Br J Ophthalmol 1999;83:670-675 ( June )
Chronic cortical visual impairment in children: aetiology,
prognosis, and associated neurological deficits
Richard Huoa, Susan K Burdenb, Creig S Hoyta, William V Goodc
a Department of
Ophthalmology, University of California, San Francisco, CA, USA, b University of
Michigan Medical School, Ann Arbor, Michigan, USA, c Smith-Kettlewell Eye Research Institute, San
Francisco, CA, USA
Correspondence to: William V Good, MD, Smith-Kettlewell Eye Research Institute, 2232 Webster Street, San Francisco, CA 94115, USA.
Accepted for publication 18 December 1998
BACKGROUND/AIMS To
evaluate prevalence, aetiology, prognosis, and associated neurological
and ophthalmological problems in children with cortical visual
impairment (CVI).
METHODSThe
records of 7200 outpatients seen in the paediatric ophthalmology
practice over the past 15 years were reviewed in order to compile data
concerning CVI. In addition, the authors devised and applied a system
for grading visual recovery in order to assess prognosis.
RESULTSCVI occurred
in 2.4% of all patients examined. The four most common causes of CVI
were perinatal hypoxia (22%), cerebral vascular accident (14%),
meningitis (12%), and acquired hypoxia (10%). Most children with CVI
had associated neurological abnormalities. The most common were
seizures (53%), cerebral palsy (26%) hemiparesis (12%), and
hypotonia (5%). Associated ophthalmological problems were esotropia
(19%), exotropia (18%), optic nerve atrophy (16%), ocular motor
apraxia (15%), nystagmus (11%), and retinal disease (3%). On
average, CVI patients improved by two levels as measured by the
authors' scale.
CONCLUSIONThe
majority of children with CVI showed at least some recovery. In this
group of children, CVI is often accompanied by additional ophthalmological problems and is nearly always associated with other,
serious neurological abnormalities.
© 1999 by British Journal of Ophthalmology
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