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Clinical and demographic associations with optic nerve hypoplasia in New Zealand

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Authors:
Summary:

These researchers retrospectively reviewed the medical records of 1500 children with severe visual impairment registered with Blind and Low Vision Educational Network New Zealand. The study aimed to determine the clinical features of optic nerve hypoplasia (ONH) and prevalence within this population. The review identified 94 children (6.3%) with ONH; 91 cases (97%) were bilateral. Of all 94 cases, 52 children (55%) were male and ethnicities were European Caucasian (52%), Māori (40%), Pasifika (6%) and other (2%). Most children with ONH had poor vision; 60% demonstrated ≤6/60 Snellen visual acuity equivalent. The median maternal age was 20.0 years, with 52% aged ≤20 years. The ONH cohort had significantly higher rates of Māori ethnicity (40%) and young maternal age (44% were aged <20 years) compared with the general population (14.6% and 7.4%, respectively; p<0.0001). Half had hypopituitarism and 60% of cases demonstrated neuroimaging abnormalities. Cerebral neuroradiographic abnormalities were associated with a higher rate of developmental delay (OR 9.764; 95% CI, 3.246 to 29.373).

Comment:
The incidence of ONH is increasing internationally, it is associated with other important outcomes (including developmental delay), and although some studies have described possible risk factors (such as young maternal age), the cause is yet to be identified. Importantly, there is clear evidence here that it occurs more frequently for Māori, requiring appropriate screening (and hopefully treatment) interventions.
Reference: Br J Ophthalmol. 2014;98(10):1364-7
Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

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Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.

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