Nearly one in every eight children is born prematurely in the US, yet very little is known about visual development or patterns of vision damage in this large group of children. The leading cause of bilateral low vision in children in the US is cerebral visual impairment (CVI), usually caused by neurological injury in premature infants. This condition will be potentially preventable or amenable to treatment in the near future as new therapies emerge for the prevention and treatment of neurological disease that result from extreme prematurity. Clearly, better methods to test and assay vision are needed. Otherwise, there will be no accurate way to judge the effects of medical or rehabilitative intervention. In this study, we will measure visual development in healthy, premature infants less than 32 weeks gestational age, and compare this to full term infants. Sweep VEP grating acuity, vernier acuity, and contrast sensitivity measures will be obtained at 6, 9, and 12 months chronological age in the premature group, and at 3, 6, 9, and 12 months chronological age in the fullterm group. In a second aim, we will measure these same three visual functions at 6, 9, and 12 months in infants who suffer an intraventricular hemorrhage (IVH) as a complication of prematurity. Results from this study will provide important information about visual development in normal premature infants, and the manner in which such visual development is perturbed by extreme prematurity and neurological damage (IVH). In a third aim, we will evaluate the role of diffusion tensor imaging (DTI) in identifying infants with vision abnormalities. DTI is performed early in the infant's life, at a time when intervention is most likely to prevent or treat neurological damage. By performing a structure-function analysis, comparing the spectrum of acuity changes in children with the spectrum of changes on their scans, we expect to be able to identify those children who have suffered damage to their visual system. This will allow early detection of vision abnormalities and pave the way for early medical and rehabilitation efforts. A comparison of head ultrasound and DTI findings will demonstrate whether DTI should replace ultrasound for the diagnosis of neurological injury in the newborn nursery. ? ?

Agency
National Institute of Health (NIH)
Institute
National Eye Institute (NEI)
Type
Research Project (R01)
Project #
1R01EY015228-01A2
Application #
6968858
Study Section
Central Visual Processing Study Section (CVP)
Program Officer
Oberdorfer, Michael
Project Start
2005-09-15
Project End
2009-08-31
Budget Start
2005-09-15
Budget End
2006-08-31
Support Year
1
Fiscal Year
2005
Total Cost
$420,299
Indirect Cost
Name
Smith-Kettlewell Eye Research Institute
Department
Type
DUNS #
073121105
City
San Francisco
State
CA
Country
United States
Zip Code
94115
Good, William V; Hou, Chuan (2015) Visuocortical bilirubin-induced neurological dysfunction. Semin Fetal Neonatal Med 20:37-41
Hou, Chuan; Norcia, Anthony M; Madan, Ashima et al. (2014) Visuocortical function in infants with a history of neonatal jaundice. Invest Ophthalmol Vis Sci 55:6443-9
Madan, Ashima; Norcia, Anthony M; Hou, Chuan et al. (2012) Effect of Grade I and II intraventricular hemorrhage on visuocortical function in very low birth weight infants. Seeing Perceiving 25:143-54
Good, William V; Hou, Chuan; Norcia, Anthony M (2012) Spatial contrast sensitivity vision loss in children with cortical visual impairment. Invest Ophthalmol Vis Sci 53:7730-4
Hou, Chuan; Norcia, Anthony M; Madan, Ashima et al. (2011) Visual cortical function in very low birth weight infants without retinal or cerebral pathology. Invest Ophthalmol Vis Sci 52:9091-8
Good, William V; Hou, Chuan; Frieden, Ilona J et al. (2009) Evidence for visual compromise in preverbal children with orbital vascular birthmarks. Am J Ophthalmol 147:679-682.e1
Good, William V (2008) Retinopathy of prematurity and the peripheral retina. J Pediatr 153:591-2
Good, William V (2008) Standardization of retinopathy of prematurity clinical examinations in clinical trials: risks, benefits and alternatives. Clin Experiment Ophthalmol 36:1-2
Carden, Susan Mary; Luu, Lan Ngoc; Nguyen, Tinh Xuan et al. (2008) Retinopathy of prematurity: postmenstrual age at threshold in a transitional economy is similar to that in developed countries. Clin Experiment Ophthalmol 36:159-61
Good, W V; Gendron, R L (2007) Genomics and proteomics of retinopathy of prematurity: DNA-based prevention and treatment. Br J Ophthalmol 91:1577

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