perception deficits (p=.010), and between CS and visual memory scores (CpD3: p=.018, CpD6: p=.004, CpD12: p=.039, CpD18: p=.025). There were also positive correlations between CS and pattern separation scores (CpD3: p=.004, CpD6= p=.034, CpD18: p=.021) (Figure 1). Clinical brain MRI did not reveal signs of preterm brain injury.Conclusion(s): In a population of school-aged children born extremely preterm in Norway with no sign of preterm brain injury on clinical MRI, visual function and neurodevelopmental outcomes seemed to vary with GA, with lower scores in those with lower GA. Furthermore, results indicate that ROP may affect the visual quality of contrast sensitivity. The association between visual function and neurodevelopmental outcomes should be investigated in larger populations of children born extremely preterm.
Table 1: Visual function presented as mean ± SD and n (%) of the cohort with scores outside normal values, by gestational age at birth.BCVA= best corrected visual acuity; SE = spherical equivalent; IOP = intraocular pressure; CpD = cycles per degree (measure of contrast sensitivity).

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