Private Niv Eye Center, Adana, Türkiye.
Toros University, Vocational School, Program of Opticianry, Mersin, Türkiye.
Turk J Ophthalmol. 2023 Feb 24;53(1):1-7. doi: 10.4274/tjo.galenos.2022.14296.
To evaluate the behavioral characteristics of infants with cerebral visual impairment (CVI) in response to visual stimuli and the frequency of these features.
In this retrospective study, 32 infants aged 8-37 months who were referred to the low vision unit in 2019-2021 and diagnosed with CVI based on their demographic characteristics, systemic findings, and standard and functional visual examinations were evaluated. The frequency of ten behavioral characteristics exhibited by infants with CVI in response to visual stimuli as defined by Roman-Lantzy was examined in the patients.
The mean age was 23.46±11.45 months, the mean birth weight was 2,550±944 g, and the mean gestational age at birth was 35.39±4.68 weeks. There was hypoxic-ischemic encephalopathy in 22%, prematurity in 59%, periventricular leukomalacia in 16%, cerebral palsy in 25%, epilepsy in 50%, and strabismus in 68.7% of the patients. Color preference for fixation was observed in 40% and visual field preference was observed in 46% of the patients. The most preferred color was red (69%) and the most preferred visual field was right visual field (47%). Difficulty with distance viewing was observed in 84% of patients, visual latency in 72%, need for movement in 69%, absence of visually guided reach in 69%, difficulty with visual complexity in 66%, difficulty with visual novelty in 50%, light-gazing/nonpurposeful gaze in 50%, and atypical visual reflexes in 47%. There was no fixation in 25% of the patients.
Behavioral characteristics in response to visual stimuli were observed in most infants with CVI. Knowing and recognizing these characteristic features by ophthalmologists will assist in early diagnosis, referral to visual habilitation, and planning habilitation techniques. These characteristic features are important in order to not miss this critical period in which the brain is still plastic and good responses to visual habilitation can be obtained.
评估脑视觉损伤（CVI）婴儿对视觉刺激的行为特征及其出现频率。
本回顾性研究纳入了 2019 年至 2021 年期间因 CVI 被转诊至低视力科的 32 名 8-37 月龄婴儿，根据其人口统计学特征、系统检查结果以及标准和功能视觉检查结果进行诊断。对患儿对视觉刺激的 10 种行为特征进行评估，这些行为特征由 Roman-Lantzy 定义。
患儿的平均年龄为 23.46±11.45 个月，平均出生体重为 2550±944g，平均胎龄为 35.39±4.68 周。22%的患儿存在缺氧缺血性脑病，59%的患儿存在早产，16%的患儿存在脑室周围白质软化，25%的患儿存在脑瘫，50%的患儿存在癫痫，68.7%的患儿存在斜视。40%的患儿对注视有颜色偏好，46%的患儿对视野有偏好。最偏好的颜色是红色（69%），最偏好的视野是右眼视野（47%）。84%的患儿存在远距离视物困难，72%的患儿存在视觉潜伏期延长，69%的患儿存在无需运动，69%的患儿存在无视觉引导伸手，66%的患儿存在视觉复杂性困难，50%的患儿存在视觉新颖性困难，50%的患儿存在凝视灯光/无目的凝视，47%的患儿存在非典型视觉反射。25%的患儿无法注视。
大多数 CVI 婴儿对视觉刺激存在行为特征。眼科医生了解并识别这些特征有助于早期诊断、转诊至视觉康复，并规划康复技术。这些特征很重要，因为错过了大脑仍具有可塑性且能够对视觉康复产生良好反应的关键时期，可能会导致不良后果。
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