Clinical evidence for the onset of the sensitive period in infancy.

Elston, John; Timms, Chris

doi:10.1136/bjo.76.6.327

Cited by 85 publications

(55 citation statements)

References 9 publications

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“…The findings in the present study that children born with dense, hereditary cataracts operated on very early fall into a high risk group for glaucoma raises the question of whether a better cost-benefit ratio of complications versus visual outcome can be obtained by delaying the surgery a few weeks. Elston & Timms (1992) have proposed that the first six weeks of life represents a latent period for binocular development, and bearing in mind the relationship between early surgery and development of glaucoma, it may be reasonable to avoid surgery during the first weeks of life.…”

Section: Early Surgerymentioning

confidence: 99%

Glaucoma following congenital cataract surgery: An 18‐year longitudinal follow‐up

Magnusson

Abrahamsson

Sjöstrand

2000

Acta Ophthalmologica Scandinavica

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ABSTRACT.Purpose: To report the occurrence of postoperative glaucoma and to evaluate risk factors. Methods: Children born in four of the western counties of Sweden who were diagnosed with congenital cataracts formed a cohort (nΩ137). The following parameters were evaluated: age at cataract surgery; type of surgery; visual outcome; postoperative IOP; optic disc abnormalities; date of onset of the complication; number of reoperations, including treatment for secondary cataract; presence of systemic anomalies; microphthalmus; and eye-related anomalies. Results: A diagnosis of glaucoma was recorded for 12% of the eyes. The mean follow-up time was 9.6 years. There is a relationship between surgery before the age of 10 days and development of glaucoma. Microphthalmus is an important risk factor as well. Conclusions: Despite modern surgical techniques the incidence of aphakic glaucoma is 10% or higher. No time-dependent increase in the incidence of lateonset glaucoma between the 1980s and the 1990s could be proven.

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Section: Early Surgerymentioning

confidence: 99%

Glaucoma following congenital cataract surgery: An 18‐year longitudinal follow‐up

Magnusson

Abrahamsson

Sjöstrand

2000

Acta Ophthalmologica Scandinavica

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“…A latent period for visual development has been described in the first six weeks of life when vision is subcortically mediated. During this time, the risk of developing stimulus deprivation amblyopia is low [5][6][7][8]. However, operating on very young eyes has disadvantages too.…”

Section: Clinical Aspects Of Congenital or Paediatric Cataract (A) Comentioning

confidence: 99%

Clinical and experimental advances in congenital and paediatric cataracts

Churchill

Graw

2011

Phil. Trans. R. Soc. B

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Cataracts (opacities of the lens) are frequent in the elderly, but rare in paediatric practice. Congenital cataracts (in industrialized countries) are mainly caused by mutations affecting lens development. Much of our knowledge about the underlying mechanisms of cataractogenesis has come from the genetic analysis of affected families: there are contributions from genes coding for transcription factors (such as FoxE3, Maf, Pitx3) and structural proteins such as crystallins or connexins. In addition, there are contributions from enzymes affecting sugar pathways (particularly the galactose pathway) and from a quite unexpected area: axon guidance molecules like ephrins and their receptors. Cataractous mouse lenses can be identified easily by visual inspection, and a remarkable number of mutant lines have now been characterized. Generally, most of the mouse mutants show a similar phenotype to their human counterparts; however, there are some remarkable differences. It should be noted that many mutations affect genes that are expressed not only in the lens, but also in tissues and organs outside the eye. There is increasing evidence for pleiotropic effects of these genes, and increasing consideration that cataracts may act as early and readily detectable biomarkers for a number of systemic syndromes.

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“…42 The evidence that the human visual system is anatom ically less mature at birth than that of the monkey is also of interest in relation to the evidence for a latent period of at least 6 weeks from birth before the onset of sensitivity to deprivation in man. 41,43 There is such a latent period in the cat, which also has an anatomically immature visual system at birth,44 but not in the monkey, in which depri vation effects occur within a few days of birth. This differ ence between monkey and man probably represents simply a difference in the timing of birth in relation to the developmental process rather than a fundamental differ ence in visual development.…”

mentioning

confidence: 99%

Competition and cooperation in visual development

Sloper¹

1993

Eye

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SUMMARYVisual disorders of early childhood occur in a visual system which is still undergoing development. They are influenced by this development and may influence its sub sequent progress. This review describes experiments per formed to investigate visual development in the primate and in particular the way in which the central visual path ways related to the two eyes interact during both normal and abnormal development. There is evidence that these interactions play an important role in the developmental process and understanding them should allow better The effects of abnormal visual experience on develop ment were first shown experimentally in the classical stud ies of Wiesel and Hubel in the cat. These showed that closure of one eye in kittens caused marked changes in the structure and function of the visual pathways.3 , 4 Three major changes were described. Firstly the eye became amblyopic; secondly the closed eye became much less effective in driving cells in the visual cortex which became dominated by inputs from the other, open eye; and thirdly neuronal cell bodies in the lateral geniculate nucleus (L GN) which received input from the closed eye shrank when compared with cells in the LGN laminae related to the open eye. These studies were the first demonstration that abnormal visual experience, in the absence of direct anatomical interference, had a marked effect on the development of the structure and function of the visual pathways and they introduced two important concepts. Firstly they showed that the development of the visual system was only affected by abnormal visual experience during a restricted period early in life: the critical or sensi tive period. Secondly, because the closure of one eye has a much greater disruptive effect than the closure of both, they suggested that the changes produced by visual depri vation were due at least in part to a competitive interaction between the pathways related to the two eyes. 5The concept of competition in visual development was further investigated and developed by Guillery who stud ied the changes in LGN cell size produced by visual depri vation in kittens. He demonstrated that closure of both eyes had much less effect on LGN cell size than closure of one eye.6 He also studied the cells in the LGN related to the extreme temporal visual field, which is monocular because there is no corresponding area of retina in the other eye. He showed that these LGN cells in the monocu-

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Clinical evidence for the onset of the sensitive period in infancy.

Cited by 85 publications

References 9 publications

Glaucoma following congenital cataract surgery: An 18‐year longitudinal follow‐up

Glaucoma following congenital cataract surgery: An 18‐year longitudinal follow‐up

Clinical and experimental advances in congenital and paediatric cataracts

Competition and cooperation in visual development

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