Visual impairment and periventricular leukomalacia in children: A systematic review.
MRI lesions in the optical radiations warn that a child with PVL is headed for visual problems, so schedule vision rehab early.
01Research in Context
What this study did
Stefania et al. (2023) looked at every paper that linked brain scans to vision problems in kids with periventricular leukomalacia. They wanted to know which MRI clues warn of future visual deficits.
The team pulled studies on children with PVL and checked how often MRI spots matched later eye exams.
What they found
Damage in the optical radiations showed up on about six out of ten scans. When that spot was present, visual impairment was very likely.
Other MRI lesions also tied to vision loss, but the optical radiation signal was the clearest red flag.
How this fits with other research
Mukherjee et al. (2021) used wearable tech to catch early motor risk in babies. Stefania adds the visual side: once PVL is seen, check eyes right away.
Cavézian et al. (2010) built a quick preschool vision screen for the general class. Stefania narrows the focus: kids with PVL need deeper, MRI-guided vision checks.
Voss et al. (2019) showed that sound-augmented toys help school kids with low vision stay busy. Stefania’s data say you can spot these kids sooner if you read the MRI correctly.
Why it matters
If the radiologist notes optical radiation injury, loop in a TVI or ophthalmologist before the child shows reading trouble. Early vision rehab can start while motor or language therapy is still rolling, saving time and boosting overall learning.
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Check the latest MRI report for the words 'optical radiations' and, if seen, send a referral to vision services today.
02At a glance
03Original abstract
BACKGROUND: Thanks to Magnetic Resonance Imaging (MRI) it is now possible to diagnose lesions of the central nervous system (CNS) such as periventricular leukomalacia (PVL) from the first days of life. However, there are still few studies aimed at describing the relationship between MRI and the outcome of visual function in patients with PVL. AIM: To systematically review and investigate the relationship between MRI neuroimaging and visual impairment arising from PVL. METHODS AND PROCEDURES: Three electronic databases (PubMed, SCOPUS, Web of Science) were consulted from 15 June 2021-30 September 2021. Of the 81 records identified, 10 were selected for the systematic review. The STROBE Checklist was used to assess the quality of the observational studies. OUTCOME AND RESULTS: PVL on MRI was found to have a strong association with visual impairment in the various aspects of visual function (visual acuity, ocular motility, visual field); in 60% of these articles, the selected subjects also reported damage to optical radiations. CONCLUSION AND IMPLICATIONS: there is a clear need for more extensive and detailed studies on the correlation between PVL and visual impairment, in order to set up a personalized early therapeutic-rehabilitation plan. WHAT THIS PAPER ADDS?: Over the past decades numerous studies have reported increasing evidence that one of the most frequent sequelae in subjects with PVL, in addition to motor impairment, is the impairment of visual function even if it is still not clear what different authors mean with the term visual impairment. This systematic review presents an overview of the relationship between structural correlates of MRI and visual impairment in children with periventricular leukomalacia. Interesting correlations emerge between MRI radiological finding and consequences on visual function especially between damage to the periventricular white matter and the impairment of various aspects of visual function and also between the impairment of optical radiation and visual acuity. Thanks to this literature revision, it is now clear that MRI plays an important role in the screening and diagnosis of significant intracranial brain changes in very young children in particular about the outcome of visual function. This is of great relevance since that visual function represents one of the main adaptive functions in the development of the child.
Research in developmental disabilities, 2023 · doi:10.1016/j.ridd.2023.104439