Ophthalmic, clinical and visual electrophysiological findings in children born to mothers prescribed substitute methadone in pregnancy

Abstract

Michael S Bradnam, et al.. Ophthalmic, clinical and visual electrophysiological findings in children born to mothers prescribed substitute methadone in pregnancy.

Deviant smooth pursuit in preschool children exposed prenatally to methadone or buprenorphine and tobacco affects integrative visuomotor capabilities

“…Prolonged development of the brain makes the smooth pursuit function susceptible to influence from substrates operating during the fetal period. Previous studies have found an association between prenatal exposure to methadone and a condition of involuntary eye movements, which is assumed to interfere with the voluntary control needed in smooth pursuit 18,19. In the present study we found evidence of deviant smooth pursuit that we may relate to fetal exposure to methadone or buprenorphine, perhaps mediated by decreased availability of dopamine.…”

“…The complexity of this process makes it particularly susceptible to impairment by a variety of factors, including the presence of teratogen substrates, such as tobacco, during the fetal period. Previous studies have found an association between prenatal exposure to methadone and nystagmus, suggesting that drug-exposed children may have difficulty controlling their eye movements 18,19. In addition, difficulties with smooth pursuit have been found in individuals suffering from schizophrenia 20.…”

Reasons for Rehospitalization in Children Who Had Neonatal Abstinence Syndrome

“…For example, they were up to 12-fold more likely to be admitted for strabismus and nystagmus. The underlying cause of visual disturbances in opioid-exposed children are unclear 23 but, if untreated, may lead to difficulties with self-image and social adjustment that intensifies to adulthood. 24 After NAS, children were also admitted more frequently for conditions that usually develop insidiously and which may not be apparent in early infancy, when medical and social surveillance of the high-risk mother and child is at its most intense.…”

The management of heroin misuse in pregnancy: time for a rethink?

“…Observed effects include strabismus, nystagmus and refractive errors as well as delayed visual maturation and cerebral visual impairment, and these may be associated with abnormal visual electrophysiology 37–40. Although study numbers are small, nystagmus appears to be more common in those infants treated for NAS 38. The majority of infants with impaired visual development reported to date have been exposed in utero to both opiates and benzodiazepines and so it is impossible to determine exact aetiology.…”