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Patel R, Park AY, Marchi E, Gropman AL, Whitehead MT, Lyon GJ. Ophthalmic Manifestations of NAA10-Related and NAA15-Related Neurodevelopmental Syndrome: Analysis of Cortical Visual Impairment and Refractive Errors. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.02.01.24302161. [PMID: 38352572 PMCID: PMC10862986 DOI: 10.1101/2024.02.01.24302161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/19/2024]
Abstract
NAA10-related and NAA15-related neurodevelopmental syndrome, otherwise known as Ogden Syndrome, is known to present with varying degrees of intellectual disability, hypotonia, congenital cardiac abnormalities, seizures, and delayed speech and motor development. However, the ophthalmic manifestations of NAA10 and NAA15 mutations are not yet fully characterized or understood. This study analyzed the prevalence of six ophthalmic conditions (cortical visual impairment, myopia, hyperopia, strabismus, nystagmus, and astigmatism) in 67 patients with pathogenic mutations in the NAA10 cohort (54 inherited, 10 de novo; 65 missense, 2 frameshift) and 19 patients with pathogenic mutations in the NAA15 cohort (18 de novo; 8 frameshift, 4 missense, 4 nonsense, and 1 splice site). Patients were interviewed virtually or in-person to collect a comprehensive medical history verified by medical records. These records were then analyzed to calculate the prevalence of these ophthalmic manifestations in each cohort. Analysis revealed a higher prevalence of ophthalmic conditions in our NAA10 cohort compared to existing literature (myopia 25.4% vs. 4.7%; astigmatism 37.3% vs. 13.2%; strabismus 28.4% vs. 3.8%; CVI 22.4% vs. 8.5%, respectively). No statistically significant differences were identified between the NAA10 and NAA15 mutations. Our study includes novel neuroimaging of 13 NAA10 and 5 NAA15 probands, which provides no clear correlation between globe size and severity of comorbid ophthalmic disease. Finally, anecdotal evidence was compiled to underscore the importance of early ophthalmologic evaluations and therapeutic interventions.
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Affiliation(s)
- Rahi Patel
- Department of Human Genetics, New York State Institute for Basic Research in Developmental Disabilities, Staten Island, New York, United States of America
| | - Agnes Y. Park
- Department of Human Genetics, New York State Institute for Basic Research in Developmental Disabilities, Staten Island, New York, United States of America
| | - Elaine Marchi
- Department of Human Genetics, New York State Institute for Basic Research in Developmental Disabilities, Staten Island, New York, United States of America
| | - Andrea L. Gropman
- Division of Neurogenetics and Developmental Pediatrics, Children’s National Health System, Washington, DC, USA
- Department of Neurology, George Washington University, Washington, DC, US
| | - Matthew T. Whitehead
- Division of Neuroradiology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Radiology Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Gholson J. Lyon
- Department of Human Genetics, New York State Institute for Basic Research in Developmental Disabilities, Staten Island, New York, United States of America
- George A. Jervis Clinic, New York State Institute for Basic Research in Developmental Disabilities, Staten Island, New York, United States of America
- Biology PhD Program, The Graduate Center, The City University of New York, New York, United States of America
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Wilkinson KM, Elko LR, Elko E, McCarty TV, Sowers DJ, Blackstone S, Roman-Lantzy C. An Evidence-Based Approach to Augmentative and Alternative Communication Design for Individuals With Cortical Visual Impairment. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:1939-1960. [PMID: 37594735 DOI: 10.1044/2023_ajslp-22-00397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
PURPOSE This article highlights the contributions of three pillars of an evidence-based practice approach (service providers, researchers, and families/clients) in the development of a framework to offer a way forward for professionals, families, and technology companies to support optimal visual and communication outcomes of individuals with cortical visual impairment (CVI) who use augmentative and alternative communication (AAC). By providing available research findings as well as practical information and lived experiences, the article offers clinical considerations and design features that can lead to addressing the unique needs of these individuals. METHOD This article reviews literature concerning what is known about CVI and describes in detail and from multiple viewpoints important features required in AAC systems to support individuals with CVI and enable them to communicate effectively. RESULTS Components necessary for teams, communication partners, and AAC designers to optimize AAC system design in CVI are presented using external research evidence as internal evidence from lived experience to support their importance. CONCLUSIONS An AAC system design that is tailored to the unique visual processing characteristics in CVI is likely to promote positive communication outcomes. The presentation of the lived experience of an individual who has CVI themselves illustrates the need for individualized assessments and interventions that incorporate and reflect the research presented here. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.23902239.
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Affiliation(s)
- Krista M Wilkinson
- Department of Communication Sciences and Disorders, The Pennsylvania State University, University Park
| | | | | | - Tara V McCarty
- Department of Communication Sciences and Disorders, The Pennsylvania State University, University Park
| | - Dawn J Sowers
- Department of Communication Sciences and Disorders, The Pennsylvania State University, University Park
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3
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Weden K, DeCarlo DK, Barstow E. A Scoping Review of Intervention for Pediatric Cerebral Visual Impairment: Calling All Pediatric Occupational Therapists. Occup Ther Health Care 2023; 37:326-356. [PMID: 37139689 PMCID: PMC10950195 DOI: 10.1080/07380577.2023.2172761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 01/22/2023] [Indexed: 05/05/2023]
Abstract
Cerebral visual impairment is the leading cause of low vision in children, and functional gains can be achieved with intervention. To date there exists no evidence-based intervention protocol to guide rehabilitation therapists. This scoping review was conducted to synthesize the evidence currently available and explore current interventions in order to guide future research. This review identified five types of interventions for cerebral visual impairment; habilitation, visual stimulation, video game, color tent, and medical and also evidenced the need for standardized, objective measures of function for this population.
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Affiliation(s)
- Kathleen Weden
- Department of Occupational Therapy, University of Alabama at Birmingham, Birmingham, USA
| | - Dawn K. DeCarlo
- Department of Ophthalmology & Visual Sciences, School of Medicine, University of Alabama at Birmingham, Birmingham, USA
| | - Elizabeth Barstow
- Department of Occupational Therapy, University of Alabama at Birmingham, Birmingham, USA
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Delay A, Rice M, Bush E, Harpster K. Interventions for children with cerebral visual impairment: A scoping review. Dev Med Child Neurol 2023; 65:469-478. [PMID: 36217216 DOI: 10.1111/dmcn.15431] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 11/28/2022]
Abstract
AIM To examine the nature and scope of the literature on interventions implemented for children with cerebral visual impairment (CVI). METHOD Using a scoping review methodology, a systematic search of the literature was conducted using four databases including PubMed, Web of Science, Scopus, and Embase. Titles and abstracts were screened and data were extracted and synthesized from full-text, eligible studies. Twenty-three articles were identified and evaluated using quality criteria. RESULTS Twenty-three of the 895 studies were included with children aged between 1 month and 17 years 6 months. Interventions were grouped into six categories including visual stimulation, task/environmental adaptations, vision training, acupuncture, stem cell transplantation, and transcranial electric stimulation. Outcome measures examined changes in visual function, functional vision, and visual processing. INTERPRETATION Intervention research for children with CVI is in its infancy. Interventions for children with CVI may be beneficial; however, comparing results is difficult due to inconsistency in outcome measures. Most of the intervention studies had lower-level evidence and included small sample sizes. High-quality studies with larger samples and comparison groups are needed to fully understand which evidence-based interventions are most effective for children with CVI. With the incidence of CVI increasing, further development and validation of intervention methods is imperative. WHAT THIS PAPER ADDS Intervention studies for children with cerebral visual impairment (CVI) are sparse. Most intervention studies for children with CVI have low-level evidence with low critical appraisal scores. High-quality, controlled intervention studies are needed to guide families and clinicians toward evidence-based practice.
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Affiliation(s)
- Ariana Delay
- Department of Occupational Therapy, Huntington University, Fort Wayne, IN, USA
- Division of Occupational Therapy and Physical Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Melissa Rice
- Division of Pediatric Ophthalmology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Ophthalmology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Elsie Bush
- Division of Occupational Therapy and Physical Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Karen Harpster
- Division of Occupational Therapy and Physical Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Rehabilitation, Exercise, and Nutrition Sciences, College of Allied Health Sciences, University of Cincinnati, Cincinnati, OH, USA
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5
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Boster JB, McCarthy JW, Brown K, Spitzley AM, Blackstone SW. Creating a Path for Systematic Investigation of Children With Cortical Visual Impairment Who Use Augmentative and Alternative Communication. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:1880-1893. [PMID: 34081538 DOI: 10.1044/2021_ajslp-20-00203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose There is limited information about how to support children with cortical visual impairment (CVI) who require augmentative and alternative communication (AAC). An initial review designed to explore the available evidence was used to outline critical needs in moving research and intervention forward for children who use AAC and have CVI. Method Previous systematic reviews, six databases, and theses and dissertations were systematically searched, along with reviews of the resulting works cited. An initial yield of 575 articles was narrowed to 10, which discussed AAC interventions that included children with CVI. Results Three interventions were technology based, and seven were instructional based. The use of textured microswitches was the most frequent form of technology intervention, with the frequency of switch activations being the most frequently coded outcome. Overall, the studies represent explorations in the area rather than systematic lines of inquiry. Conclusions While evidence shows at least some children with CVI have been included in AAC research to date, the inclusion is more incidental than deliberate. Issues such as clear descriptions of the vision capabilities and needs of participants may have impacted study results.
