Philip Swetha Sara, Guzzetta Andrea, Chorna Olena, Gole Glen, Boyd Roslyn N
The University of Queensland, Queensland Cerebral Palsy and Rehabilitation Research Centre, Centre for Children's Health Research, Brisbane, Australia.
Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy; Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy.
Res Dev Disabil. 2020 Jan 28;99:103580. doi: 10.1016/j.ridd.2020.103580.
Cerebral Visual Impairment (CVI) is very common yet often unrecognised visual dysfunction in children with Cerebral Palsy (CP). Magnetic Resonance Imaging (MRI) is the diagnostic tool in the investigation of brain lesions in children with CP and CVI.
The aim of this systematic review is to evaluate the relationship between brain structure and CVI, as determined by MRI in children with CP.
A comprehensive search of 5 database (PubMed, EMBASE, SCOPUS, CINAHL and Cochrane Database) was undertaken up until June 2019. The PRISMA checklist was then utilised to report on the process of selecting eligible papers. A total of 30 observational studies met the full inclusion criteria. Further, STROBE checklist was employed to report on the observational studies.
Periventricular leucomalacia on MRI was found to have a strong association with CVI in all 30 studies. Only 13 (43 %) studies described dorsal and/ ventral stream dysfunction. There was ambiguity in the definition of CVI.
The overall level of evidence correlating different patterns of CVI and CP (based on GMFCS, motor type and distribution) and MRI was low. Further studies utilising advances in MRI are needed to understand brain reorganisation and patterns of CVI and suggest rehabilitation therapy inclusive of vision.
脑性视觉障碍（CVI）在脑瘫（CP）患儿中非常常见，但往往未被识别。磁共振成像（MRI）是用于调查CP和CVI患儿脑损伤的诊断工具。
本系统评价的目的是评估CP患儿中由MRI确定的脑结构与CVI之间的关系。
截至2019年6月，对5个数据库（PubMed、EMBASE、SCOPUS、CINAHL和Cochrane数据库）进行了全面检索。然后使用PRISMA清单报告选择合格论文的过程。共有30项观察性研究符合全部纳入标准。此外，采用STROBE清单报告观察性研究。
在所有30项研究中，MRI上的脑室周围白质软化被发现与CVI有很强的关联。只有13项（43%）研究描述了背侧和/或腹侧流功能障碍。CVI的定义存在模糊性。
将不同模式的CVI与CP（基于GMFCS、运动类型和分布）及MRI相关联的证据总体水平较低。需要利用MRI的进展进行进一步研究，以了解脑重组和CVI模式，并提出包括视力康复在内的治疗方法。
