Pediatric Ophthalmology (SH), KK Women's and Children's Hospital, Singapore; Centre for Quantitative Medicine (SES), Duke-NUS Medical School, Singapore; and Children's Hospital Los Angeles and the Vision Center (MB), USC/Keck School of Medicine, Los Angeles, California.
J Neuroophthalmol. 2018 Dec;38(4):429-433. doi: 10.1097/WNO.0000000000000610.
Improvement in vision has been noted in children with cortical visual impairment (CVI), resulting from disparate types of brain injury. The purpose of our study was to determine the risk factors associated with poor recovery of vision in this group of patients.
Case records of children who were born before 2010 with at least 4 follow-up visits for CVI were reviewed for underlying etiologies of CVI, visual acuity (VA), and associated neurological and ophthalmological disorders. VA was assessed in 6 qualitative grades. Changes in VA were recorded as the difference between the grades of VA at presentation and the last follow-up visit. The outcome was calculated as a ratio of actual improvement to potential improvement in grades of qualitative VA. Multiple linear regression determined factors associated with lack of vision improvement in all children and based on etiology.
Fifty-three children with CVI were identified. The median age at presentation was 13.6 months (range: 2.9-76.4 months) and the median follow-up was 5.8 years (1.1-16.3 years). CVI resulted from central nervous system (CNS) malformation (9.4%), hypoxic/inflammatory injury (15.1%), seizures (24.5%), and combined causes (51.0%). Vision improvement was noted in 83% of children. Lack of VA improvement was associated with older age at presentation in all children with CVI and within each etiological group except CNS malformation. None of the other investigated variables were associated with poor recovery of VA.
Most of the children with CVI showed improvement in vision. Older age at presentation, but not etiology of CVI, was associated with poor improvement in VA.
皮质视觉障碍（CVI）患儿的视力有所改善，这归因于不同类型的脑损伤。我们研究的目的是确定与这组患者视力恢复不良相关的风险因素。
回顾了 2010 年前出生的至少接受 4 次 CVI 随访的患儿的病例记录，以了解 CVI 的潜在病因、视力（VA）以及相关的神经和眼科疾病。VA 评估分为 6 个定性等级。VA 的变化记录为就诊时 VA 等级与最后一次随访时 VA 等级之间的差异。将结果计算为实际改善程度与定性 VA 等级潜在改善程度的比值。多元线性回归确定了所有儿童和基于病因的视力改善缺乏相关因素。
确定了 53 名 CVI 患儿。就诊时的中位年龄为 13.6 个月（范围：2.9-76.4 个月），中位随访时间为 5.8 年（1.1-16.3 年）。CVI 由中枢神经系统（CNS）畸形（9.4%）、缺氧/炎症损伤（15.1%）、癫痫发作（24.5%）和混合病因（51.0%）引起。83%的患儿视力有所改善。在所有 CVI 患儿和除 CNS 畸形以外的每个病因组中，就诊时年龄较大与 VA 改善不良有关。其他调查变量均与 VA 恢复不良无关。
大多数 CVI 患儿的视力有所改善。就诊时年龄较大，但不是 CVI 的病因，与 VA 改善不良有关。
