Ophthalmologic characteristics and outcomes of children with cortical visual impairment and cerebral palsy

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A Method to Quantify Visual Information Processing in Children Using Eye Tracking
09:47

A Method to Quantify Visual Information Processing in Children Using Eye Tracking

Published on: July 9, 2016

17.8K

Michael R West1, Mark S Borchert2, Melinda Y Chang2

  • 1University of Southern California, Los Angeles, California.

Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
|July 16, 2021
PubMed

Insights

Children with cortical visual impairment (CVI) and cerebral palsy (CP) show more eye problems and poorer long-term outcomes from strabismus surgery compared to those with CVI alone. This highlights key differences in pediatric visual impairment management.

Area of Science:

  • Ophthalmology
  • Pediatrics
  • Neurology

Background:

  • Cortical visual impairment (CVI) is a leading cause of vision loss in children.
  • Cerebral palsy (CP) co-occurs in about half of children with CVI.
  • The comparative characteristics and surgical outcomes for children with CVI and co-occurring CP (CVI+CP) versus CVI without CP (CVI-CP) are not well understood.

Purpose of the Study:

  • To compare the ophthalmic characteristics and strabismus surgery outcomes in children with CVI+CP versus CVI-CP.
  • To identify differences in refractive error, optic atrophy, strabismus prevalence, and surgical success rates between the two groups.
  • To evaluate long-term strabismus surgery outcomes in pediatric patients with CVI, stratified by the presence or absence of CP.

Main Methods:

  • Retrospective review of medical records for children diagnosed with CVI between 2013 and 2019.
  • Comparison of presentation characteristics, including refractive error, optic atrophy, and strabismus, between CVI+CP and CVI-CP groups.
  • Analysis of strabismus surgery outcomes, including ocular alignment and long-term follow-up, for both groups.

Main Results:

  • Children with CVI+CP had higher rates of significant refractive error (53.6% vs 41.2%), optic atrophy (46.4% vs 32.7%), and strabismus (82.8% vs 72.5%) at presentation.
  • While immediate post-operative alignment rates were similar (30% vs 63.6%), long-term outcomes (≥8 years) showed significantly worse results for CVI+CP patients (0% vs 100%).
  • Visual acuity at presentation and improvement rates did not differ significantly between the CVI+CP and CVI-CP groups.

Conclusions:

  • Children with CVI+CP exhibit a greater prevalence of ophthalmic comorbidities compared to those with CVI-CP.
  • Long-term outcomes following strabismus surgery appear to be poorer in children with CVI+CP.
  • These findings underscore the importance of considering co-occurring CP when managing visual impairment and strabismus in pediatric patients.
Abstract

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