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Prematuriteit en cerebral visual impairment

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Tijdschrift voor Kindergeneeskunde

Samenvatting

De ontwikkeling van ernstig prematuur geboren kinderen (<32 weken en/of <1500 gram) wordt protocollair gevolgd. In dit protocol is weinig aandacht voor de ontwikkeling van de visuele functie en de oogheelkundige verwijscriteria zijn onvoldoende gevoelig voor beperkingen in de visuele perceptie. Longitudinale studies identificeren ontwikkelingsproblemen bij zo’n 50% van de prematuur geboren kinderen op de basisschoolleeftijd. Beeldvormende studies tonen wittestofbeschadigingen in de hersenen aan bij 15-36% van de prematuur geboren kinderen. Periventriculaire wittestofbeschadigingen vormen een groot risico voor cerebral visual impairment (CVI), visueel functieverlies ten gevolge van schade aan het retrochiasmatische deel van het visuele systeem. Het is onbekend in welke mate en met welke ernst CVI onder prematuur geboren kinderen voorkomt. Het is evenmin duidelijk of de reeds gesignaleerde ontwikkelingsproblemen samengaan met of een oorsprong hebben in een visuele functiebeperking. Als dit zo blijkt te zijn, heeft dat implicaties voor de revalidatie en secundaire preventie van onder meer leer- en gedragsproblemen.

Summary

Prematurely born children (<32 weeks and/or <1500 grams) are monitored during their development according to a set protocol. There is only little attention for visual development and ophthalmologic criteria for referral are not sensitive enough to detect impairments in visual perception. Longitudinal studies have identified developmental problems among up to 50% of prematurely born children at primary school age. Imaging studies show white matter damage in 15-36% of prematurely born children. Periventricular white matter damage is known to be a main risk factor for cerebral visual impairment (CVI), visual impairment due to damage in the retrochiasmatic part of the visual system. Both the proportion and severity of CVI among prematurely born children are unknown. It is also not clear whether the already identified developmental problems co-occur with or originate from CVI. If the latter is the case, it has it’s consequences for rehabilitation and secondary prevention of learning and behavioural disorders.

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    C. J. A. Geldof

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  1. C. J. A. Geldof
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  2. M. Dik
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  3. M. J. de Vries
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Correspondence to C. J. A. Geldof.

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Dhr. drs. C.J.A. Geldof, neuropsycholoog, mw. drs. M. Dik, GZ-psycholoog/neuropsycholoog, dhr. drs. M.J. de Vries, revalidatieoogarts, Visio, Amsterdam.

Correspondentieadres: Drs. C.J.A. Geldof, Visio, Paasheuvelweg 17, 1105 BE Amsterdam,

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Geldof, C.J.A., Dik, M. & de Vries, M.J. Prematuriteit en cerebral visual impairment. KIND 76, 234–237 (2008). https://doi.org/10.1007/BF03078210

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