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  • Visual outcome in infants born to drug-misusing mothers prescribed methadone in pregnancy.

Visual outcome in infants born to drug-misusing mothers prescribed methadone in pregnancy.

The British journal of ophthalmology (2013-11-20)
Laura McGlone, Ruth Hamilton, Daphne L McCulloch, Jane R MacKinnon, Michael Bradnam, Helen Mactier
ABSTRACT

Flash visual evoked potentials (VEPs) were abnormal in a cohort of 100 neonates exposed to maintenance methadone in utero. This prospective cohort study now describes clinical visual and electrophysiological outcomes at 6 months. Visual assessment included modified Atkinson test battery; strabismus, nystagmus, reduced visual acuity, delayed visual maturation or refractive error (>3 dioptres) defined a fail. Pattern-onset VEPs were recorded to 120', 60' and 15' checks. 81 drug-exposed and 26 comparison infants (79% and 52% of the original cohorts) were assessed at a median age of 27 weeks (range 26-30). 90% of drug-exposed infants had been additionally exposed to illicit drugs and 41% to excess alcohol in utero. 40% of the drug-exposed cohort failed clinical visual assessment: the relative risk of abnormal assessment was 5.1 (95% CI 1.3 to 20; p=0.02). Nystagmus was particularly common. VEP peak times were slower and amplitudes smaller in drug-exposed infants, of whom 70% had one or more abnormal VEP parameter. Abnormal visual outcome at 6 months was not associated with the pattern of additional drug exposure or a history of neonatal abstinence. Abnormal visual electrophysiology in infants born to drug-misusing mothers prescribed maintenance methadone persists to 6 months of age, and is associated with abnormal clinical visual assessment.

MATERIALS
Product Number
Brand
Product Description

Sigma-Aldrich
(±)-Methadone hydrochloride, powder, ≥98%
Supelco
(±)-Methadone solution, 1 mg/mL in methanol, ampule of 1 mL, certified reference material, Cerilliant®