WIP 82 - NAVEG: A Novel Screening Method for Cortical Visual Impairment in Neonates

Publication Number: WIP 82.7557

Amanda B. Deford, Riley Hospital for Children at Indiana University Health, Indianapolis, IN, United States; Heather J. Bruckman, Riley Hospital for Children at Indiana University Health, Maritnsville, IN, United States; Brittany McFarland, iu health, Indianapolis, IN, United States; Julie Phelps, Riley Hospital for Children at Indiana University Health, Indianapolis, IN, United States; Attie Vogler, IU Health, Indianapolis, IN, United States; Bittu Majmudar-Sheth, Riley Hospital for Children at Indiana University Health, Indianapolis, IN, United States; Sarah Wing, Riley Hospital for Children at Indiana University Health, Indianapolis, IN, United States; Beatrice Stefanescu, Riley Hospital for Children at Indiana University Health, Indianapolis, IN, United States

Background: Cortical visual impairment (CVI), which results from damage to neurologic pathways, is the leading cause for childhood blindness and low vision.
Identification of CVI is often delayed by years, prolonging time to therapies. The Neonatal Assessment Visual European Grid (NAVEG) screen was suggested as a tool to help identify premature infants at risk for CVI. The feasibility and validity of NAVEG has not been evaluated among other high-risk populations prior to NICU discharge.

Objective: Evaluate feasibility of implementing NAVEG screening in at-risk neonates prior to NICU discharge; validate NAVEG instrument to predict CVI in specific high-risk populations.

Design/Methods: This is an ongoing cohort study of infants admitted to our level IV NICU. Neonates are screened for eligibility by identification of risk factors for CVI including prematurity of < 32 weeks gestation at birth, or neurologic conditions including seizure, perinatal asphyxia, brain anomaly, intracranial hemorrhage, or stroke. Enrolled neonates undergo NAVEG screening by trained examiners, consisting of ocular, motor, and perceptual visual components. Infants with abnormal results are referred for additional evaluation with specialized early intervention services and results collected. A one-year parental survey captures perceptions of the infants’ visual function.
IRB approval is obtained, and we are enrolling neonates. So far, we have enrolled 55 infants and screened 47 (21 abnormal, 26 normal). 29 were < 32 weeks gestation with the remainder qualifying due to another risk factor.
We anticipate completing enrollment by spring of 2025, when we will conduct data analysis for short-term outcomes. Descriptive analysis will assess recruitment rates, outcomes, and screening resources. Additional tests will compare continuous and categorical variables between the CVI and non-CVI groups. Sensitivity, specificity, PPV, and NPV will determine instrument performance in risk identification. Log-rank tests will evaluate time to intervention. Multivariate analysis will assess the effect of comorbidities on risk.