Abstract
Purpose :
Cerebral Visual Impairment (CVI) is the leading cause of bilateral visual impairment in developed countries. Recent literature supports an earlier diagnosis improves patient outcome. The primary purpose of this chart review was to determine the mean age of CVI diagnosis at Cincinnati Children’s Hospital (CCHMC). A secondary aim was to assess the time delay between first visit and diagnosis. Lastly, correlation between time of diagnosis, CVI severity and patient’s concurrent diagnoses was analyzed.
Methods :
A retrospective chart review was completed for all CVI patients diagnosed at CCHMC between January 1, 2007-March 1, 2018. Patients were excluded if a concurrent diagnosis of autism was documented. CVI severity was determined using CVI range score 2 and phase recorded from the CVI range encounter. If CVI range score 2 was not documented, the median of the CVI range phase was analyzed. P-values were determined using a Welch Two Sample t-test.
Results :
A total of 199 CVI patients met inclusion. The mean (SD) age of diagnosis at CCHMC was 4.79 (4.93) years old. The mean (SD) age of first ophthalmology visit was 3.69 (4.53) years old. The mean time between first visit to ophthalmology and diagnosis was 1.08 years. On average our patients were diagnosed at their third visit. 117 patients had a completed CVI range. Patients diagnosed at first visit to ophthalmology had a mean CVI range score 2 of 4.65, mean CVI range phase of 1.82, and mean age of diagnosis of 4.34 years old. Patients diagnosed with CVI not at the first visit had a mean CVI range score 2 of 6.04, mean CVI range phase of 2.16, and mean age of diagnosis of 5.43 years old. The CVI range score 2 (p-value < 0.01) and CVI range phase (p-value = 0.02) between the two groups were significant. The most common concurrent diagnoses of patients diagnosed at the first visit were cerebral palsy, developmental delay, epilepsy, and seizures.
Conclusions :
Literature reports mean age of CVI diagnosis at 0.57 years old. We report a higher mean age of CVI diagnosis at CCHMC. Less severe CVI patients in our clinic are diagnosed later when compared to more severe CVI patients. Early diagnosis and assessment is critical as visual rehabilitation is possible to help improve the patient’s quality of life. Changes in practice patterns should be made to ensure prompt CVI diagnosis.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.