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Published Online First: 10 May 2006. doi:10.1136/bjo.2006.094250
British Journal of Ophthalmology 2006;90:960-963
Copyright © 2006 by the BMJ Publishing Group Ltd.

SCIENTIFIC REPORT

Cryptic cerebral visual impairment in children

R S Lowery1,3, D Atkinson2 and S R Lambert1

1 Department of Ophthalmology, Emory University Atlanta, GA, USA
2 Department of Radiology, Emory University Atlanta, GA, USA
3 Department of Ophthalmology, University of Arkansas, Little Rock, AR, USA

Correspondence to:
Correspondence to:
Scott R Lambert
Emory Eye Center, 1365B Clifton Road, Suite B4500, Atlanta, GA 30322, USA; slamber{at}emory.edu

ABSTRACT

Aim: To review the medical records of seven children with a delayed diagnosis of cerebral visual impairment.

Methods: The charts of a consecutive series of children examined in a university based ophthalmology clinic with a delayed diagnosis of cerebral visual impairment were reviewed. Their neuroimaging studies were evaluated by a paediatric neuroradiologist.

Results: The seven patients ranged in age from 2 years to 10 years at the time of presentation and had acuities ranging from 20/40 to 20/400. Their visual fields ranged from full visual fields to homonymous hemianopias. Neuroimaging findings ranged from subtle occipital lobe abnormalities to obvious cerebral volume loss.

Conclusions: Cerebral visual impairment can be cryptic in children with mild visual impairment. Neuroimaging studies and visual field testing can help to differentiate this condition from other causes of visual impairment.

Abbreviations: CVI, cerebral visual impairment; ERG, electroretinogram; MRI, magnetic resonance imaging; PVL, periventricular leucomalacia; VEPs, visually evoked potentials

Keywords: cerebral visual impairment; neuroimaging; periventricular leucomalacia; striate cortex; children


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