ICNC Abstracts, ICNC 2018

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Cerebral vision impairment in children: How much of it is preventable?
Ramesh Konanki, Sravanthi Kuruva, Lokesh Lingappa, Nikit Milind Shah, Srikanth Domala

Last modified: 2018-09-09

Abstract


Background: Cerebral vision impairment (CVI) is a common sensory impairment in children. Identifying preventable causes is crucial for planning preventive strategies.

Methods: Prospective, observational study of children with CVI between 2017-2018

Results: 130 children with CVI identified: mean age 34.5 months (3-151 months), males were 80 (62%). The presenting complaints were: global developmental delay and poor visual fixation in 92 (71%), while rest did not have concern for vision impairment at presentation. At presentation, 50 children had inconsistent fixation/tracking (39%), perception of hand movements in 7 (5%), light perception in 23 (18%), no fixation in 50 (38%). One hundred-fourteen infants had normal ocular examination (87%) while 4 had non-paralytic strabismus. Neonatal hypoglycemic brain injury (NHBI) was the commonest cause of CVI (50/130; 38.5%), followed by perinatal hypoxic-ischemic encephalopathy (HIE) (31/130; 24%), genetic (30/130; 23%), cortical malformations (7/130; 5%) and unknown (5%). Epilepsy was seen 109 children (84%) with epileptic spasms in 32 (29%). Majority children required ³2 anti-epileptic drugs (101/109; 93%). The neuroimaging revealed parieto-occipital gliosis in 28 (21%), HIE changes in 26 (20%) while normal in 15 (12%). As compared with non-NHBI group, children with NHBI were more likely to have epilepsy, epileptic spasms, require ³2 anti-epileptic drugs for seizure control, and global developmental delay. They were less likely to have received antenatal education about feeding compared with non-NHBI group (0 Vs 80%).

Conclusions: NHBI is the commonest cause of cerebral vision impairment in children. Antenatal education about feeding can potentially reduce the burden of CVI

Keywords


Cerebral vision imparment; cortical vision impairment; cortical blindness; neonatal hypoglycemic brain ijury

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