Visual impairment in children with cerebral palsy: Croatian population-based study for birth years 2003-2008

Area of Science:

• Pediatric Ophthalmology
• Neurology
• Public Health

Background:

• Cerebral palsy (CP) is a common neurodevelopmental disorder affecting motor function.
• Visual impairment (VI) is a frequent comorbidity in children with CP, impacting their development and quality of life.
• Understanding the prevalence and risk factors for VI in CP is crucial for early intervention and support.

Purpose of the Study:

• To determine the prevalence of visual impairment (VI) in a population-based cohort of children with cerebral palsy (CP).
• To investigate the association between VI and different types/subtypes of CP, motor function levels, and gestational age.
• To identify specific risk factors for severe VI in children with CP.

Main Methods:

• A population-based study utilizing data from the Surveillance of Cerebral Palsy in Europe (SCPE) register in Croatia.
• Inclusion of 419 children diagnosed with CP, born between 2003-2008.
• Classification of vision as normal or impaired (including severe VI) and analysis of proportions based on CP characteristics, motor function (Gross Motor Function Classification System, Bimanual Fine Motor Function), and gestational age.

Main Results:

• A high proportion of children with CP (66.5%) exhibited some degree of VI, with 11% experiencing severe VI.
• The prevalence of VI and severe VI increased with higher levels of gross and fine motor impairment.
• Children with bilateral spastic CP showed the highest frequency of severe VI (14.9%), particularly those born extremely premature (<28 weeks GA).

Conclusions:

• Children with CP have a significant burden of visual impairment, including severe forms.
• Motor impairment severity is directly correlated with the likelihood and severity of VI.
• Bilateral spastic CP and extreme prematurity are critical risk factors for severe visual impairment in this population, necessitating targeted screening and management.