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Cerebral visual impairment and effect of phase-wise stimulation strategies-An interim analysis
K S Smitha1, Bhagyajyothi Kurbet1, Mahesh Kamate2
1Department of Ophthalmology, Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research, Belagavi, Karnataka, India.
Insights
Early intervention for children with cerebral visual impairment (CVI) is crucial. Structured screening and tailored programs improve outcomes, as perinatal insults significantly impact CVI severity.
Area of Science:
- Pediatric Neurology
- Ophthalmology
- Developmental Pediatrics
Background:
- Cerebral visual impairment (CVI) is a brain-based visual disorder in children, often undiagnosed due to lack of awareness.
- Early intervention is critical during the first three years of life due to maximum neuroplasticity.
- A structured approach can improve CVI diagnosis and management.
Purpose of the Study:
- To investigate the causes of CVI in children.
- To correlate radiological findings with CVI severity.
- To evaluate the outcomes of structured interventions for CVI.
Main Methods:
- Prospective interventional study conducted at a tertiary care hospital.
- Consecutive enrollment of children aged six months to 12 years diagnosed with CVI.
- Nonparametric statistical analysis using SPSS software.
Main Results:
- Age was significantly associated with the phase of CVI.
- Perinatal insults showed a significant correlation with CVI severity.
- MRI findings did not negatively impact CVI recovery.
Conclusions:
- Encourage early intervention programs tailored to individual needs.
- Emphasize ophthalmic screening for high-risk infants, including preterm babies with perinatal hypoxia or convulsions, from six months of age.
Context:
Cerebral visual impairment (CVI) is an overarching term, defined as a brain-based visual impairment with onset in childhood, unexplained by an ocular disorder and associated with unique visual and behavioral characteristics. Good vision and awareness of visual function in a child are highly essential as neuroplasticity is maximum in the first three years of life and response to intervention is utmost in this period. Awareness is lacking regarding CVI, and the diagnosis is largely missed. This can be easily addressed if a structured approach is employed.
Purpose:
This study aims to evaluate the etiology and radiological correlation with the severity of CVI and outcome after structured intervention in children with CVI.
Settings And Design:
Prospective-interventional study.
Methods And Material:
Children attending the Child Development Centre (CDC) of a tertiary care hospital in North Karnataka and diagnosed with CVI in the age group of six months to 12 years and meeting the sampling criteria were screened and enrolled consecutively after obtaining parental consent/assent. Statistical analysis used is nonparametric test with SPSS software.
Results:
Age showed a significant association with the phase of CVI. Perinatal insult was associated significantly with the severity of CVI. Magnetic resonance imaging (MRI) findings did not hamper the recovery of CVI.
Conclusions:
Enrolment in early intervention programs tailored according to child's specific needs should be encouraged, with stress on ophthalmic screening of preterm and high-risk babies with perinatal hypoxia and history of convulsions, as early as six months.
