Ann Hellström
MD, Professor Pediatric Ophthalmology
The Queen Silvia Children's HospitalGöteborg University/Östra
SE - 416 85 GÖTEBORG
Tel: +46 31 3435774
Fax: +46 31 3435771
e-mail: ann.hellstrom@oft.gu.se
The eye and visual pathways –
a model for studies on pre- and perinatal adverse events affecting the central nervous and vascular systems
The aim of the research project is to study mechanisms and outcome
of pre- and perinatal adverse events affecting the central nervous
and vascular systems, using the eye and visual pathways as a model.
The optic disc and retinal vessel morphology are evaluated and it is
investigated whether ocular fundus morphology can reflect aetiology
and timing of the pre- and perinatal damage, as well as associated
brain lesions. Mechanisms on the embryo and foetus, critical
time-periods, specificity and long-term effects on the child are
studied. By this, the teratogenes and their mode of action may be
identified.Various conditions affecting the foetus or new-born at different stages of development are studied, e.g. preterm birth, growth retardation, assisted fertilisation, fetal alcohol syndrome and cranio-facial abnormalities. Each child is subjected to a detailed ophthalmologic examination by which visual development, the presence of congenital ocular malformations and morphological abnormalities of the optic nerve and retinal vessels are characterised by biometrical analysis. In addition, a majority of the children are subjected to neuro-radiological imaging. Cross-sectional and prospective epidemiological studies of specific patient-groups are performed in multidisciplinary co-operation.
The results from these studies provide possibilities for therapeutical and preventive actions that may minimise the often severe disabilities caused by pre- and perinatal adverse events.
Publications
The optic disc and retinal vessels in children with adverse events during pre- and perinatal life. Göteborg University 1997,ISBN 91-628-2417-1.Strömland K, Hellström A, Gustavsson T. Morphometry of the optic nerve and retinal vessels in children by computer assisted image analysis of fundus photographs. Graefes Archive for Clinical and Experimental Ophthalmology 1995; 233: 150-53.
Hellström A, Svensson E. Optic disc size and retinal vessel characteristics in healthy children. Acta Ophthalmol 1998; 76: 260-67.
Hellström A, Chen YH, Strömland K. Fundus morphology assessed by digital image analysis in children with fetal alcohol syndrome. Journal of Pediatric Ophthalmology & Strabismus 1997; 1: 17-23.
Hellström A, Hård A-L, Chen YH, Niklasson A, Albertsson- Wikland K. Ocular fundus morphology in preterm children - Influence of gestational age, birth size, perinatal morbidity and postnatal growth. Investigative Ophthalmology & Visual Science 1997;38:1184-92.
Jacobson L, Hellström A, Flodmark O. Large cups in normal-sized optic discs - A variant of optic nerve hypoplasia in children with periventricular leukomalaci. Archives of Ophthalmology 1997; 115: 1263-69.
Hellström A, Wiklund L-M, Svensson E, Albertsson-Wikland K, Strömland K Optic disc and retinal vessel abnormalities in children with pituitary hormone insufficiency- relationship with anterior visual pathway dimensions and midline brain anomalies. Manuskriptet är omstrukturerat & delat (se nedan).
Strömland K, Hellström A. Fetal Alcohol Syndrome - An ophthalmological and socio-educational prospective study. Pediatrics 1996; 97: 845-50.
Hellström A, Jansson C, Boguszewski M, Olegård R, Laegreid L, Albertsson- Wikland K. Growth hormone status in six children with fetal alcohol syndrome. Acta Pediatrica 1996; 85: 1456-62.
Hellström A, Svensson E, Strömland K. Eye size in healthy Swedish children and in children with fetal alcohol syndrome. Acta Ophthalmologica 1997; 75: 423-28.
Hellström A, Wiklund L-M, Svensson E, Strömland K, Albertsson- Wikland K. Midline brain lesions in children with hormone insufficiency indicate early prenatal damage. Acta Paediatrica 1998; 87:528-536.
Holm S, Svensson E, Strömland K, Hellström A. Fitting age related reference intervals to ocular axial length in children using a four-parameter curve family. Biometrical Journal 1998; 40: 281-293.
Hellström A, Hård A-L, Niklasson A, Svensson E, Jacobsson B. Abnormal retinal vascularisation in preterm children as a general vascular phenomenon. Lancet 1998; 352: 1827.
.Hellström A, Svensson E, Carlsson B, Niklasson A, Albertsson-Wikland K. Reduced Retinal Vascularisation in Children with Growth Hormone Deficiency. Journal of Clinical Endocrinology and Metabolism, 1999; 84: 795-798.
