• Pediatric Ophth/Strabismus

    Review of: Ophthalmologic characteristics and outcomes of children with cortical visual impairment and cerebral palsy

    West M, Borchert M, Chang M. Journal of American Association for Pediatric Ophthalmology and Strabismus, August 2021

    A retrospective chart review evaluated children with cortical visual impairment (CVI) and with or without comorbid cerebral palsy (CP) to assess the difference in outcomes between the two populations.

    Study design

    This is a retrospective review of records from a single U.S. institution of children with CVI and with or without CP, comparing associated ocular comorbidities and long-term outcomes of vision and eye alignment.

    Outcomes

    The study included 151 children with CVI and CP, and 153 children with CVI but without CP. Children with both CVI and CP were more likely to have significant refractive error, optic atrophy, and strabismus at presentation than children without CP. In patients who had strabismus surgery, those with CVI without CP were more than twice as likely to achieve good eye alignment (64% vs 30%) than children with CVI and CP. Nine patients had data available after 8 years of postsurgical follow-up; none of the patients with CP and all of the patients without CP had achieved good alignment outcomes. There was no difference in visual acuity at presentation or improvement in visual acuity between the 2 groups.

    Limitations

    This is a retrospective study with self-admitted inconsistent follow-up. The number of patients who underwent strabismus surgery was relatively small compared with the entire cohort (31 out of a total of 273 patients).

    Clinical significance

    Children with CVI with or without CP have similar presenting visual acuity and potential for improvement, but strabismus surgery is less likely to achieve good alignment in children with CP.