Retinal ganglion cell topography predicts visual field function in spastic cerebral palsy

Jacobson, Lena; Lennartsson, Finn; Nilsson, Maria

doi:10.1111/dmcn.14545

Cited by 13 publications

(17 citation statements)

References 28 publications

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“…Lesions affecting the optic radiations lead to detectable ganglion cell absence in predictable retinal areas owing to a process known as retrograde transynaptic degeneration (Lennartsson et al, 2014) with lack of the optic nerve fibers causing optic atrophy or optic disk cupping which can be misdiagnosed as glaucoma (Jacobson et al, 2020), when brain injury occurs in later pregnancy (Jacobson and Dutton, 2000) or optic nerve hypoplasia, as a sequel to earlier injury (Zeki et al, 1992).…”

Section: Optical Ophthalmological and Neurological Disorders Associated With Cortical Or Cerebral Visual Impairmentmentioning

confidence: 99%

Cortical Visual Impairments and Learning Disabilities

Chokron

Kovarski

Dutton

2021

Front. Hum. Neurosci.

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Medical advances in neonatology have improved the survival rate of premature infants, as well as children who are born under difficult neurological conditions. As a result, the prevalence of cerebral dysfunctions, whether minimal or more severe, is increasing in all industrialized countries and in some developing nations. Whereas in the past, ophthalmological diseases were considered principally responsible for severe visual impairment, today, all recent epidemiological studies show that the primary cause of blindness and severe visual impairment in children in industrialized countries is now neurological, with lesions acquired around the time of birth currently comprising the commonest contributor. The resulting cortical or cerebral visual impairments (CVIs) have long been ignored, or have been confused either with other ophthalmological disorders causing low vision, or with a range of learning disabilities. We present here the deleterious consequences that CVI can have upon learning and social interaction, and how these can be given behavioral labels without the underlying visual causes being considered. We discuss the need to train and inform clinicians in the identification and diagnosis of CVI, and how to distinguish the diagnosis of CVI from amongst other visual disorders, including the specific learning disorders. This is important because the range of approaches needed to enhance the development of children with CVI is specific to each child’s unique visual needs, making incorrect labeling or diagnosis potentially detrimental to affected children because these needs are not met.

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Section: Optical Ophthalmological and Neurological Disorders Associated With Cortical Or Cerebral Visual Impairmentmentioning

confidence: 99%

Cortical Visual Impairments and Learning Disabilities

Chokron

Kovarski

Dutton

2021

Front. Hum. Neurosci.

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“…Diffusion-weighted MRI (dMRI) and fiber tractography was used to investigate the OR and to assess lesion involvement to the tract (studies I-IV) (Lennartsson et al, 2014(Lennartsson et al, , 2018Jacobson et al, 2019Jacobson et al, , 2020. In study II, our investigations were refined by inclusion of retinotopic functional MRI (fMRI) mapping.…”

Section: Study I-ivmentioning

confidence: 99%

Pre- and Postnatal Damage to the Retro-Geniculate Visual Pathways Cause Retinal Degeneration Predictive for Visual Function

Lennartsson¹,

Öhnell²,

Jacobson³

et al. 2021

Front. Hum. Neurosci.

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To increase the understanding of the relationship between structure and function in individuals with damage to the brain from different stages of maturation of the visual system, we examined 16 teenagers and young adults. We used diffusion-weighted magnetic resonance imaging (MRI) and fiber tractography of the optic radiation (OR) and optical coherence tomography (OCT) of the peripapillary retinal nerve fiber layer (pRNFL) and the ganglion cell layer + inner plexiform layer (GC+IPL) in the macula. Visual field (VF) function was assessed with the Humphrey Field Analyzer (HFA). Injuries to the immature OR were associated with thinning of the pRNFL and GC+IPL, and corresponding VF defects irrespectively of timing of the lesion. However, in cases with bilateral white-matter damage of immaturity (WMDI) we noticed a well preserved central VF despite a very thin GC+IPL. We speculate that this is due to plasticity in the immature visual system. Similar results were not noticed among cases with unilateral damage, acquired pre- or postnatally, in which the central VF was affected in most cases. OCT has proved to be a valuable targeted tool in children with damage to the retro-geniculate visual pathways, and that focal thinning of the GC+IPL predicts VF defects. This brief research report includes a review of four previously published papers. In addition, we present one new case and apply a recently developed classification system for CVI. The classification was applied on cases with bilateral WMDI to investigate its relation to retinal structure.

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“…Thus the focal loss of peripapillary RNFL and macular GCL tends to correlate with the visual field defects in such patients and also the PVD. [ 54 55 56 ] OCT also helps to act as a surrogate marker for potential visual field defects, which are difficult to assess because of difficulties in using automated perimetry at a young age and the visual issues related to dorsal stream dysfunction. One should remember that there are many other causes for thinning of the RNFL and GCL in addition to optic radiation injury, and that visual field defects and PVD can be present even in those with a normal peripapilary RNFL and normal macular GCL thicknesses.…”

Section: When To Suspect Pvd In a Child?mentioning

confidence: 99%

Perceptual visual dysfunction in children - An Indian perspective

Pehere

Dutton

2021

Indian Journal of Ophthalmology

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Perceptual visual dysfunction (PVD) comprises a group of vision disorders resulting from dysfunction of the posterior parietal and/or temporal lobes. Often, affected children have normal/near normal visual acuities and/or visual fields, but have difficulties in activities of daily living involving the use of vision. PVDs are known to be common among children with risk factors such as a history of prematurity and/or neurodevelopmental disorders. The inferior temporal lobes and ventral stream transform visual signals into perception, while the posterior parietal lobes and dorsal stream transform visual signals to non-consciously map the scene to guide action and facilitate attention. Dysfunction of these can lead to specific visual impairments that need to be identified during history taking, triggering ascertainment of further details by a structured inventory approach. Clinical tests to elicit dorsal and ventral stream visual dysfunctions have good specificity but low sensitivity. Neuropsychologists are rarely available in the developing world to perform detailed assessments, but there are a few tests that can be used by eye care professionals with some training. Optical coherence tomography (OCT) showing thinning of the ganglion cell layer and retinal nerve fiber layer is being explored as a potential tool for rapid assessment in the clinic. The behavioral outcomes of PVD can mimic psychological conditions including autism spectrum disorder, attention deficit hyperactivity disorder, specific learning disability, and intellectual impairment, and one needs to be aware of overlap among these differential diagnoses. A practical functional approach providing working solutions for each child's set of difficulties in day-to-day activities is needed.

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Retinal ganglion cell topography predicts visual field function in spastic cerebral palsy

Cited by 13 publications

References 28 publications

Cortical Visual Impairments and Learning Disabilities

Cortical Visual Impairments and Learning Disabilities

Pre- and Postnatal Damage to the Retro-Geniculate Visual Pathways Cause Retinal Degeneration Predictive for Visual Function

Perceptual visual dysfunction in children - An Indian perspective

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