Including visual orienting functions into cerebral visual impairment screening: Reliability, variability, and ecological validity

Itzhak, Nofar Ben; Kooiker, Marlou J. G.; Pel, J.J.M.; Ortibus, Els

doi:10.1016/j.ridd.2022.104391

Cited by 6 publications

(5 citation statements)

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“…A combined evaluation of structure (RNFL, RGCL, and optic disk) and function (visual fields) helps to understand the integrity of the visual pathways in CVI (Jacobson et al, 2020). Several studies provided evidence for ocular motor dysfunction in children with CVI (Kooiker et al, 2015;Ben Itzhak et al, 2023). Measuring fixation and eye movements in children with CVI can be used to estimate visual information processing (spatial orientation, visual attention, recognition, memory etc.)…”

Section: Introductionmentioning

confidence: 99%

Childhood cerebral visual impairment subtype classification based on an extensive versus a limited test battery

Philip,

Huurneman,

Jansonius

et al. 2023

Front. Neurosci.

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PurposeTo classify CVI subtypes and compare the added value of an extensive test battery over a limited test battery in subtype classification of cerebral visual impairment (CVI) in children.MethodsSeventy-five children with a clinical diagnosis of CVI (median [IQR] age: 9 [7–12] years) were identified from the medical records. The extensive test battery included visual acuity, contrast sensitivity, ocular alignment, eye movement analysis, visual field analysis, optic nerve head evaluation, and evaluation of visual perception. The limited test battery included visual acuity, contrast sensitivity, ocular alignment, and evaluation of visual perception. Principal component analysis (PCA) followed by cluster analysis was done, for both test batteries separately, to determine the optimum subtype classification for CVI.ResultsFifty-one participants with an extensive test battery with mild to moderate visual impairment were included in the main analysis. This resulted in four CVI subtypes for the extensive test battery (subtle characteristics, higher-level visual function deficits, lower-level visual function deficits, and higher- and lower- level visual function deficits) and three CVI subtypes for the limited test battery (subtle characteristics, higher-level visual function deficits, and higher- and lower- level visual function deficits). There were significant differences between the subtypes for 9 out of 10 measures of the extensive and all 4 measures of the limited test battery (p < 0.05). The subtle characteristics subtype (extensive n = 19, limited n = 15) showed near normal lower and higher-level visual functions in both test batteries. The higher-level visual function deficits subtype (extensive n = 18, limited n = 24) showed near normal visual acuity combined with significant visual perceptual deficits in both test batteries; accompanied by visual pathways defects and abnormal eye movement behavior in the extensive test battery. The higher- and lower- level visual function deficits subtype (extensive n = 4, limited n = 12) showed both higher and lower-level visual function deficits in both test batteries, but application of the extensive test battery revealed additional visual pathways defects and abnormal eye movement behavior. The lower-level visual function deficits CVI subtype (extensive n = 10) was a new subtype identified by the extensive test battery. This subtype showed lower-level visual function deficits together with abnormal eye movement measures.ConclusionThis data-driven study has provided meaningful CVI subtype classifications based on the outcomes of various key functional and structural measures in CVI diagnosis. Comparison of the extensive test battery to the limited test battery revealed the added value of an extensive test battery in classifying CVI. The outcomes of this study, therefore, have provided a new direction in the area of CVI classification.

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Section: Introductionmentioning

confidence: 99%

Childhood cerebral visual impairment subtype classification based on an extensive versus a limited test battery

Philip,

Huurneman,

Jansonius

et al. 2023

Front. Neurosci.

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“…15 To address the need for standardized, quantifiable measures of visual function and visual perception for children diagnosed or at risk for CVI, computer-based activities with integrated eye-tracking systems have been trialed. [16][17][18] However, these computer-based activities have been developed for children with medium to high levels of visual ability and higher cognitive levels.…”

Section: Assessment Of Pediatric CVImentioning

confidence: 99%

“…To address the need for standardized, quantifiable measures of visual function and visual perception for children diagnosed or at risk for CVI, computer-based activities with integrated eye-tracking systems have been trialed. 16–18 However, these computer-based activities have been developed for children with medium to high levels of visual ability and higher cognitive levels. Screen-based methods for measuring acuity in young children using a preferential-looking paradigm have also been trialed and have shown high correlation with gold-standard clinic measures.…”

Section: Introductionmentioning

confidence: 99%

A Quantitative Assessment of Visual Function for Young and Medically Complex Children With Cerebral Visual Impairment: Development and Inter-Rater Reliability

