Article

Cerebral visual impairment (CVI) is a disorder caused by damage to the
retrogeniculate visual pathways. Cerebral palsy (CP) and CVI share a common
origin: 60 to 70% of children with CP also have CVI. We set out to describe
visual dysfunction in children with CP. A further aim was to establish whether
different types of CP are associated with different patterns of visual
involvement. METHODS: A total of 129 patients (54 females, 75 males; mean age 4 y
6 mo, SD 3 y 5 mo; range 3 mo-15 y) with CP (51 with diplegia, 61 with
tetraplegia, and 17 with hemiplegia; 62 [48%] of participants were able to walk)
and CVI enrolled at the Centre of Child Neuro-ophthalmology (at the Department of
Child Neurology and Psychiatry, IRCCS 'C. Mondino Institute of Neurology',
University of Pavia) underwent an assessment protocol including neurological
examination, developmental and/or cognitive assessment, neuro-ophthalmological
evaluation including ophthalmological assessment, evaluation of visual acuity,
contrast sensitivity, optokinetic nystagmus, visual field and stereopsis, and
neuroradiological investigations. RESULTS: Visual dysfunction in diplegia was
characterized mainly by refractive errors (75% of patients), strabismus (90%),
abnormal saccadic movements (86%), and reduced visual acuity (82%). The
participants with hemiplegia showed strabismus (71%) and refractive errors (88%);
oculomotor involvement was less frequent (59%). This group had the largest
percentage of patients with altered visual field (64%). Children with tetraplegia
showed a severe neuro-ophthalmological profile, characterized by ocular
abnormalities (98%), oculomotor dysfunction (100%), and reduced visual acuity
(98%). INTERPRETATION: Neuro-ophthalmological disorders are one of the main
symptoms in CP. Each clinical type of CP is associated with a distinct
neuro-ophthalmological profile. Early and careful neuro-ophthalmological
assessment of children with CP is essential for an accurate diagnosis and for
personalized rehabilitation.
CI - (c) The Authors. Developmental Medicine & Child Neurology (c) 2012 Mac Keith
Press.

Langue : ANGLAIS