Factors Associated With Lack of Vision Improvement in Children With Cortical Visual Impairment
Factors Associated With Lack of Vision Improvement in Children With Cortical Visual Impairment
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DOI：
10.1097/wno.0000000000000610
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发表时间：
2018-12-01
影响因子：
2.9
通讯作者：
Borchert, Mark
中科院分区：
文献类型：
--
作者：
Handa, Swati;Saffari, Seyed E.;Borchert, Mark
背景：由于不同类型的脑损伤而导致的皮质视觉障碍（CVI）儿童的视力有所改善。我们的研究的目的是确定与视力恢复不佳的风险因素，在这组patients.Methods：2010年之前出生的儿童的病例记录，至少有4个后续访问的CVI进行了审查的根本病因的CVI，视力（VA），以及相关的神经和眼科疾病。VA分为6个定性等级。VA的变化记录为就诊时和末次随访访视时VA等级之间的差异。结果计算为定性VA等级的实际改善与潜在改善的比率。多元线性回归确定与缺乏视力改善的所有儿童和病因的基础上的因素。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）。中枢神经系统（CNS）畸形（9.4%）、缺氧/炎症损伤（15.1%）、癫痫（24.5%）及多种原因（51.0%）是导致CVI的主要原因。83%的儿童视力得到改善。在所有CVI儿童和除中枢神经系统畸形外的每个病因组中，VA缺乏改善与就诊时年龄较大有关。没有其他的调查变量与VA的恢复差。结论：大多数的儿童CVI表现出改善视力。就诊时年龄较大，而不是CVI的病因，与VA改善不佳相关。(C)2017年北美神经眼科学会
Background: 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.Methods: 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.Results: 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.Conclusions: 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. (C) 2017 by North American Neuro-Ophthalmology Society