Neurological and Visual Outcomes in Infants and Toddlers Following Therapeutic Hypothermia for Neonatal Hypoxic-Ischemic Encephalopathy.

Autor: Imamoglu EY; Neonatology Department, Goztepe Prof. Dr. Suleyman Yalcın City Hospital, Istanbul Medeniyet University, Istanbul, Turkey. Electronic address: ebruli013@hotmail.com., Acar Z; Pediatric Ophthalmology Department, Haydarpaşa Numune Training and Research Hospital, Saglık Bilimleri University, Istanbul, Turkey., Karatoprak EY; Pediatric Neurology Department, Goztepe Prof. Dr. Suleyman Yalcın City Hospital, Istanbul Medeniyet University, Istanbul, Turkey., Ozumut SH; Neonatology Department, Goztepe Prof. Dr. Suleyman Yalcın City Hospital, Istanbul Medeniyet University, Istanbul, Turkey., Ocak SY; Ophthalmology Department, Istanbul Prof. Dr. Cemil Tascıoglu City Hospital, Saglık Bilimleri University, Istanbul, Turkey., Imamoglu S; Ophthalmology Department, Haydarpaşa Numune Training and Research Hospital, Saglık Bilimleri University, Istanbul, Turkey., Ovalı F; Neonatology Department, Goztepe Prof. Dr. Suleyman Yalcın City Hospital, Istanbul Medeniyet University, Istanbul, Turkey.
Jazyk: angličtina
Zdroj: Pediatric neurology [Pediatr Neurol] 2024 Feb; Vol. 151, pp. 131-137. Date of Electronic Publication: 2023 Nov 17.
DOI: 10.1016/j.pediatrneurol.2023.11.002
Abstrakt: Background: The majority of studies have investigated neurodevelopmental outcomes, whereas visual impairment is less explored in children with a history of neonatal (hypoxic-ischemic) encephalopathy. Our aim was to perform a detailed neurological and visual assessment and also to investigate the presence of cerebral visual impairment in infants and toddlers with neonatal encephalopathy.
Methods: Thirty participants with a history of neonatal encephalopathy, who had been hospitalized for therapeutic hypothermia, underwent a detailed neurological examination at age five to 36 months. Age-matched, 30 healthy children were also enrolled as a control group. All children in the study and control groups received neurological and a comprehensive ophthalmologic examination, including visual field and visual acuity. Presence of cerebral visual impairment was also evaluated clinically.
Results: Rates of cerebral palsy, severe motor impairment, cognitive impairment, epilepsy, and cerebral visual impairment were found to be 20%, 10%, 15.3%, 10%, and 20%, respectively. When compared with healthy controls, oculomotor functions, pupillary light response, refractive parameters, anterior/posterior segment examinations, ocular visual impairment rates, and last, visual acuities were found similar. However, we found a statistically significant increase in visual field defects in our study group.
Conclusions: It could be better to perform a comprehensive ophthalmologic examination including visual field, visual acuity, and oculomotor functions by a pediatric ophthalmologist to accurately diagnose neurovisual deficits in infants following therapeutic hypothermia. Early identification and rehabilitation of the visual deficits might improve the neurodevelopment in these children.
Competing Interests: Declaration of competing interest None.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE