Diagnosing Cerebral Visual Impairment in Children with Good Visual Acuity

Strabismus ◽  
2012 ◽  
Vol 20 (2) ◽  
pp. 78-83 ◽  
Author(s):  
Maria van Genderen ◽  
Marjoke Dekker ◽  
Florine Pilon ◽  
Irmgard Bals
Keyword(s):  
Visual Acuity ◽  
Visual Impairment ◽  
Good Visual Acuity ◽  
Cerebral Visual Impairment

scholarly journals Higher Visual Function Deficits in Children With Cerebral Visual Impairment and Good Visual Acuity

2021 ◽  
Vol 15 ◽  
Author(s):  
Arvind Chandna ◽  
Saeideh Ghahghaei ◽  
Susan Foster ◽  
Ram Kumar
Keyword(s):  
Visual Acuity ◽  
Brain Development ◽  
Visual Impairment ◽  
Brain Damage ◽  
Visual Function ◽  
Visual Processing ◽  
Typically Developing ◽  
Typically Developing Children ◽  
Good Visual Acuity ◽  
Cerebral Visual Impairment

In clinical practice Cerebral Visual Impairment (CVI) is typically diagnosed by observation of abnormal visually guided behaviors which indicate higher visual function deficits (HVFDs) suggesting abnormal brain development or brain damage in a child with a suitable clinical history. HVFDs can occur even in the presence of good visual acuity and may remain undiagnosed because the good visual acuity does not prompt further investigation. This leads to a lack of understanding of the child’s visual perceptual difficulties. In a prospective study, we determined the spectrum of HVFDs in a group of children with history suggestive of brain damage or disruption of brain development and an independent diagnosis of CVI in comparison with typically developing children with a structured 51 question inventory, the Higher Visual Function Question Inventory (HVFQI-51) adapted from the Cerebral Vision Impairment Inventory, CVI-I. Here, we show that the HVFQI-51 can detect a range of HVFDs in children with CVI with good visual acuity and clearly distinguishes these children from typically developing children. HVFDs in our study group could mostly be attributed to dorsal stream visual processing dysfunction though the spectrum varied between children. We report on the inclusion of the “not applicable” response option in analysis providing a picture of HVFDs more in tune with the overall disability of each child. We also propose a subset of 11 questions (Top-11) which discriminate between children with CVI vs. behaviors seen in typical children: this provides both a potential screening tool for initial assessment of HVFDs and a measure of CVI-related impairment, and needs further validation in a secondary independent sample.

scholarly journals Motion Processing Deficits in Children With Cerebral Visual Impairment and Good Visual Acuity

2021 ◽  
Vol 62 (14) ◽  
pp. 12
Author(s):  
Arvind Chandna ◽  
Nikolay Nichiporuk ◽  
Spero Nicholas ◽  
Ram Kumar ◽  
Anthony M. Norcia
Keyword(s):  
Visual Acuity ◽  
Visual Impairment ◽  
Motion Processing ◽  
Good Visual Acuity ◽  
Processing Deficits ◽  
Cerebral Visual Impairment

scholarly journals Should we add visual acuity ratios to referral criteria for potential cerebral visual impairment?

2017 ◽  
Vol 10 (2) ◽  
pp. 95-103
Author(s):  
Ymie J. van der Zee ◽  
Peter Stiers ◽  
Heleen M. Evenhuis
Keyword(s):  
Visual Acuity ◽  
Visual Impairment ◽  
Referral Criteria ◽  
Cerebral Visual Impairment

scholarly journals Evaluation of the Relationship Between Preferential Looking Testing and Visual Evoked Potentials as a Biomarker of Cerebral Visual Impairment

2021 ◽  
Vol 15 ◽  
Author(s):  
Sruti Raja ◽  
Batool Sahar Emadi ◽  
Eric D. Gaier ◽  
Ryan A. Gise ◽  
Anne B. Fulton ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Evoked Potentials ◽  
Visual Impairment ◽  
Visual Evoked Potentials ◽  
Visual Development ◽  
Diagnostic Tools ◽  
Preferential Looking ◽  
The Relationship ◽  
Cerebral Visual Impairment ◽  
Visual Evoked

Cerebral visual impairment (CVI) is a leading cause of visual impairment in children in developed countries, but diagnostic tools to detect CVI are limited. We sought to analyze the visual acuity of children with CVI as assessed by visual evoked potentials (VEPs) and preferential looking test (PLT) to determine whether the relationship between the visual outcomes on these two testing methods may serve as a biomarker of CVI. We performed a retrospective chart review of patients with a confirmed diagnosis of CVI and at least one ophthalmological assessment with visual acuity measured by VEP and PLT. Of the 218 patients included in the study, the most common condition associated with CVI was an underlying genetic disorder (36%, 79/218). Treatment for seizures occurred in the majority of the entire cohort of patients (80%, 175/218). Ophthalmic comorbidities included retinal disease in 23 patients, optic nerve disease in 68 patients, nystagmus in 78 patients, and strabismus in 176 patients. When assessed by either VEP or PLT, visual acuity in children with CVI fell below expected norms. At initial and final presentations, VEP acuity exceeded PLT acuity by one or more octaves, and this difference was greater than expected compared with normal visual development. We propose utilizing this quantifiable disparity between VEP and PLT as a biomarker of CVI.

scholarly journals Changes in prevalence and causes of visual impairment and cataract surgical coverage in Nampula, Mozambique between 2011 and 2018: findings from two cross-sectional surveys

2020 ◽  
Author(s):  
Emma Jolley ◽  
Mércia Cumaio ◽  
Anselmo Vilanculos ◽  
Izidine Hassan ◽  
Kahaki Kimani ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Visual Impairment ◽  
Gender Disparity ◽  
Cluster Sampling ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Good Visual Acuity ◽  
Eye Health ◽  
Random Samples ◽  
Service Coverage

Abstract Background Globally, there are few examples of repeated eye health surveys to assess changes in prevalence and causes of visual impairment, and service coverage over time. Two separate, unlinked rapid assessments of avoidable blindness (RAAB) were conducted in Nampula province, Mozambique in 2011 and 2018. This paper reports the observed changes and examines how the trends differ for males and females. Methods Standard RAAB methodology was used in both studies. Two-stage cluster sampling was used to generate random samples of adults aged over 50 years. Participants underwent a simplified visual acuity exam focusing on presenting and pinhole visual acuity (VA), a lens exam and posterior segment exam using a direct ophthalmoscope for all subjects with presenting VA < 6/18. Data were analysed using Stata and logistic regression models were developed to assess changes. Results The 2011 study enrolled 3,050 people and examined 96.9% (2,954 people). The 2018 survey enrolled 4,191 people and examined 95.8% (4,015 people). Age and sex adjusted estimates of blindness decreased from 6.2% in 2011 to 4.5% in 2018 (z=-2.21, p = 0.028), severe visual impairment remained the same (2.6% in 2011 and 2.7% in 2018, z = 0.1, p = 0.9) and moderate visual impairment increased (5.9% in 2011 to 11.0% in 2018, z = 5.78, p < 0.001). Cataract surgical coverage was higher among males in both surveys (13.4% among males vs 7.7% among females in 2011, and 40.0% among males vs 19.4% among females in 2018) and the gender disparity grew between surveys. Conclusions Significant changes were observed in the eye health and service coverage between 2011 and 2018. An increase in the proportion of good visual acuity among operated eyes between the surveys is of note and may correspond with improvements made to the services provided in the province. Further improvements to services are required to improve access for women and people with moderate visual impairment.

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