Hellström A, Hård A-L, Niklasson A, Svensson E, Jacobsson B. Abnormal retinal vascularisation in preterm children as a general vascular phenomenon. Lancet 1999; 353: 1099-1100 (Authors' reply)
Hellström A, Wiklund L-M, Svensson E. Diagnostic value of magnetic resonance imaging and planimetric measurement of optic disc size in confirming optic nerve hypoplasia. AAPOS 1999;3 : 104-108.
Hellström A, Wiklund L-M, Svensson E. The clinical and morphological spectrum of optic nerve hypoplasia. AAPOS 1999; 3: 212-220.
Hellström A, Wiklund L-M, Svensson E, Albertsson-Wikland K, Strömland K. Optic nerve hypoplasia with isolated tortuosity of the retinal veins A marker of endocrinopathy. Archives of Ophthalmology 1999; 117: 880-884.
Hellström A. Optic nerve morphology may reveal adverse events during pre- and perinatal life - digital image analysis. Survey of Ophthalmology 1999; 44: S63-73.
Teär-Fahnehielm K, Ygge J, Wide K, Tomson T, Hellström A, Strömland K. Visual and ocular outcome in children after prenatal exposure to antiepileptic drugs. AAPOS 1999; 77: 530-535.
Hård A-L, Niklasson A, Svensson E, Hellström A. Visual function in school-aged children born very preterm a population-based study. Developmental Medicine and Child Neurology 2000; 42: 100-105..
Hellström A, Hård A-L, Svensson E. Ocular fundus abnormalities in children born very preterm. Eye accepted
Berglund G, Hellström A, Ljungman S, Hartford M, Wikstrand J: The relationship between obesity-related metabolic factors and vascular changes in early hypertension. J Human Hypertension 1987; 1: 25-30.
Strömland K, Hamberg L, Miller M, Brent R, Svensson E, Webster W, Gillberg C, Hellström A. Threats against the health of our unborn children-teratological aspects. Acta Ophthalmologica 1998; 76: 634-638 (Symposium abstracts).
Hellström A, Chatelain P, Cuffield W, Jönsson P, Price T, Ranke M, Wilton P, Albertsson-Wikland K. Septo-optic dysplasia: Experience with 151 cases in KIGS (Pharmacia & Upjohn International Growth Database. In Growth Hormone Therapy in KIGS: Ten Years' Experience 1987-1997 eds Ranke & Wilton, 1999; 14: 147-157.
Hellström A, Aronsson M, Axelson C, Kyllerman M, Kopp S, Steffenburg S, Strömland K, Westphal O, Wiklund L-M, Albertsson-Wikland K. Septo-optic dysplasia in children how to improve and sharpen the diagnose. Hormone Research, Supplement in Press.
Hellström A. Informationsskrift. Septo-optisk dysplasi. Socialstyrelsen 2000.
Hellström A, Wiklund L-M, Svensson E, Albertsson-Wikland K. A specific ocular fundus morphology in children with optic nerve hypoplasia indicates endocrinopathy. Acta Paediatr Suppl 433 (1999) 157.
Niklasson A, Engström E, Hård A-L, Albertsson-Wikland K, Hellström A. Growth in very preterm children a longitudinal study.
Grönqvist S, Flodmark O, Tornqvist K, Edlund G, Hellström A. Association between visual impairment in full-term children and functional and morphological cerebral abnormalities.
Mikael Hellström, Hugo Hessel, Ulf Jodal, Martin Wennerström, Aimon Niklasson, Bo Jacobsson, Ann Hellström. Association between renal damage and birth size in children with urinary tract infection.
Hellström A, Chatelain P, Cuffield W, Jönsson P, Price T, Ranke M, Wilton P, Albertsson-Wikland K. Characteristics of Septo-optic dysplasia in 151 children on growth hormone treatment in KIGS (Pharmacia & Upjohn International Growth Database).
Wiklund L-M, Hellström A. Assymetric gyrus rectus might indicate pituitary hormone insufficiency.
Ann Hellström, Eva Engström, Anna-Lena Hård, Kerstin Albertsson Wikland, Lois Smith, Aimon Niklason. Postnatal Growth and Retinopathy of Prematurity -a link possibly mediated by growth factors.
Teär-Fahnehielm K, Hellström A, Ygge J, Jacobson L, Wide K, Evengård B, Lewensohn-Fuchs I, Nemeth A, Fischler B, Strömland K. Ophthalmological and neurological characteristics in children with severe visual impairment due to optic nerve malformations.
Kistner A, Jacobson L, Jacobsson S, Svensson E, Hellström A. Low Gestational age associated with abnormal Retinal Vascularization and Increased Blood Pressure in Adult Women.
Hellström A, Jacobson L, Hård A-L, Svensson E, Flodmark O. Optic Nerve Morphology may reveal timing of brain lesion in Children with Periventricular Leukomalacia.
