Profile of children with cerebral visual impairment and cerebral palsy - An Australian cohort

Abstract

Objective: To describe the characteristics of cerebral visual impairment (CVI) in children with cerebral palsy (CP) attending a tertiary care referral centre in Australia. Method: Prospective cross- sectional study, children aged 3 months to ≤14 years with/high risk of CP or neurodevelopmental delay and a clinical MRI already performed were recruited. All children underwent a complete ophthalmological and visuo-perceptual assessment. Results: One hundred and two children, M:F = 2:1, age range 7 months-14 years were recruited. Most common motor type and distribution (18%) was spastic quadriplegia. Features suggestive of CVI were seen in 98% of the cohort. Definite CVI seen in (62%) with predominantly dorsal stream dysfunction seen in 42% of children. Periventricular leucomalacia accounted for 75% of the brain lesion, with hypoxic ischaemic encephalopathy (50%) being the most common aetiology of brain injury. Nearly 32% of participants had visual acuity ≤ 6/60, 32% had hypo accommodation, 18% had convergent squint and 61% of children required hypermetropic correction. Among the visual perceptual dysfunction: impaired visual attention (83%), simultanagnosia (55%), problems with clutter (89%), impaired visual guidance of hands (49%), lower visual field defects (51%) and impaired recognition of faces (18%) of the cohort. Conclusion: CVI is an under recognised clinical presentation in children with CP. It is important that all children with early brain injury with high risk of CP or adverse neurodevelopmental outcome have a detailed ophthalmological and CVI assessment performed to help understand the underpinnings of CVI and initiate rehabilitative strategies early to improve the quality of life of these children.L6366696252021-12-27 <br />