White-Matter Injury is Associated With Impaired Gaze in Premature Infants
Received 13 February 2007; accepted 28 August 2007.
Periventricular leukomalacia is a risk factor for visual impairment in children born prematurely. The impact of diffuse white-matter injury, as detected on magnetic resonance imaging, on early visual function is unknown. We developed two 5-point visual-gaze scores to analyze the association between this clinical assessment and white-matter injury in 93 premature neonates <34 weeks of gestational age at birth. Older postmenstrual age was associated with higher values of the two gaze scores. Infants with moderate or severe white-matter injury had lower scores than their peers without white-matter injury (0.41 points, 95% confidence interval of 0.13-0.69 for visual fixation score; and 0.70 points, 95% confidence interval of 0.30-1.10 for conjugate score, P < 0.005). Using the results from both scales, a score of ≥9 in an infant examined at ≥36 weeks postmenstrual age predicted normal white matter on magnetic resonance examination, with a sensitivity of 84% and a specificity of 100%. These preliminary findings suggest that white-matter injury affects visual function even before term equivalent postmenstrual age.
⁎Department of Neurology, University of California at San Francisco, San Francisco, California
†Department of Radiology, University of California at San Francisco, San Francisco, California
‡Department of Pediatrics, University of California at San Francisco, San Francisco, California
§Department of Epidemiology, University of California at San Francisco, San Francisco, California
¶Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.
Communications should be addressed to: Dr. Miller; Division of Neurology, K3-180; British Columbia Children’s Hospital, University of British Columbia; 4480 Oak St.; Vancouver, British Columbia V6H 3V4, Canada.
ABSTRACT