Survey of Ophthalmology
Volume 45, Issue 1 , Pages 1-13, 15 July 2000

Periventricular Leukomalacia:

An Important Cause of Visual and Ocular Motility Dysfunction in Children

  • Lena K. Jacobson, MD, PhD

      Affiliations

    • Karolinska Institutet, St Eriks Eye Hospital, Stockholm, Sweden
    • Corresponding Author InformationReprint address: Lena Jacobson, MD, Dept. of Paediatric Ophthalmology, St. Erik's Eye Hospital, S-112 82 Stockholm, Sweden
  • ,
  • Gordon N. Dutton, MD, FRCOphth

      Affiliations

    • Royal Hospital for Sick Children, Yorkhill, Glasgow, United Kingdom

Abstract 

The immature visual system in infants born preterm is vulnerable to adverse events during the perinatal period. Periventricular leukomalacia affecting the optic radiation has now become the principal cause of visual impairment and dysfunction in children born prematurely. Visual dysfunction is characterized by delayed visual maturation, subnormal visual acuity, crowding, visual field defects, and visual perceptual-cognitive problems. Magnetic resonance imaging is the method of choice for diagnosing this brain lesion, which is associated with optic disk abnormalities, strabismus, nystagmus, and deficient visually guided eye movements. Children with periventricular leukomalacia may present to the ophthalmologist within a clinical spectrum from severe cerebral visual impairment in combination with cerebral palsy and mental retardation to only early-onset esotropia, normal intellectual level, and no cerebral palsy. Optimal educational and habilitational strategies need to be developed to meet the needs of this group of visually impaired children.

Keywords:  magnetic resonance imaging, nystagmus, optic disk abnormalities, periventricular leukomalacia, preterm birth, strabismus, visual impairment

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 The authors have no proprietary or commercial interest in any product or concept discussed in this article.

PII: S0039-6257(00)00134-X

Survey of Ophthalmology
Volume 45, Issue 1 , Pages 1-13, 15 July 2000