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Summary: Babies who experience severe bleeding in the brain during the first year of life are more likely to have long-term vision problems, according to a new study.
Source: University of Bristol
Severe ‘brain hemorrhage’, which some babies experience in the first year after birth, leads to long-term vision problems, researchers at the University of Bristol have found in a ten-year follow-up study.
The study published in the journal Developmental Medicine & Pediatric Neurology today [23 June]studied 32 children aged 10 to 11 years who were evaluated in detail after grade 3 or 4 intraventricular hemorrhage (brain hemorrhage) and ventricular dilatation (IVHVD) in a study called DRIFT10.
The DRIFT10 study was set up to investigate a “brainwashing” technique for cerebral hemorrhage called DRIFT (Drainage, Irrigation and Fibrinolytic Therapy). Developed by Bristol researchers, DRIFT is the first and only treatment to objectively benefit infants with severe cerebral hemorrhage by washing out the ventricles in the brain to remove toxic fluids and reduce pressure.
The research team reviewed 32 children aged 10 to 11 years. They examined whether the IVHVD level they experienced as babies affected their visual performance at the end of their elementary school years and examined associations between visual performance and cognitive performance and with additional support at school.
The visual assessments were part of a 10-year follow-up study in children in the original randomized DRIFT study. The testers followed a protocol and were unaware of whether the child had grade 3 or grade 4 IVHVD and all other data.
The study found that all 32 children studied had at least one visual impairment. The average number of impairments per child was six in children with IVHVD grade 4 compared to three in children with IVHVD grade 3. Each additional visual impairment for each child was associated with increased academic support, after adjustment for age equivalence of development.
These vision problems, which affected the children ten years later, were often due to damage to the visual areas of the brain. These included problems moving the eyes accurately, detecting objects in the space around them, or visually adjusting shapes or alignments of lines.
The children’s parents were unaware of these problems and mostly reported that their children’s vision was normal as long as they wore glasses.
However, the researchers found that for each additional vision problem a child had, they were more likely to receive additional study support. This suggests that the vision problems may have contributed to the learning difficulties in this group of children.
Cathy Williams, the lead author of the study and Professor of Pediatric Ophthalmology at Bristol Medical School: Population Health Sciences and Consultant Pediatric Ophthalmologist at University Hospitals Bristol and Weston NHS Foundation Trust (UHBW), stated: “Our research suggests that all children who who are having cerebral hemorrhage or similar problems, as babies should have eye tests to detect brain-related vision problems as they grow up so that appropriate support can be offered to see if it will help them.
“Future researchers should be aware that parents who report normal vision may be overlooking vision problems important to their children’s learning and development.”
About this news from neurodevelopment and visual neuroscientific research
Author: press office
Source: University of Bristol
Contact: Press Office – University of Bristol
Picture: The image is attributed to the University of Bristol
See also
Original research: Open access.
“Visual function in children 10 years after a grade 3 or 4 intraventricular hemorrhage with ventricular dilatation: A masked prospective study” by Cathy Williams et al. Developmental Medicine & Pediatric Neurology
abstract
Visual function in children 10 years after grade 3 or 4 intraventricular hemorrhage with ventricular dilatation: a masked prospective study
target
We studied children 10 to 11 years of age after grade 3 or 4 intraventricular hemorrhage and ventricular dilatation (IVHVD) and examined whether the grade of IVHVD affected their visual outcome. We examined associations between visual outcomes with cognitive outcomes and additional support at school.
method
The visual examinations were part of a 10-year follow-up study in children in a randomized study. The testers followed a protocol and were masked as to whether the child had grade 3 or grade 4 IVHVD and all other data.
Results
32 children were tested: 24 were male and the mean age (SD) was 10 years 5 months (1 year 2 months); Range 8 years 9 months to 12 years 9 months. All had at least one visual impairment. The median (interquartile range) number of disabilities per child was six (six to nine) in children with Grade 4 IVHVD compared to three (two to four) in children with Grade 3 IVHVD (p = 0.003). Each additional visual impairment per child was associated with increased educational support at school after adjustment for age equivalence of development (odds ratio = 1.7 [95% confidence interval 1.1–2.6], p = 0.015).
interpretation
Children with IVHVD grade 3 or 4 have high levels of visual morbidity by age 10 to 11 years. These children may have unmet visual needs and their outcomes could improve if these needs could be addressed.
