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

Chandna, Arvind; Ghahghaei, Saeideh; Foster, Susan; Kumar, Ram

doi:10.3389/fnhum.2021.711873

Cited by 25 publications

(27 citation statements)

References 78 publications

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“…Gorrie ( Gorrie et al, 2019 ): Two questionnaires: the CVI questionnaire (Zihl) and Five questions, derived from the 50 items of the Macintyre-Beon questionnaire as was the HVFQ51 (Higher Visual Function Deficits in Children With CVI) questionnaire ( Chandna et al, 2021b ).…”

Section: Resultsmentioning

confidence: 99%

“…• The Express questionnaire: To identify CVI in children born extremely preterm (Hellgren et al, 2020). • Gorrie (Gorrie et al, 2019): Two questionnaires: the CVI questionnaire (Zihl) and Five questions, derived from the 50 items of the Macintyre-Beon questionnaire as was the HVFQ51 (Higher Visual Function Deficits in Children With CVI) questionnaire (Chandna et al, 2021b). • The PQCVI (Parental Questionnaire for children with CVI)…”

Section: Topic One: Medical History and Cerebral Visual Impairmentmentioning

confidence: 99%

“…The HVFQI-51 (Higher Visual Function Deficits in Children with Visual Impairments) can detect a range of HVFDs in children with CVI with good visual acuity and clearly distinguishes these children from typically developing children (Chandna et al, 2021b).…”

Section: Moderate Gradementioning

confidence: 99%

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The Multidisciplinary Guidelines for Diagnosis and Referral in Cerebral Visual Impairment

Boonstra

Bosch

Geldof

et al. 2022

Front. Hum. Neurosci.

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IntroductionCerebral visual impairment (CVI) is an important cause of visual impairment in western countries. Perinatal hypoxic-ischemic damage is the most frequent cause of CVI but CVI can also be the result of a genetic disorder. The majority of children with CVI have cerebral palsy and/or developmental delay. Early diagnosis is crucial; however, there is a need for consensus on evidence based diagnostic tools and referral criteria. The aim of this study is to develop guidelines for diagnosis and referral in CVI according to the grade method.Patients and MethodsWe developed the guidelines according to the GRADE method 5 searches on CVI (children, developmental age ≤ 18 years) were performed in the databases Medline, Embase, and Psychinfo, each with a distinct topic.ResultsBased on evidence articles were selected on five topics: 1. Medical history and CVI-questionnaires 23 (out of 1,007). 2. Ophthalmological and orthoptic assessment 37 (out of 816). 3. Neuropsychological assessment 5 (out of 716). 4. Neuroradiological evaluation and magnetic resonance imaging (MRI) 9 (out of 723). 5. Genetic assessment 5 (out of 458).ConclusionIn medical history taking, prematurity low birth weight and APGAR (Appearance, Pulse, Grimace, Activity, Respiration) Scores (<5) are important. Different questionnaires are advised for children under the age of 3 years, older children and for specific risk groups (extremely preterm). In ophthalmological examination, eye movements, specially saccades, accommodation, crowding, contrast sensitivity and visual fields should be evaluated. OCT can show objective signs of trans-synaptic degeneration and abnormalities in fixation and saccades can be measured with eye tracking. Screening of visual perceptive functioning is recommended and can be directive for further assessment. MRI findings in CVI in Cerebral Palsy can be structured in five groups: Brain maldevelopment, white and gray matter lesions, postnatal lesions and a normal MRI. In children with CVI and periventricular leukomalacia, brain lesion severity correlates with visual function impairment. A differentiation can be made between cortical and subcortical damage and related visual function impairment. Additional assessments (neurological or genetic) can be necessary to complete the diagnosis of CVI and/or to reveal the etiology.

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Section: Resultsmentioning

confidence: 99%

Section: Topic One: Medical History and Cerebral Visual Impairmentmentioning

confidence: 99%

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The Multidisciplinary Guidelines for Diagnosis and Referral in Cerebral Visual Impairment

Boonstra

Bosch

Geldof

et al. 2022

Front. Hum. Neurosci.

