Kozeis Nikos, Anogeianaki Antonia, Mitova Daniela Tosheva, Anogianakis George, Mitov Tosho, Klisarova Anelia
Department of Ophthalmology, Hippokrateion Hospital, Thessaloniki, Greece.
Ophthalmic Physiol Opt. 2007 Jan;27(1):44-53. doi: 10.1111/j.1475-1313.2006.00413.x.
To investigate visual function and perception in cerebral palsied (CP) children.
A total of 105 congenitally CP children (aged 6-15 years), without severe mental retardation, were classified into three groups: those with spastic quadriplegia, spastic diplegia and spastic hemiplegia. Data collected included patient history, IQ, refraction, far and near visual acuity, position of the eyes and eye movements, visual fields, colour perception, stereoacuity, slit lamp and fundoscopic examinations, and evaluation of visual perception. The results were compared with a control group from the general paediatric population.
The IQ of the CP children ranged between 70 and 100. A total of 59% of them had best corrected distance visual acuity <6/6, with 25.5% <6/9. Near visual acuity was also reduced (70.1% scored <6/6 and 38.4% scored <6/9). Incidence of refractive errors was higher than in the control group (hypermetropia in 43.8% of the eyes, myopia 16.19% and astigmatism 40.9%) as was the incidence of strabismus (26.7% esotropic and 27.6% exotropic). In visual field testing, 80.95% of CP children were normal. A total of 94.28% had normal colour perception and 89.52% were free of ocular pathology. Stereopsis was abnormal or absent in 85.71% of the cases. Visual perception was markedly reduced: in 57.14% of the cases it was less than or equal to that of 6-year-old children; in 26.66% equal to that of 6- to 7.5-year-old children, and in 16.2% of the cases greater than or equal to that of 7.5-year-old children.
In the absence of severe mental retardation, CP children have deficient visual skills. It is suggested that the poor visual skills of CP children are a separate, identifiable factor compounding the adverse effects of mental retardation.
研究脑性瘫痪（CP）儿童的视觉功能与感知能力。
选取105名6至15岁、无严重智力障碍的先天性CP儿童，分为痉挛性四肢瘫、痉挛性双瘫和痉挛性偏瘫三组。收集的数据包括患者病史、智商、屈光、远近视敏度、眼位和眼球运动、视野、颜色感知、立体视锐度、裂隙灯和眼底检查以及视觉感知评估。将结果与普通儿科人群的对照组进行比较。
CP儿童的智商在70至100之间。其中59%的儿童最佳矫正远视力<6/6，25.5%<6/9。近视力也有所下降（70.1%得分<6/6，38.4%得分<6/9）。屈光不正的发生率高于对照组（43.8%的眼睛为远视，16.19%为近视，40.9%为散光），斜视发生率也较高（26.7%为内斜视，27.6%为外斜视）。在视野测试中，80.95%的CP儿童正常。94.28%的儿童颜色感知正常，89.52%无眼部病变。85.71%的病例立体视异常或缺失。视觉感知明显降低：57.14%的病例视觉感知能力低于或等于6岁儿童；26.66%等于6至7.5岁儿童；16.2%的病例视觉感知能力大于或等于7.5岁儿童。
在无严重智力障碍的情况下，CP儿童的视觉技能存在缺陷。提示CP儿童较差的视觉技能是一个独立的、可识别的因素，加重了智力障碍的不良影响。