Hellström A, Teär-Fahnehielm K, Kyllerman M, Eken U, Strömland K, Westphal O, Wiklund L-M, Albertsson-Wikland K. Indikators of endocrinopathy in children with optic nerve malformations.
Abstracts:
Hellström A, Strömland K. Långtidsuppföljning av ögonbottenmorfologi hos barn påverkade av fosterskadande ämnen. XXXI Nordiska Ögonläkarmötet, Göteborg, 1993.
Pinazo-Durán MD, Iborra FJ, Hellström A, Strömland K. Developmental changes in the retina and optic nerve induced by alcohol exposure in children and experimental animals. XXXI Nordiska Ögonläkarmötet, Göteborg, 1993.
Kerstin Strömland och Ann Hellström. Tio års uppföljning av synskärpan hos barn med fetalt alkoholsyndrom och hypoplasi av nervus opticus. Svenska Läkaresällskapets Riksstämma, Stockholm, 1993.
Strömland K, Hellström A, Pinazo-Duran MD, Guerri C. Ocular abnormalities in humans and rats exposed to alcohol during preg-nancy. 21st European Teratology Society Conference, Lyon, Frankrike, 1993.
Pinazo-Duran MD, Hellström A, Strömland K. Ocular malformations related to alcohol intake during pregnancy. Abstract till ESBRA, Genua, Italien 1993.
Strömland K, Hellström A, Pinazo-Duran MD, Guerri C. Ocular abnormalities in humans and rats exposed to alcohol during pregnancy. Abstract till XXIII Annual Nordic Meeting on Biological Alcohol Research, Stockholm, 1994.
Strömland K, Hellström A. Long term follow-up of visual acuity in children with the fetal alcohol syndrome and optic nerve hypoplasia. XXVIIth International Congress of Ophthalmology, Toronto, Canada, 1994.
Strömland K and Hellström A. Ophthalmological and developmental long-term follow-up of children with the fetal alcohol syndrome. 7:e Nordiska Barnoftalmologiska Kongressen i Esbo och Helsingfors, Finland, 1994.
Hellström A och Strömland K. Datoriserad bildanalys av ögonbottenstrukturer hos barn. Svenska Läkaresällskapets Riksstämma, Stockholm, 1994.
Hellström A, Chen Y. Strömland K. Ögonbottenmorfologi hos barn med fetalt alkoholsyndrom - en långtidsuppföljning med digital bildanalys. Svenska ögonläkarför årsmöte, Norrköping, 1995.
K Teär Fahnehjelm, M Faxander, K Strömland, A Hellström, K Wide, T Tomson. Barn med prenatal exponering för antiepileptika. Svenska ögonläkarföreningens årsmöte, Norrköping, 1995.
Hellström A, Chen Y, Strömland K. Fundus morphology assessed by digital image analysis in children with fetal alcohol syndrome. 21st Meeting of the European Paediatric Ophthalmology Group, Cambridge, England, 1995.
Strömland K and Hellström A. Fetal alcohol syndrome - an ophthalmologic and socio-educational prospective study. 21st Meeting of the European Paediatric Ophthalmology Group, Cambridge, England, 1995
Strömland K and Hellström A. Fetal alcohol syndrome - an ophthalmologic and socio-educational prospective study. Meeting of the Steering Committee EDAC, Amsterdam, 1995.
Hellström A, Hård A-L, Chen YH, Niklasson A, Albertsson- Wikland K. Influence of gestational age, birth size, perinatal morbidity and postnatal growth on ocular fundus morphology in preterm children. XXXII Nordiska Ögonläkarmötet, Gentofta, 1996.
Strömland K, Hellström A. Fetal alcohol syndrome - an ophthalmologi-cal and socio-educational prospective study. Meeting of the Steering Committee EDAC, Amsterdam, 1995.
Strömland K and Hellström A. Fetal alcohol syndrome - an ophthalmological and socio-educational prospective study. XXIV Nordic meeting on Biological Alcohol Research, Imatra, 1996.
Strömland K, Hellström A. Fetal alcohol syndrome - an ophthalmological and socio-educational prospective study. International Society for Eye genetics, Chicago, 1996.
Hellström A. Septo-optisk dysplasi: ett tvärdisciplinärt projekt i socialstyrelsens regi. Svenska ögonläkarföreningens årsmöte i Halmstad, 1996.
Hellström A, Hård A-L, Chen YH, Niklasson A, Albertsson- Wikland K. Influence of gestational age, birth size, perinatal morbidity and postnatal growth on ocular fundus morphology in preterm children. 22nd Meeting of the European Paediatric Ophthalmology Group, Valencia, Espania, 1996.
