Acuity, ophthalmoscopy, and visually evoked potentials in the prediction of visual outcome in infants with bilateral optic nerve hypoplasia. 2003

Avery H Weiss, and J P Kelly
Department of Ophthalmology, University of Washington School of Medicine, Seattle, WA, USA.

OBJECTIVE To determine whether Teller Acuity Cards, transient visually evoked potentials (VEPs), and optic disc size estimated from ophthalmoscopy were predictive of acuity outcome in infants and young children with bilateral optic nerve hypoplasia (ONH). METHODS Twenty-eight infants (mean age, 7 months) with bilateral ONH underwent clinical assessment, including ophthalmoscopy. All but a few of these patients underwent neuroimaging studies, analysis of transient VEPs to multiple stimuli, and repeated acuity assessment. Acuity outcome was assessed, on average, 28 months later. RESULTS Acuity outcome was significantly correlated with the estimated optic disc diameter, initial acuity, and VEP signal-to-noise ratios (r = 0.80, 0.71, 0.69, respectively; all P <.001). Multiple regression analysis showed that the initial acuity and estimated optic disc diameter accounted for 73% of the variation in acuity outcome. VEPs to white-black gratings segregated infants by 6 months of age, whose acuity outcome was better or worse than 5.6 cycles/degree (20/100). CONCLUSIONS Acuity outcome was predicted in infants with bilateral ONH with a linear equation using initial acuity and estimated optic disc diameter. Additionally, analysis of VEPs may segregate infants with a good visual outcome from those with a poor visual outcome. Longer follow-up will be necessary to determine final Snellen acuity.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D008297 Male Males
D009887 Ophthalmoscopy Examination of the interior of the eye with an ophthalmoscope. Ophthalmoscopies
D009898 Optic Disk The portion of the optic nerve seen in the fundus with the ophthalmoscope. It is formed by the meeting of all the retinal ganglion cell axons as they enter the optic nerve. Blind Spot,Optic Disc,Optic Nerve Head,Optic Papilla,Blind Spots,Disc, Optic,Disk, Optic,Head, Optic Nerve,Nerve Head, Optic,Optic Discs,Optic Disks,Optic Nerve Heads,Optic Papillas,Papilla, Optic,Papillas, Optic,Spot, Blind
D009900 Optic Nerve The 2nd cranial nerve which conveys visual information from the RETINA to the brain. The nerve carries the axons of the RETINAL GANGLION CELLS which sort at the OPTIC CHIASM and continue via the OPTIC TRACTS to the brain. The largest projection is to the lateral geniculate nuclei; other targets include the SUPERIOR COLLICULI and the SUPRACHIASMATIC NUCLEI. Though known as the second cranial nerve, it is considered part of the CENTRAL NERVOUS SYSTEM. Cranial Nerve II,Second Cranial Nerve,Nervus Opticus,Cranial Nerve, Second,Cranial Nerves, Second,Nerve, Optic,Nerve, Second Cranial,Nerves, Optic,Nerves, Second Cranial,Optic Nerves,Second Cranial Nerves
D011379 Prognosis A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations. Prognostic Factor,Prognostic Factors,Factor, Prognostic,Factors, Prognostic,Prognoses
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D011930 Reaction Time The time from the onset of a stimulus until a response is observed. Response Latency,Response Speed,Response Time,Latency, Response,Reaction Times,Response Latencies,Response Times,Speed, Response,Speeds, Response
D012044 Regression Analysis Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see LINEAR MODELS) the relationship is constrained to be a straight line and LEAST-SQUARES ANALYSIS is used to determine the best fit. In logistic regression (see LOGISTIC MODELS) the dependent variable is qualitative rather than continuously variable and LIKELIHOOD FUNCTIONS are used to find the best relationship. In multiple regression, the dependent variable is considered to depend on more than a single independent variable. Regression Diagnostics,Statistical Regression,Analysis, Regression,Analyses, Regression,Diagnostics, Regression,Regression Analyses,Regression, Statistical,Regressions, Statistical,Statistical Regressions
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children

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