Abstract
Purpose :
Cortical/Cerebral Visual Impairment (CVI) is the leading cause of visual impairment among
children in developed countries, yet there is limited understanding of its impact on vision-specific
quality of life (VS-QOL). We performed a prospective cohort study to characterize VS-QOL in
children with CVI and assessed the influence of clinical factors on these measures.
Methods :
We prospectively recruited children with CVI between the ages of 12 months and 12 years, as
well as typically developing pediatric controls with no ophthalmologic conditions. All children
with CVI underwent a complete pediatric neuro-ophthalmologic examination. VS-QOL was
assessed by caregiver completion of the Children’s Visual Function Questionnaire (CVFQ).
Overall and subscale CVFQ scores were compared between children with CVI and controls.
The association of ophthalmologic findings (visual acuity, strabismus, nystagmus, and optic
atrophy) with CVFQ scores was assessed using Spearman’s correlation for ordinal data and
unpaired t-tests for normally distributed continuous data. P-values less than 0.05 were
considered significant.
Results :
43 children with CVI and 21 typically developing controls were included in this study (median
age 5 vs. 3 years, p=0.21). All children with CVI had a developmental age less than 7 years,
and all controls had a chronological age less than 7 years (the upper age limit at which the
CVFQ is validated). Children with CVI demonstrated significantly lower CVFQ scores than
controls (total CVFQ score 0.58±0.13 vs. 0.95±0.06, Competence subscale 0.42±0.26 vs.
0.96±0.08, Personality subscale 0.72±0.13 vs. 0.91±0.13, Family Impact subscale 0.58±0.18 vs.
0.94±0.10, p<0.0001 for all comparisons). Visual acuity, optic atrophy, and nystagmus did not
significantly impact CVFQ scores. However, a history of strabismus was associated with worse
scores on the CVFQ Family Impact subscale (0.52±0.16 vs. 0.69±0.19, p=0.03).
Conclusions :
Children with CVI experience markedly lower VS-QOL compared to typically developing
children. While visual acuity was not significantly correlated with VS-QOL, a history of
strabismus was associated with worse VS-QOL (specifically, greater family impact). Our
findings highlight the profound impact of a CVI diagnosis on both the affected child and family
members, and illustrate the importance of factors other than visual acuity on VS-QOL in CVI.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.