Severe ‘brain haemorrhages’ 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]examined 32 children who underwent detailed assessments at ages 10 to 11 after experiencing grade 3 or 4 intraventricular hemorrhage (cerebral bleeds) and ventricular dilatation (IVHVD) in a study called OPERATION10.
The DRIFT10 study was set up to study 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 were following a protocol, and they didn’t know if the child had undergone IVHVD grade 3 or 4 and all other data.
The study revealed that the 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.
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 who experience brain bleeds or similar problems as babies should have eye tests to identify brain-vision problems related to their growth, so that appropriate support can be offered to see if it helps 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.”
“Function of vision in children 10 years after grade 3-4 intraventricular hemorrhage with ventricular dilatation: a masked prospective study”, by Cathy Williams et al, is published in Developmental medicine and child neurology.
Cathy Williams et al, Visual function in children 10 years after grade 3 or 4 intraventricular hemorrhage with ventricular dilatation: a masked prospective study, Developmental medicine and child neurology (2022). DOI: 10.1111/dmcn.15294
University of Bristol
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