Morelli Federica, Aprile Giorgia, Martolini Chiara, Ballante Elena, Olivier Lucrezia, Ercolino Elisa, Perotto Eleonora, Signorini Sabrina
Developmental Neuro-Ophthalmology Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy.
Department of Brain and Behavioural Sciences, University of Pavia, 27100 Pavia, Italy.
Children (Basel). 2022 Jun 19;9(6):921. doi: 10.3390/children9060921.
Cerebral Visual Impairment (CVI) has become the leading cause of children’s visual impairment in developed countries. Since CVI may negatively affect neuropsychomotor development, an early diagnosis and characterization become fundamental to define effective habilitation approaches. To date, there is a lack of standardized diagnostic methods to assess CVI in children, and the role of visual functions in children’s neuropsychological profiles has been poorly investigated. In the present paper, we aim to describe the clinical and neuropsychological profiles and to investigate the possible effects of visual functions on neuropsychological performance of a cohort of children diagnosed with CVI. Fifty-one children with CVI were included in our retrospective analysis (inclusion criteria: verbal IQ > 70 in Wechsler scales; absence of significant ocular involvement). For each participant, we collected data on neuropsychological assessment (i.e., cognitive, cognitive visual, and learning abilities), basic visual functions (e.g., Best Corrected Visual Acuity—BCVA, contrast sensitivity, and ocular motor abilities) and global development features (e.g., neurological signs and motor development delay) based on standardized tests, according to patients’ ages. The results showed that oculomotor dysfunction involving saccades and smooth pursuit may be a core symptom of CVI and might have a significant impact on cognitive visual and other neuropsychological abilities. Furthermore, visual acuity and contrast sensitivity may influence cognitive, cognitive visual, and academic performances. Our findings suggest the importance of a comprehensive assessment of both visual and neuropsychological functions in children when CVI is suspected, which is needed to provide a more comprehensive functional profile and define the best habilitation strategy to sustain functional vision.
脑性视觉损害（CVI）已成为发达国家儿童视力损害的主要原因。由于CVI可能对神经心理运动发育产生负面影响，早期诊断和特征描述对于确定有效的康复方法至关重要。迄今为止，缺乏评估儿童CVI的标准化诊断方法，并且视觉功能在儿童神经心理特征中的作用尚未得到充分研究。在本文中，我们旨在描述临床和神经心理特征，并研究视觉功能对一组被诊断为CVI的儿童神经心理表现的可能影响。我们的回顾性分析纳入了51名CVI儿童（纳入标准：韦氏量表中言语智商>70；无明显眼部病变）。根据患者年龄，通过标准化测试，我们收集了每位参与者的神经心理评估数据（即认知、认知视觉和学习能力）、基本视觉功能（如最佳矫正视力——BCVA、对比敏感度和眼动能力）以及整体发育特征（如神经体征和运动发育延迟）。结果表明，涉及扫视和平稳跟踪的眼动功能障碍可能是CVI的核心症状，并且可能对认知视觉和其他神经心理能力产生重大影响。此外，视力和对比敏感度可能会影响认知、认知视觉和学业表现。我们的研究结果表明，当怀疑儿童患有CVI时，全面评估视觉和神经心理功能非常重要，这对于提供更全面的功能特征描述以及确定维持功能性视力的最佳康复策略是必要的。
