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Cerebral visual impairment in children: Multicentric study determining the causes, associated neurological and ocular
Monalisa Mohapatra1, Soveeta Rath2, Pradeep Agarwal3
1Department of Pediatric Ophthalmology, MGM Eye Institute, Raipur, Chattisgarh; The Bodhya Eye Consortium, a. MGM Eye Institute, Raipur, Chhattisgarh, India, b. Dr. Shroff's Charity Eye Hospital, New Delhi, India, c. CL Gupta Eye Institute, Moradabad, Uttar Pradesh, India.
Insights
Cerebral visual impairment (CVI) in children is often caused by hypoxic-ischemic encephalopathy or seizures. Optic atrophy and seizure disorders are risk factors for severe vision impairment in these children.
Area of Science:
- Pediatric Ophthalmology
- Neuroscience
- Developmental Pediatrics
Background:
- Cerebral visual impairment (CVI) is a significant cause of visual disability in children.
- Understanding the underlying causes and associated findings is crucial for effective management.
Purpose of the Study:
- To evaluate the causes and neurological/ocular findings in children with CVI.
- To identify risk factors for severe vision impairment in pediatric CVI cases.
Main Methods:
- Multicenter, retrospective, cross-sectional analysis of 405 children diagnosed with CVI.
- Data collected from January 2017 to December 2019.
Main Results:
- Hypoxic-ischemic encephalopathy (35.1%) and seizures (31.3%) were leading causes of CVI.
- Common neurological findings included seizures (50.4%) and cerebral palsy (13.6%).
- Severe visual impairment was linked to optic atrophy (OR 2.9) and seizure disorders (OR 1.9).
Conclusions:
- Ophthalmic and neurological findings in CVI are diverse and impact neurodevelopment.
- This knowledge aids multidisciplinary teams in planning rehabilitation strategies for children with CVI.
Purpose:
To evaluate the causes, associated neurological and ocular findings in children with cerebral visual impairment (CVI), and to identify risk factors for severe vision impairment.
Methods:
A multicenter, retrospective, cross-sectional analysis was carried out from January 2017 to December 2019 on patients less than 16 years of age with a diagnosis of CVI.
Results:
A total of 405 patients were included of which 61.2% were male and 38.8% were female. The median age at presentation was 4 years (range 3 months to 16 years). Antenatal risk factors were present in 14% of the cases. The most common cause of CVI was hypoxic-ischemic encephalopathy (35.1%), followed by seizure associated with brain damage (31.3%). The most common neurological finding was seizure (50.4%), followed by cerebral palsy (13.6%). Associated ophthalmological findings were significant refractive error (63.2%), esotropia (22.2%), exotropia, (38%), nystagmus (33.3%), and optic nerve atrophy (25.9%). Severe visual impairment (<20/200) was associated with optic atrophy (odds ratio: 2.9, 95% confidence interval: 1.4-6.0; P = 0.003) and seizure disorder (odds ratio: 1.9, 95% confidence interval: 1.2-3.3; P = 0.012).
Conclusion:
The various ophthalmic, neurological manifestations and etiologies could guide the multidisciplinary team treating the child with CVI in understanding the visual impairment that affects the neuro development of the child and in planning rehabilitation strategies.
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