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A.R. O'Connor, E.E. Birch, J. Leffler, S.R. Salomão, R. Spencer; Infant Visual Evoked Potential (VEP) and Preferential-Looking (PL) Grating Acuity as Predictors for Recognition Acuity in Low Birth Weight Children . Invest. Ophthalmol. Vis. Sci. 2003;44(13):2712.
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Purpose: The predictive value of infant PL grating acuity for long-term recognition acuity outcome in low birthweight (LBW) children has been reported (Mash & Dobson, 1998) but analysis was limited by low prevalence of visual impairment in the cohort. The predictive value of infant VEP grating acuity, which because of VEP topography may be more sensitive to macular dysfunction in LBW infants, has not been reported. The present study evaluates predictive value of PL and VEP grating acuity for recognition acuity outcomes in a LBW cohort with high prevalence of visual impairment. Methods: 148 children <2000g birthweight underwent monocular grating acuity assessment by sweep VEP (n=47) and/or PL (n=86) on 2-7 visits at 1-24 months of age. To ensure the groups were comparable, children with cortical abnormality and/or retinal detachment were excluded, since they were ineligible for VEP assessment. At 4-8 years of age, recognition acuity was assessed. Results: Neither VEP nor PL grating acuity at 1-6 months of age was predictive of recognition acuity outcome (VEP: n=36, p=0.18; PL: n=70, p=0.2). Both VEP and PL grating acuity at 7-12 months of age were predictive of recognition acuity outcome (VEP: n=52 p=0.001; PL: n=82, p<0.001). The most sensitive test for predicting recognition acuity was VEP grating acuity at 7-12months (85.7%) compared to the early VEP (70%) and the early and late PL (66.7% & 73.3%). However, specificity was lower for the 7-12 month VEP than PL (78.7%). Rate of maturation of grating acuity was not significantly different for VEP or PL (p=0.1). The rate of VEP, but not PL, maturation was predictive of recognition acuity outcome (VEP: p=0.04; PL: p=0.2). Conclusions: Grating acuity measured at 7-12 months by either VEP or PL is predictive of recognition acuity at age of 4-8 years in low birthweight children. Abnormal VEP grating acuity is a stronger indicator of a long-term deficit than PL acuity, but a normal response must be interpreted with caution, as the specificity is lower than the sensitivity.
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