Background: Visual acuity is often reduced in very low birth weight (VLBW) adolescents, even in the absence of ocular pathology. Periventricular leucomalacia (PVL) is an important risk factor for visual impairment in VLBW children. However, visual impairment is also seen in ex-premature children with no PVL and more subtle brain pathology is thought to be responsible. Diffusion tensor imaging (DTI) provides information about the microstructural organisation of cerebral white matter and is well suited to detect subtle neuronal pathology.
Objective: To assess the correlations between visual acuity and the microstructural organisation of the brain as indicated by fractional anisotropy (FA) values.
Methods: 30 adolescents with VLBW and a control group of 45 term-born adolescents were examined at 15 years of age. Subjects underwent magnetic resonance imaging examination including DTI. FA values were correlated with distance visual acuity using linear regression (p<0.001, extent threshold 10 voxels).
Results: Visual acuity correlated significantly with FA values in the splenium part of the corpus callosum in VLBW subjects, but not in the control group (see figure).
Conclusions: Reduced FA values, indicating reduced axonal integrity in the corpus callosum, was found to correlate with reduced visual acuity in adolescents with VLBW. This is, to our knowledge, the first study to prove a correlation between visual function and the structural integrity of the corpus callosum, supporting the hypothesis that slightly reduced visual acuity often encountered in ex-prematures with no obvious retinal pathology may be caused by subtle damage to the brain.
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