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Optic disc morphology in children may give information about the timing of periventricular white matter damage. In Sweden (

) 35 children aged 4–11 (median 7 years, 21 boys) with MRI or CT evidence of periventricular white matter damage on scans taken at age 4 years or older had fundus photography with digital image analysis. These children’s optic discs had a large cup area and a small neuroretinal rim area compared with 100 healthy control children born at term. An attempt was made to assess the timing of the periventricular lesions from the site of white matter loss (anterior lesions suggesting periventricular haemorrhage probably occurred earlier (24–26 weeks of gestation) than posterior lesions suggesting periventricular leucomalacia (around 31 weeks)). On this basis 10 children were thought to have suffered white matter lesions before 28 weeks gestation and 25 after. Of the ten children with earlier lesions six had normally sized optic discs (two with large cup area) and four had small optic discs. All 25 children with later lesions had normal optic disc area, nine with large cup area. Thus nine of 11 children with a large optic cup area and all four with small optic discs had white matter lesions thought to have occurred before 28 weeks gestation.

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