Predisposing Factors, Ophthalmic Manifestations, and Radiological Findings in Children With Cerebral Visual Impairment

Abstract

Purpose: To describe predisposing factors, ophthalmic manifestations, and magnetic resonance imaging (MRI) findings in children with cerebral visual impairment. Methods: A retrospective cross-sectional analysis of patients younger than 16 years with neuroradiological and clinical evidence of retrogeniculate visual pathway pathology was performed. Detailed histories, ophthalmic examinations, and MRI findings were compiled and analyzed. Results: Of the 88 cases included in the study, the median age was 32 months (range: 1 to 180 months). Ante-natal history and preterm delivery was positive in 25.0% and 37.5% of patients, respectively. A simple myopic astigmatism was the most common refractive error. Accommodative anomalies were noted in 6 children. Conclusions: The demographic trends found in the study were similar to those of developed nations, but the frequency of the predisposing factors varied. A comprehensive knowledge of cerebral visual impairment in the developing world can aid an earlier diagnosis, appropriate management, and the development of better rehabilitation teams. [ J Pediatr Ophthalmol Strabismus . 2019;56(5):313–318.]

Cerebral visual impairment in children: Multicentric study determining the causes, associated neurological and ocular findings, and risk factors for severe vision impairment

“…The proportion of male to female was 1.6:1 in our study, which is similar to observations made in other studies. [ 14 17 ] As no sex predilection has been reported in CVI, this gender inequality may be because of the societal norms. It has been observed that ocular diseases in males are prioritized more than females in both adults and children in low- and middle-income countries, including India.…”

“…[ 19 20 ] Our study reports a late age at presentation with a median age of 4 years in comparison to other studies where they reported a young age at presentation. [ 8 15 17 ] In the Pehere et al . [ 15 ] and Ganesh et al .…”

“…[ 15 ] and Ganesh et al . [ 17 ] studies, median age at presentation was 3 years. The late age at presentation in our study can possibly be attributed to a late diagnosis and reporting of patients by pediatricians and ophthalmologists in this region.…”

“…Ganesh et al . [ 17 ] also reported hypoglycemia in 19.31% patients. Counseling the parents by a neonatologist can help in reducing the prevalence of neonatal hypoglycemia by keeping babies warm and dry and offering early feeds.…”

“…There have been only a few reports of large series of patients with CVI. [ 2 3 14 15 16 17 ] Late diagnosis and treatment can lead to childhood blindness, which has a significant impact on the psychomotor, social, and emotional development of the child. The goal of this study was to determine the causes, associated neurological and ocular findings of children with CVI, and factors associated with vision impairment.…”