Clinical and demographic associations with optic nerve hypoplasia in New Zealand

Br J Ophthalmol. 2014 Oct;98(10):1364-7. doi: 10.1136/bjophthalmol-2013-304605. Epub 2014 May 13.

Abstract

Aim: To identify the clinical features of optic nerve hypoplasia (ONH) and prevalence within a population of New Zealand children with severe visual impairment.

Methods: Retrospective review of medical records of children with severe visual impairment registered with Blind and Low Vision Educational Network New Zealand.

Results: Of 1500 children with severe visual impairment, 94 (6.3%) exhibited ONH, and 91 (97%) cases were bilateral. Of these 94 cases, 52 (55%) were males and ethnicities were European Caucasian (52%), Maori (40%), Pasifika (6%) and other (2%). Most children with ONH had poor vision, with 60% having ≤ 6/60 Snellen visual acuity equivalent. The median maternal age was 20.0 years old with 52% ≤ 20 years. There was a statistically significant over-representation of Maori ethnicity (40%) and young maternal age with age less than 20 years old (44%) in our cohort compared to the general population (14.6% and 7.4%, respectively; p<0.0001). Half had hypopituitarism, while neuroimaging abnormalities were detected in 60% cases. Cerebral neuroradiographic abnormalities were found to be associated with higher rate of developmental delay (OR 9.764 95% CI 3.246 to 29.373).

Conclusions: This is the first major study of visual impairment in New Zealand children, and it demonstrates that ONH is an important cause of severe visual disability; with an over-representation of Maori children and younger maternal age.

Keywords: Imaging; Optic Nerve.

MeSH terms

  • Brain / abnormalities
  • Developmental Disabilities / diagnosis
  • Developmental Disabilities / epidemiology
  • Ethnicity
  • Female
  • Humans
  • Hypopituitarism / diagnosis
  • Hypopituitarism / epidemiology
  • Infant
  • Magnetic Resonance Imaging
  • Male
  • Maternal Age
  • New Zealand / epidemiology
  • Optic Nerve Diseases / congenital*
  • Optic Nerve Diseases / diagnosis
  • Optic Nerve Diseases / epidemiology
  • Prevalence
  • Registries
  • Retrospective Studies
  • Vision Disorders / diagnosis
  • Vision Disorders / epidemiology
  • Visual Acuity / physiology

Supplementary concepts

  • Optic Nerve Hypoplasia, Bilateral