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“…Abnormal brain development or damage to the brain results in cerebral visual impairment (CVI) previously known as cortical blindness which presents with visual deficits and perceptual deficits. The CVI inventory and assessment are used to diagnose the functional deficits that occur due to cerebral visual impairment [ 59 ]. Treatment of hypoxic-ischemic encephalopathy can prevent incidences of CVI, and other treatment approaches like visual stimulation techniques and stem cell therapy need to be assessed further [ 60 ].…”

Section: Resultsmentioning

confidence: 99%

A Review on Recent Advances of Cerebral Palsy

Paul

Nahar

Bhagawati

et al. 2022

Oxidative Medicine and Cellular Longevity

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This narrative review summarizes the latest advances in cerebral palsy and identifies where more research is required. Several studies on cerebral palsy were analyzed to generate a general idea of the prevalence of, risk factors associated with, and classification of cerebral palsy (CP). Different classification systems used for the classification of CP on a functional basis were also analyzed. Diagnosis systems used along with the prevention techniques were discussed. State-of-the-art treatment strategies for CP were also analyzed. Statistical distribution was performed based on the selected studies. Prevalence was found to be 2-3/1000 lives; the factors that can be correlated are gestational age and birth weight. The risk factors identified were preconception, prenatal, perinatal, and postnatal categories. According to the evidence, CP is classified into spastic (80%), dyskinetic (15%), and ataxic (5%) forms. Diagnosis approaches were based on clinical investigation and neurological examinations that include magnetic resonance imaging (MRI), biomarkers, and cranial ultrasound. The treatment procedures found were medical and surgical interventions, physiotherapy, occupational therapy, umbilical milking, nanomedicine, and stem cell therapy. Technological advancements in CP were also discussed. CP is the most common neuromotor disability with a prevalence of 2-3/1000 lives. The highest contributing risk factor is prematurity and being underweight. Several preventions and diagnostic techniques like MRI and ultrasound were being used. Treatment like cord blood treatment nanomedicine and stem cell therapy needs to be investigated further in the future to apply in clinical practice. Future studies are indicated in the context of technological advancements among cerebral palsy children.

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“…Currently, children with issues with their basic visual functions are more often being identified as having CVI. Whereas, children with issues with their higher visual functions are often going undiagnosed, due to having normal or near normal visual acuity (Chandna et al, 2021).…”

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confidence: 99%

Using digital technology to help identify children with brain based visual issues

McDowell

2022

pjtel

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Brain based, or cerebral visual impairments (CVI) are the most common cause of vision impairment affecting children in the economically developed world, with a prevalence rate of 3.4% of children in mainstream education (Williams et al., 2021). However, many of these children are going unrecognized or misdiagnosed due to the challenges of identifying the visual issues commonly associated with CVI. CVI has recently been defined as a verifiable visual dysfunction which cannot be attributed to disorders of the anterior visual pathways of any potentially co-occurring ocular impairment (Sakki et al., 2018). CVI can affect the basic visual functions, such as visual acuity, visual fields and contrast sensitivity and also, the higher visual functions or visual perceptual abilities. Currently, children with issues with their basic visual functions are more often being identified as having CVI. Whereas, children with issues with their higher visual functions are often going undiagnosed, due to having normal or near normal visual acuity (Chandna et al., 2021). This has highlighted the need for a novel, yet simple way to screen for higher visual function issues in children. As part of her doctoral research, the author developed the Austin Assessment for this purpose. Following the success of the initial research, which used playing cards in real time, the Austin Assessment was made into an App for iPads. The Austin Assessment is a simple activity of matching cards over five levels, with each level increasing the number of cards and pairs. The shapes on the cards on the App have been developed to for intrinsic crowding and visual crowding as the numbers of cards is increased. This allows the App to measure the key features of higher visual function issues, including: random search pattern using darting eye movements, increased search times (especially as the complexity increases) and decreases in performance when the numbers of objects increases (Bennett et al., 2018; Zihl & Dutton, 2015). The Austin Assessment App has been developed for the latest iPad with the TrueDepth camera, as this allows the child’s eyes to be tracked as they are completing the assessment and provides real time data on eye movement in the results section of the App. The App also measures time taken and accuracy in matching the pairs, as the initial research showed that children with higher visual function issues took twice as long as children without visual issues to match the pairs and also, that they were less accurate. In terms of helping to identify children with CVI, the App has the potential to be used as a screening tool to identify any children that warrant further assessment. Research is currently being undertaken to validate the Austin Assessment and also, to create a database of normative ranges by age group. Although developed as an assessment, the Austin Assessment can also be used as a training tool to improve visual abilities and different themes will be included in the App in future versions.

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

Cited by 25 publications

References 78 publications

The Multidisciplinary Guidelines for Diagnosis and Referral in Cerebral Visual Impairment

The Multidisciplinary Guidelines for Diagnosis and Referral in Cerebral Visual Impairment

A Review on Recent Advances of Cerebral Palsy

Using digital technology to help identify children with brain based visual issues

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