Vestibular-Ocular Motor Research Group, Dept. of Neuroscience, Erasmus MC, Rotterdam, the Netherlands.
Res Dev Disabil. 2010 Nov-Dec;31(6):1149-59. doi: 10.1016/j.ridd.2010.08.001. Epub 2010 Sep 6.
The current definition of Cerebral Visual Impairment (CVI) includes all visual dysfunctions caused by damage to, or malfunctioning of, the retrochiasmatic visual pathways in the absence of damage to the anterior visual pathways or any major ocular disease. CVI is diagnosed by exclusion and the existence of many different causes and symptoms make it an overall non-categorized group. To date, no discrimination is made within CVI based on types of perceptive visual dysfunctions. The aim of this review was to outline which perceptive visual dysfunctions are to be expected based on a number of etiologies of brain damage and brain development disorders with their onset in the pre-, peri- or postnatal period. For each period two etiologies were chosen as the main characteristic brain damage. For each etiology a main search was performed. The selection of the articles was based on the following criteria: age, etiology, imaging, central pathology and perceptive visual function test. The perceptive visual functions included for this review were object recognition, face recognition, visual memory, orientation, visual spatial perception, motion perception and simultaneous perception. Our search resulted in 11 key articles. A diversity of research history is performed for the selected etiologies and their relation to perceptive visual dysfunctions. Periventricular Leukomalacia (PVL) was most studied, whereas the main tested perceptive visual function was visual spatial perception. As a conclusion, the present status of research in the field of CVI does not allow to correlate between etiology, location and perceptive visual dysfunctions in children with brain damage or a brain development disorder. A limiting factor could be the small number of objective tests performed in children experiencing problems in visual processing. Based on recent insights in central visual information processing, we recommend an alternative approach for the definition of CVI that is based on functional visual processing, rather than anatomical landmarks. This could be of benefit in daily practice to diagnose CVI.
目前，脑性视觉障碍（Cerebral Visual Impairment，CVI）的定义包括由于视交叉后视觉通路的损伤或功能障碍而引起的所有视觉功能障碍，而不包括前视觉通路的损伤或任何主要眼部疾病。CVI 的诊断是通过排除法进行的，由于存在许多不同的原因和症状，因此它是一个总体上无分类的群组。迄今为止，CVI 并未根据感知视觉功能障碍的类型进行区分。本综述的目的是概述在脑损伤和脑发育障碍的多种病因及其在产前、围产期或产后期间发生的情况下，可能会出现哪些感知视觉功能障碍。对于每个时期，选择了两种病因作为主要特征性脑损伤。对于每种病因，都进行了主要的搜索。文章的选择基于以下标准：年龄、病因、影像学、中枢病理学和感知视觉功能测试。本综述纳入的感知视觉功能包括物体识别、面部识别、视觉记忆、定向、视觉空间感知、运动感知和同时感知。我们的搜索结果产生了 11 篇关键文章。对选定的病因及其与感知视觉功能障碍的关系进行了多样化的研究历史。脑室周围白质软化症（PVL）的研究最多，而主要测试的感知视觉功能是视觉空间感知。因此，目前 CVI 领域的研究现状还不能将病因、位置与脑损伤或脑发育障碍儿童的感知视觉功能障碍联系起来。一个限制因素可能是在经历视觉处理问题的儿童中进行的客观测试数量较少。基于最近对中枢视觉信息处理的深入了解，我们建议采用一种替代方法来定义 CVI，该方法基于功能视觉处理，而不是解剖学标志。这可能有助于在日常实践中诊断 CVI。
