Brain bleeds in babies’ first year can lead to long-term vision problems

Summary: Babies who experience severe brain hemorrhages in their first year of life are more likely to have long-term vision problems, according to a new study.

Source: University of Bristol

Severe ‘brain bleeds’ experienced by some babies in the first year after birth lead to long-term sight problems, University of Bristol researchers have found in a 10-year follow-up study .

The study, published in the journal Developmental medicine and child neurology today [23 June]reviewed 32 children who underwent detailed assessments between 10 and 11 years of age after experiencing intraventricular hemorrhage (brain bleeds) and ventricular dilatation (IVHVD) grade 3 or 4 in a study called DRIFT10.

The DRIFT10 study was set up to investigate a “brainwashing” technique for brain bleeding called DRIFT (Drainage, Irrigation and Fibrinolytic Therapy). DRIFT, developed by Bristol researchers, is the first and only treatment to objectively benefit infants with severe brain hemorrhage by washing out the ventricles of the brain to remove toxic fluids and reduce pressure.

The research team looked at 32 children between the ages of 10 and 11. They investigated whether the level of IVHVD experienced as a baby affected their visual outcome at the end of their primary school years and explored the associations between visual outcomes with cognitive outcomes and with additional support for life. ‘school.

The eye exams were part of a ten-year follow-up study for children in the original DRIFT randomized trial. The testers followed a protocol and they did not know if the child had undergone IVHVD in grade 3 or 4 and all other data.

The study found that all 32 children assessed had at least one visual impairment. The average number of impairments per child was six for children with IVHVD in grade 4, compared to three for children with IVHVD in grade 3. Each additional visual impairment for each child was associated with increased educational support at school, after adjusting for developmental age equivalence.

These vision problems affecting children ten years later were often due to damage to the visual areas of the brain. These included problems moving the eyes precisely, detecting objects in the space around them, or visually matching the shapes or orientations of lines.

e 10-year follow-up of visual functions in 32 children who, during the first year after birth, presented with grade 3 or 4 intraventricular hemorrhage with ventricular dilatation (IVHVD). Credit: University of Bristol

The children’s parents were unaware of these issues and generally said their children had normal vision as long as their glasses were worn.

However, the researchers found that for every additional sight problem a child had, they were more likely to receive additional support in their learning. This suggests that vision problems may have contributed to the learning difficulties experienced by this group of children.

Cathy Williams, lead author of the study and Professor of Pediatric Ophthalmology at Bristol Medical School: Population Health Sciences and Consultant in Pediatric Ophthalmology at University Hospitals Bristol and Weston NHS Foundation Trust (UHBW), explained: “Our research suggests that all children experiencing brain bleeds or similar issues as babies should have eye tests to identify brain-related vision problems as they grow, so that appropriate support can be offered to see if it is useful to them.

“Researchers in the future should be aware that parents who report normal vision may miss sight problems that are important for their children’s learning and development.”

About this Neurodevelopmental and Visual Neuroscience Research News

Author: Press office
Source: University of Bristol
Contact: Press Office – University of Bristol
Image: Image is credited to University of Bristol

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Original research: Free access.
“Visual function in children 10 years after grade 3 or 4 intraventricular hemorrhage with ventricular dilatation: a masked prospective study” by Cathy Williams et al. Developmental medicine and child neurology


Summary

Visual function in children 10 years after grade 3 or 4 intraventricular hemorrhage with ventricular dilatation: a masked prospective study

Objective

We looked at 10- to 11-year-old children after grade 3 or 4 intraventricular haemorrhage and ventricular dilatation (IVHVD) and whether IVHVD grade affected their visual outcome. We explored associations between visual outcomes with cognitive outcomes and additional support at school.

Method

The eye exams were part of a 10-year follow-up study for children in a randomized trial. The testers followed a protocol and were blinded to whether the child had undergone grade 3 or 4 IVHVD and all other data.

Results

Thirty-two children were tested: 24 were boys and the mean age (standard deviation) was 10 years 5 months (1 year 2 months); ranging from 8 years 9 months to 12 years 9 months. All had at least one visual impairment. The median (interquartile range) number of impairments per child was six (six to nine) for children who underwent IVHVD grade 4, compared to three (two to four) for children who underwent IVHVD grade 3 (p = 0.003). Each additional visual impairment per child was associated with increased academic support at school, after adjusting for developmental age equivalence (odds ratio = 1.7 [95% confidence interval 1.1–2.6], p = 0.015).

Interpretation

Children who experience grade 3 or 4 IVHVD have a high level of visual morbidity at 10 to 11 years of age. These children may have unmet visual needs and their outcomes might improve if these needs could be met.

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