Articles relating to the neonatal Visual Assessment 

Ricci D, Cesarini L, Groppo M, De Carli A, Gallini F, Serrao F, Fumagalli M, Cowan F, Ramenghi LA, Anker S, Mercuri E, Mosca F. Early assessment of visual function in full term newborns. Early Hum Dev. 2008 Feb;84(2):107-13.

This paper describes the battery of test items developed to assess different aspects of visual function that could be used as early as 48 h after birth. The assessment was tested in a cohort of 50 healthy infants born at term. You can find the proforma for this assessment here and the cards used for the test here.  

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Ricci D, Romeo DM, Serrao F, Cesarini L, Gallini F, Cota F, Leone D, Zuppa AA, Romagnoli C, Cowan F, Mercuri E. Application of a neonatal assessment of visual function in a population of low risk full-term newborn. Early Hum Dev. 2008 Apr;84(4):277-80.

This study applied the visual test battery described in the previous article to a cohort of 124 low risk term-born infants at 48 and 72 h after birth in order to define the normative distribution of results for each item and to document any effect of postnatal age on visual function. These findings may be used as reference data when using this visual test battery in both clinical and research settings.

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Ricci D, Cesarini L, Romeo DM, Gallini F, Serrao F, Groppo M, De Carli A, Cota F, Lepore D, Molle F, Ratiglia R, De Carolis MP, Mosca F, Romagnoli C, Guzzetta F, Cowan F, Ramenghi LA, Mercuri E. Visual function at 35 and 40 weeks’ postmenstrual age in low-risk preterm infants. Pediatrics. 2008 Dec;122(6):e1193-8. 

Visual function was assessed by using a validated test battery at 35 and 40 weeks’ postmenstrual age in 109 low-risk preterm infants who were born at <31 weeks’ gestation. The preterm findings were compared with data from term-born infants collected by using the same test protocol.

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Bassi L, Ricci D, Volzone A, Allsop JM, Srinivasan L, Pai A, Ribes C, Ramenghi LA, Mercuri E, Mosca F, Edwards AD, Cowan FM, Rutherford MA, Counsell SJ. Probabilistic diffusion tractography of the optic radiations and visual function in preterm infants at term equivalent age. Brain. 2008 Feb;131(Pt 2):573-82.

Thirty-seven preterm infants  born at median 28 weeks gestational age, were examined at a post-menstrual age of 42 with MRI and visual assessment (a battery of nine items assessing different aspects of visual abilities). The analyses showed that the visual assessment score was independently correlated with fractional anisotropy values, but not gestational age at birth, post-menstrual age at scan or the presence of lesions on conventional MRI. Only FA in the optic radiations was correlated with visual assessment score. These results suggest that in preterm infants at term equivalent age visual function is directly related to the development of white matter in the optic radiations.

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Ricci D, Romeo DM, Serrao F, Gallini F, Leone D, Longo M, Albamonte E, Romeo MG, Mazzone D, Romagnoli C, Cowan F, Mercuri E. Early assessment of visual function in preterm infants: how early is early? Early Hum Dev. 2010 Jan;86(1):29-33.

The visual function of 64 preterm infants (<33 weeks) was assessed using the same battery of visual function tests previously validated at 35 and 40 weeks post-menstrual age in low-risk preterm infants. The study found that before 31 weeks most infants could not be reliably assessed because of clinical instability, whilst after 31 weeks most infants could be assessed and they showed progressive maturation in their responses with post-menstrual age. 

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Ricci D, Romeo DM, Gallini F, Groppo M, Cesarini L, Pisoni S, Serrao F, Papacci P, Contaldo I, Perrino F, Brogna C, Bianco F, Baranello G, Sacco A, Quintiliani M, Ometto A, Cilauro S, Mosca F, Romagnoli C, Romeo MG, Cowan F, Cioni G, Ramenghi L, Mercuri E. Early visual assessment in preterm infants with and without brain lesions: correlation with visual and neurodevelopmental outcome at 12 months. Early Hum Dev. 2011 Mar;87(3):177-82.

In this study 145 preterm infants were assessed with age specific tests for visual function at term age, and at 3 and 12 months. The results of these assessments were correlated with neurodevelopmental outcomes at 12 months. The results showed that a normal visual assessment at term age is a good predictor of normal visual and neurodevelopmental outcome at 12 months. An abnormal visual examination in the neonatal period was a less reliable prognostic indicator, but all children with abnormal visual assessment at term age whose exams had normalised at 3 months had normal developmental outcomes at 12 months. 

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Romeo DM, Ricci D, Serrao F, Gallini F, Olivieri G, Cota F, Romagnoli C, Mercuri E. Visual function assessment in late-preterm newborns. Early Hum Dev. 2012 May;88(5):301-5.

Eighty low-risk late preterm with a gestational age between 34.0 and 36.9 weeks were assessed at birth and at term equivalent age, using a structured visual assessment battery. The results were compared to those previously obtained in term born infants using the same battery. The results showed that in late preterm some aspects of visual function have a progressive maturation between birth and term age, especially in items related with vertical and arc tracking, the ability to discriminate striped black/white targets and attention at distance. 

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Groppo M, Ricci D, Bassi L, Merchant N, Doria V, Arichi T, Allsop JM, Ramenghi L, Fox MJ, Cowan FM, Counsell SJ, Edwards AD. Development of the optic radiations and visual function after premature birth. Cortex. 2014 Jul;56:30-7.

Microstructural maturation during the late preterm period, measured as fractional anisotropy on MRI, was correlated with visual function in a group of 53 preterm infants assessed at a median age of 30 weeks. 

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