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Evaluation of Behavioral Characteristics in Response to Visual Stimuli in Infants with Cerebral Visual Impairment
Deniz Altınbay1,2,3, İbrahim Taşkın1
1Private Niv Eye Center, Adana, Türkiye.
Insights
Infants with cerebral visual impairment (CVI) exhibit distinct behavioral responses to visual stimuli, including color and visual field preferences. Recognizing these patterns aids early diagnosis and visual habilitation for better outcomes in young children.
Area of Science:
- Ophthalmology
- Pediatrics
- Neuroscience
Background:
- Cerebral visual impairment (CVI) affects visual processing due to brain dysfunction, impacting infant development.
- Understanding behavioral responses to visual stimuli is crucial for diagnosing and managing CVI in infants.
- The Roman-Lantzy criteria provide a framework for assessing CVI, but characteristic behaviors require further elucidation.
Purpose of the Study:
- To evaluate the specific behavioral characteristics of infants diagnosed with CVI when presented with visual stimuli.
- To determine the frequency of these ten defined behavioral characteristics in infants with CVI.
Main Methods:
- A retrospective study analyzed 32 infants (8-37 months) diagnosed with CVI.
- Data included demographic characteristics, systemic findings, and standard/functional visual examinations.
- The frequency of ten behavioral characteristics in response to visual stimuli, per Roman-Lantzy, was assessed.
Main Results:
- Common conditions in the cohort included prematurity (59%), epilepsy (50%), and strabismus (68.7%).
- Observed behaviors included difficulty with distance viewing (84%), visual latency (72%), and need for movement (69%).
- Color preference (red, 69%) and visual field preference (right, 47%) were noted in 40% and 46% of infants, respectively.
Conclusions:
- Most infants with CVI display specific behavioral characteristics in response to visual stimuli.
- Ophthalmologists recognizing these features can facilitate earlier diagnosis and targeted visual habilitation.
- Early intervention during the brain's plastic period is vital for maximizing habilitation success in CVI.
Objectives:
To evaluate the behavioral characteristics of infants with cerebral visual impairment (CVI) in response to visual stimuli and the frequency of these features.
Materials And Methods:
In this retrospective study, 32 infants aged 8-37 months who were referred to the low vision unit in 2019-2021 and diagnosed with CVI based on their demographic characteristics, systemic findings, and standard and functional visual examinations were evaluated. The frequency of ten behavioral characteristics exhibited by infants with CVI in response to visual stimuli as defined by Roman-Lantzy was examined in the patients.
Results:
The mean age was 23.46±11.45 months, the mean birth weight was 2,550±944 g, and the mean gestational age at birth was 35.39±4.68 weeks. There was hypoxic-ischemic encephalopathy in 22%, prematurity in 59%, periventricular leukomalacia in 16%, cerebral palsy in 25%, epilepsy in 50%, and strabismus in 68.7% of the patients. Color preference for fixation was observed in 40% and visual field preference was observed in 46% of the patients. The most preferred color was red (69%) and the most preferred visual field was right visual field (47%). Difficulty with distance viewing was observed in 84% of patients, visual latency in 72%, need for movement in 69%, absence of visually guided reach in 69%, difficulty with visual complexity in 66%, difficulty with visual novelty in 50%, light-gazing/nonpurposeful gaze in 50%, and atypical visual reflexes in 47%. There was no fixation in 25% of the patients.
Conclusion:
Behavioral characteristics in response to visual stimuli were observed in most infants with CVI. Knowing and recognizing these characteristic features by ophthalmologists will assist in early diagnosis, referral to visual habilitation, and planning habilitation techniques. These characteristic features are important in order to not miss this critical period in which the brain is still plastic and good responses to visual habilitation can be obtained.
