CORTICAL VISUAL IMPAIRMENT FOLLOWING PERINATAL HYPOXIA - CLINICORADIOLOGIC CORRELATION USING MAGNETIC-RESONANCE-IMAGING

Purpose: To evaluate the value of magnetic resonance imaging (MRI) in the visual prognosis of cortical visual impairment following perinatal hypoxia. Methods: MRI findings of 19 babies with the diagnosis of a p erinatal hypoxic-ischemic insult and cortical visual impairment (CVI) were reviewed. Two groups of patients based on gestational age were co mpared, Babies with a gestational age greater than or equal to 34 week s were included in group 1(n=8). Infants <34 weeks' gestation were inc luded in group 2 (n=11). All 19 children underwent MRI. Results: Norma l MRI always correlated with better visual outcome, regardless of the gestational age at which the insult occurred, Among infants born at or later than 34 weeks' gestation, a favorable visual recovery occurred in two with normal MRI findings. The presence of infarcts or periventr icular leukomalacia indicated that full visual recovery would not occu r. Among infants born before 34 weeks' gestation, the MRI findings wer e normal in two who had a favorable visual outcome, A normal visual co rtex and the absence of periventricular leukomalacia were helpful in p rognostieating the visual outcome, A general delay in the myelination- particularly in the myelination of the optic radiation-was a common fi nding and until now has not been described in children with CVI routin ely. Conclusion: MRI's ability to follow the process of myelination ma y be of predictive value, MRI, therefore, should be obtained in a chil d with CVI following perinatal hypoxia.