Neuro-Ophthalmological Disorders in Cerebral Palsy: Ophthalmological, Oculomotor, and Visual Aspects

Autor/inn/en	Fazzi, Elisa; Signorini, Sabrina G.; La Piana, Roberta; Bertone, Chiara; Misefari, Walter; Galli, Jessica; Balottin, Umberto; Bianchi, Paolo Emilio
Titel	Neuro-Ophthalmological Disorders in Cerebral Palsy: Ophthalmological, Oculomotor, and Visual Aspects
Quelle	In: Developmental Medicine & Child Neurology, 54 (2012) 8, S.730-736 (7 Seiten) PDF als Volltext Verfügbarkeit
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	0012-1622
DOI	10.1111/j.1469-8749.2012.04324.x
Schlagwörter	Investigations; Visual Impairments; Cerebral Palsy; Psychiatry; Ophthalmology; Neurology; Visual Acuity; Depth Perception; Patients; Profiles; Disabilities; Age Differences; Children; Neurological Organization; Early Childhood Education + Suchen Sie Ihr Suchwort? Untersuchung; Visual handicap; Sehbehinderung; Hirnlähmung; Psychiatrie; Augenheilkunde; Neurologie; Optisches Differenzierungsvermögen; Depth psychology; Tiefenpsychologie; Patient; Charakterisierung; Profilanalyse; Handicap; Behinderung; Age; Difference; Age difference; Altersunterschied; Child; Kind; Kinder; Early childhood; Education; Frühkindliche Bildung; Frühpädagogik
Abstract	Aim: Cerebral visual impairment (CVI) is a disorder caused by damage to the retrogeniculate visual pathways. Cerebral palsy (CP) and CVI share a common origin: 60 to 70% of children with CP also have CVI. We set out to describe visual dysfunction in children with CP. A further aim was to establish whether different types of CP are associated with different patterns of visual involvement. Methods: A total of 129 patients (54 females, 75 males; mean age 4y 6mo, SD 3y 5mo; range 3mo-15y) with CP (51 with diplegia, 61 with tetraplegia, and 17 with hemiplegia; 62 [48%] of participants were able to walk) and CVI enrolled at the Centre of Child Neuro-ophthalmology (at the Department of Child Neurology and Psychiatry, IRCCS "C. Mondino Institute of Neurology", University of Pavia) underwent an assessment protocol including neurological examination, developmental and/or cognitive assessment, neuro-ophthalmological evaluation including ophthalmological assessment, evaluation of visual acuity, contrast sensitivity, optokinetic nystagmus, visual field and stereopsis, and neuroradiological investigations. Results: Visual dysfunction in diplegia was characterized mainly by refractive errors (75% of patients), strabismus (90%), abnormal saccadic movements (86%), and reduced visual acuity (82%). The participants with hemiplegia showed strabismus (71%) and refractive errors (88%); oculomotor involvement was less frequent (59%). This group had the largest percentage of patients with altered visual field (64%). Children with tetraplegia showed a severe neuro-ophthalmological profile, characterized by ocular abnormalities (98%), oculomotor dysfunction (100%), and reduced visual acuity (98%). Interpretation: Neuro-ophthalmological disorders are one of the main symptoms in CP. Each clinical type of CP is associated with a distinct neuro-ophthalmological profile. Early and careful neuro-ophthalmological assessment of children with CP is essential for an accurate diagnosis and for personalized rehabilitation. (As Provided).
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Update	2017/4/10