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Abnormal Vestibular–Ocular Reflexes in Children With Cortical Visual Impairment
- Source :
- Journal of Neuro-Ophthalmology. 41:531-536
- Publication Year :
- 2020
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2020.
-
Abstract
- Purpose To determine whether the vestibular-ocular reflexes (VORs) can be affected by central nervous system injury in children with cortical visual impairment (CVI). Methods Retrospective case series. Twenty consecutive children with CVI who presented to a pediatric ophthalmology practice over an 18-month period were included in the study. Horizontal and vertical VORs were assessed by a pediatric neuro-ophthalmologist using the standard doll's head maneuver. MRI studies were independently reviewed by a pediatric neuroradiologist in a masked fashion. The main outcome measures were the integrity of the VORs and the presence of brainstem abnormalities on MRI. Results VORs were found to be absent or severely impaired in 13/20 (65%) children with CVI. More surprisingly, the doll's head maneuver failed to substantially overcome the deviated eye position in 8/13 (62%) children with conjugate gaze deviations. Reduced brainstem size and signal abnormalities were found in 4/7 children with normal VORs and in 9/13 children with abnormal VORs (P = 0.6), showing noncorrelation with the integrity of the VOR. Conclusion VORs are commonly impaired in children with CVI. This ocular motor deficit reflects the diffuse cortical and subcortical injury that often accompanies perinatal injury to the developing brain. Consequently, these children may lack important visual compensatory mechanisms to stabilize gaze during head movements. This knowledge can help in planning visual rehabilitation.
- Subjects :
- medicine.medical_specialty
Eye Movements
genetic structures
Ocular motor
Central nervous system
Vision Disorders
Cortical visual impairment
Audiology
medicine
Humans
Child
Retrospective Studies
Vestibular system
business.industry
Reflex, Vestibulo-Ocular
medicine.disease
Gaze
Ophthalmology
medicine.anatomical_structure
Head Movements
Reflex
Pediatric ophthalmology
sense organs
Neurology (clinical)
Brainstem
business
Subjects
Details
- ISSN :
- 10708022
- Volume :
- 41
- Database :
- OpenAIRE
- Journal :
- Journal of Neuro-Ophthalmology
- Accession number :
- edsair.doi.dedup.....240c60705745b0c89861fee514e0332e