Correlation of visual function with semi-quantitative MRI findings in cerebral visual impairment

To evaluate visual function in children with cerebral visual impairment (CVI) from various causes, examine its relationship with the severity of cerebral involvement using a semi-quantitative MRI scoring system (sqMRI), and compare the results with strabismic controls without visual impairment.

This retrospective study included children diagnosed with CVI and controls without CVI who were followed for strabismus. MRI data were compared using a modified 24-point sqMRI scale. Inter-rater agreement was excellent (ICC = 0.91; 95% CI: 0.79-0.96). Partial correlations controlling for gestational age were computed for primary MRI-BCVA relationships.

Forty-two children with CVI and 40 strabismic controls were included. Hypoxic-ischemic encephalopathy was the most common cause (26.1%). Children with CVI had significantly lower gestational ages, birth weights, and best-corrected visual acuity (BCVA) (mean 0.28 ± 0.17 logMAR) compared to controls (0.05 ± 0.05 logMAR) (p < 0.001). The sqMRI scores showed significant correlation with BCVA, especially in the basal ganglia, thalamus, hemispheric, subcortical, and total MRI scores (p < 0.05). The total MRI-BCVA correlation remained strong after adjusting for gestational age (partial r = 0.78, p < 0.001).

A strong, prematurity-independent correlation was observed between sqMRI scores and visual impairment in a clinically diverse CVI population. These findings suggest that sqMRI scoring could be a useful additional tool for visual prognosis and early rehabilitation planning.