Abstract
Objectives
To investigate the functional and structural impact of neonatal hypoxic ischaemic encephalopathy (HIE) on childhood visual development.
Methods
In a prospective study, the neurocognitive outcomes of 42 children with a history of neonatal HIE were assessed serially up to 5 years. For the ophthalmic component of the study, visual, refractive, orthoptic and ocular biometry measurements were obtained in 32 children, with axial length measurements estimated using the IOLMaster.
Results
For the 32 children who completed the ophthalmic component of the study, severity of HIE grade was determined to be mild, moderate, or severe in 18 (56.3%), 13 (40.6%), and 1 (3.1%) cases, respectively. One (3.1%) child was classed as visually impaired. Twelve (37.5%) were found to have ametropia. Mean (±SD) axial length was 22.09 (±0.81) mm, within the normal range for the age of this cohort. Seven of the 42 (16.7%) children who were involved in the larger neurodevelopmental arm of the study had clinical evidence of a squint. There was no correlation between the severity of HIE grade at birth and axial length or occurrence of squint.
Conclusions
Neonatal HIE is associated with a higher incidence of squint compared with the general paediatric population. This occurred irrespective of severity of HIE grade. The ocular biometry measurements were consistent with published normative data, and no significant difference in ocular biometry was demonstrated between HIE severity groups.
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Acknowledgements
We wish to thank Ms Beatrix Haskins, Senior Orthoptist for the Health Service Executive South, for her dedication and expertise in assessing visual performance and detecting strabismus in the cohort of children involved in this study. We would also like to acknowledge the parents, caregivers, and children who gave their time to the study.
Funding
Funding for the broader neurodevelopmental arm of the study was received from the Health Research Board.
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James, M., Connor, C.M.O., Cullinane, A. et al. Ophthalmic outcomes following neonatal hypoxic ischaemic encephalopathy; oculomotor, biometric and refractive data in early childhood. Eye 33, 1152–1157 (2019). https://doi.org/10.1038/s41433-019-0390-6
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DOI: https://doi.org/10.1038/s41433-019-0390-6
