VISUAL FUNCTIONS IN RELATION WITH NEONATAL CEREBRAL ULTRASOUND, NEUROLOGY AND COGNITIVE-DEVELOPMENT IN VERY-LOW-BIRTH-WEIGHT CHILDREN

In order to determine the relationship between visual functions and ne onatal cerebral ultrasound, neurological examinations and cognitive de velopment, a prospective longitudinal study was conducted in 69 high-r isk very-low-birthweight children. Visual development was studied at 1 and 2.6 years of corrected age by assessment of visual acuity, binocu lar visual fields, optokinetic nystagmus and strabismus. Visual impair ments were found in 33% at age 1 and in 28% at age 2.6. Visual impairm ents were related to intraparenchymal damage, as detected by neonatal cerebral ultrasound, as well as to abnormal neurological examinations and lower mean developmental indices. A stepwise multiple regression a nalysis with neonatal cerebral ultrasound as the dependent variable an d visual functions at ages 1 and 2.6 and neurological examinations at ages 1 and 2 as independent variables, however, demonstrated that stan dardized neurological examinations were better markers of neonatal cer ebral damage than visual functions. In cognitive development at ages 1 and 2, the neurological examination at age 1 was the most important v ariable. In cognitive development at age 3.6, visual functions at age 2.6 were more important. Early visual impairments might thus influence later cognitive development. The effectiveness of appropriate early i ntervention strategies to stimulate visual and cognitive development i n infants with less severe visual impairments should be subject to fur ther study.