Strömland K, Hellström A. Fetal alcohol syndrome - an ophthalmologic and socio-educational prospective study. International Society for Eye genetics, Chicago, 1996.
Jacobsson L, Hellström A, Ygge J, Flodmark O. Large cups in normal sized optic discs -A variant of optic nerve hypoplasia in children with periventricular leukomalaci. ARVO, Miami, USA, 1997.
Hellström A, Strömland K, Albertsson- Wikland K. Associations between abnormal ocular fundus, brain lesions and hormone insufficiency. ESPE, Stockholm, 1997.
Jacobson L, Hellström A. The association between optic nerve anomalies and brain lesions. Swedish Paediatric Neuroradiology meeting, Tylösand, 1997.
Hellström A, Strömland K. Early Diagnosis of Septo-Optic Dysplasia in Children May Be Life Saving and Prevent Developmental Delay - a review of Swedish cases. 23rd Meeting of the European Paediatric Ophthalmology Group, Cambridge, England, 1997.
Jacobsson L, Hellström A, Flodmark O. Large cups in normal sized optic discs -A variant of optic nerve hypoplasia in children with periventricular leukomalaci. 23rd Meeting of the European Paediatric Ophthalmology Group, Cambridge, England, 1997.
Abarca RB, Strömland K, Hellström A, Dolores Pinazo Duran M. Estudio de la motilidad ocular en ninos afectos del sindrome alcohólico fetal. XIV Congreso de la Sociedad Espanola de Estrabologia, Valencia, 1998.
Hellström A, Svensson E, Carlsson B, Niklasson A, Albertsson-Wikland K. Reduced Retinal Vascularisation in Children with Growth Hormone Deficiency. Growth Hormone Research Society Symposium, San Fransisco, USA, 1998 - Poster Prize!
Hård A-L, Niklasson A, Svensson E, Hellström A. Visual function in very preterm schoolaged children a population based study. Nordiska Barnögonläkarnas Årsmöte, Reykjavik, Island, 1998.
Pinazo-Durán, Guerri C, Hellström A, Strömland K. Vision and myelin-related changes in fetal alcohol syndrome. ISBRA, Danmark, June 26-July 2, 1998.
Hård A-L, Niklasson A, Svensson E, Hellström A. Visual function in very preterm schoolaged children a population based study. 24th Meeting of the European Paediatric Ophthalmology Group, Dublin, Ireland, 1998.
Hellström A. Pre- and perinatal adverse events as reflected in the ocular fundus. 24th Meeting of the European Paediatric Ophthalmology Group, Dublin, Ireland, 1998. Hellström A, Svensson E, Carlsson B, Niklasson A, Albertsson-Wikland K. Reduced Retinal Vascularisation in Children with Growth Hormone Deficiency. GH and Growth Factors in Endocrinology and Metabolism, Palma de Mallorca 1998.
Hellström A, Strömland K, Wiklund L-M, Svensson E, Albertsson Wikland K. A specific ocular fundus morphology in children with optic nerve hypoplasia indicates endocrinopathy. 27th International Symposium GH and Growth Factors in Endocrinology and Metabolism, Nice, April 1999. Poster Prize!
Jacobson L, Ek U, Fernell E, Flodmark O, Hellström A, Ygge J. Ocular signs in periventricular leukomalacia. AAPOS, Toronto April 1999.
Strömland K, "skarsdóttir S, Hellström A, Aring E, Borén C. Ocular and facial characteristics in CATCH 22. XII Congress European Society of Ophthalmology, Sweden, Stockholm June 27-July 1, 1999.
Teär-Fahnehielm,Ygge J, Wide K, Tomson T, Hellström A, Strömland K. Visual and ocular outcome in children after prenatal exposure to antiepileptic drugs. EP XII Congress European Society of Ophthalmology, Sweden, Stockholm June 27-July 1, 1999.
Hellström et al. Ocular fundus, neuroimaging and neuropsychiatric findings in children with Septo-optic dysplasia. 25th Meeting of the European Paediatric Ophthalmology Group, Strasbourg, France, 1999.
Hård A-L and Hellström A. Ocular fundus morphology in children born very preterm. 25th Meeting of the European Paediatric Ophthalmology Group, Strasbourg, France, 1999.
Dahlgren J, Fors H, Ankarberg Lindgren C, Bjarnason R, Niklasson A, Hellström A and Albertsson-Wikland K. IGF-I, IGFBP-3, ESTRADIOL AND TESTOSTERONE IN ADOLESCENT MALES BORN SMALL FOR GESTATIONAL AGE (SGA). Stockholm, 2000.
Strömland K, "skarsdóttir S, Borén C, Aring E, Hellström A. The 22q11 deletion syndrome - ocular and facial characteristics. Bringing the 22q11.2 deletion into the 21th century, Philadelphia, June 2000
