Childhood cerebral visual impairment subtype classification based on an extensive versus a limited test battery

Frontiers in Neuroscience

Neuroscience

Antonius H. N. Cillessen¹  Nomdo M. Jansonius²  Jannet Philip³  Frouke N. Boonstra⁴  Bianca Huurneman⁵ 

[1] Behavioural Science Institute, Radboud University, Nijmegen, Netherlands;Department of Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands;Graduate School of Medical Science, University Medical Center Groningen, University of Groningen, Groningen, Netherlands;Royal Dutch Visio, National Foundation for the Visually Impaired and Blind, Huizen, Netherlands;Behavioural Science Institute, Radboud University, Nijmegen, Netherlands;Royal Dutch Visio, National Foundation for the Visually Impaired and Blind, Huizen, Netherlands;Behavioural Science Institute, Radboud University, Nijmegen, Netherlands;Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, Netherlands;Royal Dutch Visio, National Foundation for the Visually Impaired and Blind, Huizen, Netherlands;Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, Netherlands;

关键词: cerebral visual impairment;    childhood;    subtyping;    classification;    visual function;    eye movements;    visual fields;    optic disk;   

DOI  :  10.3389/fnins.2023.1266201

 received in 2023-08-02, accepted in 2023-10-06,  发布年份 2023

来源: Frontiers

【 摘 要 】

PurposeTo classify CVI subtypes and compare the added value of an extensive test battery over a limited test battery in subtype classification of cerebral visual impairment (CVI) in children.MethodsSeventy-five children with a clinical diagnosis of CVI (median [IQR] age: 9 [7–12] years) were identified from the medical records. The extensive test battery included visual acuity, contrast sensitivity, ocular alignment, eye movement analysis, visual field analysis, optic nerve head evaluation, and evaluation of visual perception. The limited test battery included visual acuity, contrast sensitivity, ocular alignment, and evaluation of visual perception. Principal component analysis (PCA) followed by cluster analysis was done, for both test batteries separately, to determine the optimum subtype classification for CVI.ResultsFifty-one participants with an extensive test battery with mild to moderate visual impairment were included in the main analysis. This resulted in four CVI subtypes for the extensive test battery (subtle characteristics, higher-level visual function deficits, lower-level visual function deficits, and higher- and lower- level visual function deficits) and three CVI subtypes for the limited test battery (subtle characteristics, higher-level visual function deficits, and higher- and lower- level visual function deficits). There were significant differences between the subtypes for 9 out of 10 measures of the extensive and all 4 measures of the limited test battery (p < 0.05). The subtle characteristics subtype (extensive n = 19, limited n = 15) showed near normal lower and higher-level visual functions in both test batteries. The higher-level visual function deficits subtype (extensive n = 18, limited n = 24) showed near normal visual acuity combined with significant visual perceptual deficits in both test batteries; accompanied by visual pathways defects and abnormal eye movement behavior in the extensive test battery. The higher- and lower- level visual function deficits subtype (extensive n = 4, limited n = 12) showed both higher and lower-level visual function deficits in both test batteries, but application of the extensive test battery revealed additional visual pathways defects and abnormal eye movement behavior. The lower-level visual function deficits CVI subtype (extensive n = 10) was a new subtype identified by the extensive test battery. This subtype showed lower-level visual function deficits together with abnormal eye movement measures.ConclusionThis data-driven study has provided meaningful CVI subtype classifications based on the outcomes of various key functional and structural measures in CVI diagnosis. Comparison of the extensive test battery to the limited test battery revealed the added value of an extensive test battery in classifying CVI. The outcomes of this study, therefore, have provided a new direction in the area of CVI classification.

【 授权许可】

Unknown   
Copyright © 2023 Philip, Huurneman, Jansonius, Cillessen and Boonstra.