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Profiles of Cortical Visual Impairment (CVI) Patients Visiting Pediatric Outpatient Department
Rojeeta Parajuli1, Srijana Adhikari2, Ujjowala Shrestha
1Tilganga Institute of Ophthalmology, Kathmandu, Nepal.
Insights
Cortical visual impairment in children is often linked to birth asphyxia and postnatal infections. Addressing these issues can help prevent vision loss in pediatric patients.
Area of Science:
- Ophthalmology
- Pediatrics
- Neurology
Background:
- Cortical visual impairment (CVI) results from damage posterior to the lateral geniculate nucleus, affecting optic radiations or occipital cortex.
- Understanding the profile of CVI patients is crucial for targeted interventions.
Purpose of the Study:
- To characterize the demographic and clinical profiles of pediatric patients diagnosed with cortical visual impairment.
- To identify potential risk factors and etiological causes of CVI in a pediatric cohort.
Main Methods:
- A retrospective hospital-based study included 40 pediatric patients diagnosed with CVI.
- Data collected included patient history, clinical examination, visual acuity assessment, and neuroimaging (CT/MRI).
- Refractive errors like myopia and astigmatism were assessed, with a small percentage requiring corrective lenses.
Main Results:
- The study included a male to female ratio of 3:2, with ages ranging from 4 months to 8 years.
- A significant majority (87.5%) had a history of birth asphyxia, and 67.5% had eventful postnatal histories.
- Abnormal findings on CT/MRI scans were present in 57.5% of cases, suggesting underlying neurological pathology.
Conclusions:
- Birth asphyxia and postnatal infections are identified as primary contributors to CVI in children.
- Mitigating CVI is achievable by focusing on the prevention of birth asphyxia and effective management of postnatal infections.
Introduction:
Cortical visual impairment denotes vision loss from pathology posterior to the lateral geniculate nucleus. The pathology may involve the optic radiations, as well as the occipital cortex.
Objective:
To find out the profiles of cortical visual impairment patients visiting the pediatric outpatient department.
Materials And Methods:
The study is a hospital based retrospective study in which all consecutive patients diagnosed with cortical visual impairment were included. A total of 40 patients were collected. Detailed history taking and clinical examination was done. Visual acuity was taken by fixation and follows method. Among 40 patients, only two patients were advised to use glass and the rest did not have significant refractive error. Myopia ranged from (-2D to -5D) and five patients were myopic. Astigmatism ranged from (-0.5 to -2.5 x 108°) and 10 patients had astigmatism. Suspected patients were advised for Computed Tomography/ Magnetic Resolution Imaging (CT/MRI) of the brain.
Results:
The male: female ratio was 3:2, the age group ranged from 4 months to 8 years old, antenatal checkup history was uneventful in 77.5% cases, history of birth asphyxia was present in 87.5% cases, postnatal checkup history was eventful in 67.5%, associated systemic illness was present in 60%, anterior segment examination was normal in 92.5%, posterior segment examination was normal in 72.5%, CT/MRI findings were abnormal in 57.5% and was not done in 30% of cases. Antenatal history was described as uneventful if there was absence of diabetes mellitus, hypertension, fever and intake of any medicine. Postnatal history was described as uneventful if there was absence of febrile convulsion, meningitis, encephalocele, encephalopathy, epilepsy or hydrocephalus.
Conclusion:
Birth asphyxia and postnatal infections are the major causes for cortical visual impairment. We can mitigate cortical visual impairment by limiting birth asphyxia and postnatal infections.
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