This paper is only available as a PDF. To read, Please Download here.
Abstract
Visual acuity testing using Teller Acuity Cards was carried out on 78 infants and
children affected by cerebral palsy (CP). Age of testing was between 3 and 109 months.
The aim of the study was to investigate the usefulness of acuity cards in patients
with CP, and to relate visual outcome with the type of CP, MRI findings, mental levels
and motor disabilities. Visual acuity estimates were obtained for 60 children: acuity
values were within normal values for age for 17 and below the 5th percentile for 43.
Cerebral blindness was diagnosed in 10 patients. Eight infants were not testable,
mainly because of behavioural problems. The overall success rate was 88%. Visual impairment
in most infants with low acuity and in all blind children was not due to ophthalmological
abnormalities. Visual outcome was significantly related to the type of CP, with hemiplegic
children showing the best results and tetraplegics the worst. Cerebral blindness was
significantly correlated with tetraplegia, the severity of lesions in the optic radiations,
and visual cortex areas, as indicated by MRI, and the degree of mental, motor and
oculomotor deficit. These correlations were mainly due to the blind subjects, who
consistently showed major MRI abnormalities and severe motor, mental and oculomotor
impairment. Longitudinal results obtained for 45 children showed visual outcome stable
over time in 64.4% of cases, improvement in 6.6% and deterioration in 28.9%.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Brain and DevelopmentAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
Reference
- Quality of survival after severe birth asphyxia.Arch Dis Child. 1977; 52: 620-626
- Apgar scores as predictor of chronic neurologic disability.Pediatrics. 1981; 68: 36-44
- Visual defects in children after cerebral hypoxia.Behav Brain Res. 1984; 14: 147-155
- Cerebral visual disturbance in infantile encephalopathy.Martinus Nijhoff, Dordrecht1987
- Acuity assessment of non verbal infants and children: clinical experience with the acuity cards procedure.Dev Med Child Neurol. 1988; 30: 232-244
- Acuity card testing of patients with cerebral visual impairment.Dev Med Child Neurol. 1988; 30: 632-637
- Disorders of visual perception in children with congenital encephalopathies (in Italian).Giorn Neuropsichiatr Eta' Evol. 1989; : 118-124
- The prevalence of cerebral visual disturbance in children with cerebral palsy.Dev Med Child Neurol. 1992; 34: 473-480
- Effect of mental retardation and motor disability on testing with visual acuity cards.Dev Med Child Neurol. 1992; 34: 115-122
- Neuro-imaging of cerebral visual disturbances in children.Neuropediatrics. 1988; 19: 3-6
- Permanent cortical visual impairment in children.Dev Med Child Neurol. 1985; 27: 730-739
- Neurological, electrophysiological and MRI abnormalities in infants with extensive cystic leukomalacia.Neuropediatrics. 1987; 18: 61-66
- Visuo-perceptual impairment and cerebral lesions in spastic diplegia with preterm birth.Brain Dev (Tokyo). 1992; 14: 239-244
- Magnetic resonance imaging and cerebral visual impairment in infants between 6 and 18 months (in Italian).Giorn Neuropsichiatr Eta' Evol. 1992; 12: 73-79
- The acuity cards procedure: a rapid test of infant acuity.Invest Ophthal Vis Sci. 1985; 26: 1158-1162
- Assessment of visual acuity in infants and children: the acuity card procedure.Dev Med Child Neurol. 1986; 28: 779-789
- Early detection of visual impairments.in: Galjaard H Prechtl HRF Velickovic M Early detection and management of cerebral palsy. Martinus Nijhoff, Dordrecht1987: 79-100
- Effects of perinatal hypoxia on visual development during the first year of (corrected) age.Early Hum Dev. 1989; 20: 267-279
- Ophthalmic findings in infants of very low birthweight.Dev Med Child Neurol. 1990; 32: 7-13
- Brett EM Paediatric neurology. 2nd ed. Churchill Livingstone, Edinburgh1991
- The changing panorama of cerebral palsy in Sweden 1954–1970. II. Analysis of the various syndromes.Acta Paediatr Scand. 1975; 64: 193-200
- Cerebral palsy: MR findings in 40 patients.AJNR. 1992; 13: 67-78
- Neuroimaging and functional outcome of neonatal leukomalacia.Behav Brain Res. 1992; 49: 7-19
- A coefficient of agreement for nominal scales.Educ Psychol Meas. 1960; 20: 37-46
- Assessment in infancy.University of Illinois Press, Urbana1975
- The ability of babies.University London Press, London1954
- Wechsler preschool and primary scale of intelligence (WIPPSI).The Psychological Corporation, New York1967
- Sensorimotor development in cerebral palsied infants as assessed by means of Uzgiris-Hunt Scales.Dev Med Child Neurol. 1993; 35: 1055-1066
- Age norms for visual acuity in toddlers using the acuity cards procedure.Clin Vis Sci. 1990; 5: 167-174
- The acuity card procedure: interobserver agreement in infants with perinatal complications.Clin Vis Sci. 1990; 6: 39-48
- Human visual development over the first six months of life. A review and hypothesis.Human Neurobiol. 1984; 3: 61-74
- Subcortical visual function in the newborn.Pediatr Neurol. 1990; 6: 333-336
- Early visual development: differential functioning of parvocellular and magnocellular pathways.Eye. 1992; 6: 129-135
- Visual recovery from hypoxic cortical blindness during childhood.Arch Ophthalmol. 1987; 105: 1371-1377
- Magnetic resonance imaging in children with spastic diplegia: correlation with the severity of their motor and mental abnormality.Dev Med Child Neurol. 1991; 33: 18-25
- Cerebral blindness in childhood.Neurology. 1970; 20: 1147-1156
- Visual evoked potentials in the evaluation of ‘cortical blindness’ in children.Ann Neurol. 1979; 6: 126-129
- Flash and pattern-reversal visual evoked potentials abnormalities in infants and children with cerebral blindness.Dev Med Child Neurol. 1992; 34: 305-315
- Visual acuity of low- and high-risk neonates and acuity development during the first year.Behav Brain Res. 1992; 49: 107-114
Article info
Publication history
Accepted:
January 15,
1994
Received:
September 16,
1993
Identification
Copyright
© 1994 Elsevier Science B.V. All rights reserved. Published by Elsevier Inc.