Abstract
Purpose :
Cerebral visual impairment (CVI) is the leading cause of bilateral visual impairment in developed nations. 60-70% of children with cerebral palsy (CP) have a comorbid diagnosis of CVI. The primary purpose of this study was to determine the correlation between CVI and CP severities at Cincinnati Children’s Hospital Medical Center (CCHMC). Secondary aims were to compare CVI severity between patients with and without CP as well as to assess the proportion of recorded CVI Range assessments.
Methods :
A retrospective chart review was conducted for children diagnosed with CVI who were evaluated at CCHMC from January 1, 2008- December 31, 2018. Patients with a concurrent diagnosis of Autism Spectrum Disorder were excluded. CVI severity was determined using the CVI range score 2 and phase recorded at the patients’ first CVI Range evaluation. If CVI range score 2 was not recorded, the median of the CVI range phase was analyzed. CP severity was determined using the Gross Motor Functioning Classification System (GMFCS) and the Manual Ability Classification System (MACS). P-values were determined using ANOVA, Welch’s t-Test, and Chi-Square Test.
Results :
235 CVI patients met inclusion. 124 (52.8%) patients had a concurrent diagnosis of CP, of which 73 (58.9%) had a recorded GMFCS level and CVI Range. CVI range score 2 and GMFCS levels II-V were significant (p<0.01). GMFCS level I was excluded from analysis due to small sample size (n=4). 62/124 (50.0%) of patients had a recorded MACS level and CVI Range. CVI range score 2 and MACS levels I-V were significant (p<0.01). 98/124 (79%) with CP had a mean recorded CVI range score 2 of 4.91 and 57/111 (51.4%) without CP had a mean recorded CVI range score 2 of 5.81. The CVI range score 2 means were statistically significant (p<0.03). The recorded number of CVI Range assessments administered to the groups with and without CP were compared (p<0.01).
Conclusions :
At CCHMC, CVI patients with CP are associated with more severe CVI according to both GMFCS and MACS, leading to more impairment overall than those with CVI alone. Additionally, patients with CP were significantly more likely to have had a recorded CVI range. In conclusion, practice patterns should change to ensure all patients receive a CVI Range, especially those with a concurrent diagnosis of CP as they are more likely to have more severe impairment.
This is a 2020 ARVO Annual Meeting abstract.