Weden,

Barstow,

Oster

et al. 2024

Preprint

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Background. Cerebral Visual Impairment (CVI) is the most common cause of low vision in children. Standardized, quantifiable measures of visual function are needed. Objective. This study developed and evaluated a new method for quantifying visual function in young and medically complex children with CVI using remote videoconferencing. Methods. Children diagnosed with CVI who had been unable to complete clinic-based recognition acuity tests were recruited from a low-vision rehabilitation clinic(n=22)Video-based Visual Function Assessment (VFA) was implemented using videoconference technology. Three low-vision rehabilitation clinicians independently scored recordings of each childs VFA. Interclass correlations for inter-rater reliability was analyzed using intraclass correlations (ICC). Correlations were estimated between the video-based VFA scores and both clinically obtained acuity measures and childrens cognitive age equivalence. Results: Inter-rater reliability was analyzed using intraclass correlations (ICC). Correlations were estimated between the VFA scores, clinically obtained acuity measures, and cognitive age equivalence. ICCs showed good agreement (ICC and 95% CI 0.835 (0.701-0.916)) on VFA scores across raters and agreement was comparable to that from previous, similar studies. VFA scores strongly correlated (r= -0.706, p=0.002) with clinically obtained acuity measures. VFA scores and the cognitive age equivalence were moderately correlated (r= 0.518, p=0.005), with notable variation in VFA scores for participants below a ten month cognitive age-equivalence. The variability in VFA scores among children with lowest cognitive age-equivalence may have been an artifact of the studys scoring method, or may represent existent variability in visual function for children with the lowest cognitive age-equivalence. Conclusions: Our new VFA is a reliable, quantitative measure of visual function for young and medically complex children with CVI. Future study of the VFA intrarater reliability and validity is warranted.

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“…Higher order visual perceptual functions associated with the dorsal and ventral networks should also be quantitatively investigated. Eye tracking technology may be useful in cases where conventional neuropsychological methods are challenging due to comorbid cognitive and/or communication difficulties (Ben Itzhak et al, 2023; Bennett et al, 2018; Good et al, 1994; Huo et al, 1999; Kooiker et al, 2016; Mayer et al, 2020; Mooney et al, 2021; Tanke et al, 2021). Additionally, screening for infants and toddlers at risk for CVI needs to be implemented as early as possible with follow up and monitoring over time.…”

Section: Four Main Driving Forces Behind the Issuesmentioning

confidence: 99%

Toward Removing Barriers in the Evaluation, Diagnosis, and Care of Individuals With Cerebral Visual Impairments

Lueck,

Harpster,

Hartmann

et al. 2023

Policy Insights from the Behavioral and Brain Sciences

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Cerebral visual impairment (CVI) is a leading cause of pediatric visual impairment worldwide. Despite the ramifications on multiple developmental domains and quality of life factors, substantial barriers remain for evaluation, diagnosis, treatment, and education of this growing population of children and adults. At the root is a lack of consensus on the definition and diagnostic criteria of CVI and a narrow ocular/acuity-based classification of visual impairment. This article covers four main issues that need to be urgently addressed to make strides toward removing current barriers. These challenges highlight the need for policy change at multiple levels to help ensure that individuals with CVI will have access to appropriate (re)habilitation and education services regardless of their acuity or visual function. Suggested solutions include the implementation of a globally accepted definition of CVI and increased multidisciplinary training programs. These will support international efforts to develop and implement quantitative interdisciplinary assessment methods, identify meaningful and effective intervention approaches, and monitor long-term outcomes for those with CVI. Additionally, sensitive and specific markers can be identified for differentiating CVI from other related developmental conditions, such as autism spectrum disorder and developmental coordination disorder. Ultimately, these proposed changes will lead toward improved quality of life for individuals with CVI and their caregivers.

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Including visual orienting functions into cerebral visual impairment screening: Reliability, variability, and ecological validity

Cited by 6 publications

References 67 publications

Childhood cerebral visual impairment subtype classification based on an extensive versus a limited test battery

Childhood cerebral visual impairment subtype classification based on an extensive versus a limited test battery

A Quantitative Assessment of Visual Function for Young and Medically Complex Children With Cerebral Visual Impairment: Development and Inter-Rater Reliability

Toward Removing Barriers in the Evaluation, Diagnosis, and Care of Individuals With Cerebral Visual Impairments

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