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Bennett CR, Bauer CM, Bailin ES, Merabet LB. Neuroplasticity in cerebral visual impairment (CVI): Assessing functional vision and the neurophysiological correlates of dorsal stream dysfunction. Neurosci Biobehav Rev 2020; 108:171-181. [PMID: 31655075 PMCID: PMC6949360 DOI: 10.1016/j.neubiorev.2019.10.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Revised: 10/15/2019] [Accepted: 10/18/2019] [Indexed: 12/31/2022]
Abstract
Cerebral visual impairment (CVI) results from perinatal injury to visual processing structures and pathways and is the most common individual cause of pediatric visual impairment and blindness in developed countries. While there is mounting evidence demonstrating extensive neuroplastic reorganization in early onset, profound ocular blindness, how the brain reorganizes in the setting of congenital damage to cerebral (i.e. retro-geniculate) visual pathways remains comparatively poorly understood. Individuals with CVI exhibit a wide range of visual deficits and, in particular, present with impairments of higher order visual spatial processing (referred to as "dorsal stream dysfunction") as well as object recognition (associated with processing along the ventral stream). In this review, we discuss the need for ongoing work to develop novel, neuroscience-inspired approaches to investigate functional visual deficits in this population. We also outline the role played by advanced structural and functional neuroimaging in helping to elucidate the underlying neurophysiology of CVI, and highlight key differences with regard to patterns of neural reorganization previously described in ocular blindness.
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Affiliation(s)
- Christopher R Bennett
- Massachusetts Eye and Ear, Harvard Medical School, 20 Staniford Street, Boston, MA 02114, United States
| | - Corinna M Bauer
- Massachusetts Eye and Ear, Harvard Medical School, 20 Staniford Street, Boston, MA 02114, United States
| | - Emma S Bailin
- Massachusetts Eye and Ear, Harvard Medical School, 20 Staniford Street, Boston, MA 02114, United States
| | - Lotfi B Merabet
- Massachusetts Eye and Ear, Harvard Medical School, 20 Staniford Street, Boston, MA 02114, United States.
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7
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Ortibus E, Fazzi E, Dale N. Cerebral Visual Impairment and Clinical Assessment: The European Perspective. Semin Pediatr Neurol 2019; 31:15-24. [PMID: 31548019 DOI: 10.1016/j.spen.2019.05.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
This paper summarizes the multidisciplinary pediatric assessment methods of 3 European centers for identifying and assessing cerebral visual impairment in childhood. It describes a comprehensive neurodevelopmental assessment evaluation in which visual aspects play an important part. Developmental trajectories and the heterogeneity of the clinical picture are emphasized. Multidisciplinary ophthalmology and neurodisability/neurology teamwork together with the parent and teachers, to reach an integrated and individualized perspective for the individual child, are described. This comprehensive assessment is the starting point for habilitation programs and interventions, that can support and meet the child's needs and help them reach their optimal potential. Future developments in classification of the cerebral visual impairment conditions, building on the child's individual assessment profile, will further enhance the direction of clinical, educational, and research progress.
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Affiliation(s)
- Els Ortibus
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium; Department of Pediatric Neurology, University Hospitals Leuven, Belgium.
| | - Elisa Fazzi
- Department of Clinical and Experimental Sciences, University of Brescia, Italy; Child Neurology and Psychiatry Unit, ASST Civil Hospital -Brescia, Italy; Department of Pediatric Neurology, University Hospitals Leuven, Belgium
| | - Naomi Dale
- Department of Developmental Neurosciences, UCL Great Ormond Street Institute of Child Health, and Neurodisability Service, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom; Department of Pediatric Neurology, University Hospitals Leuven, Belgium
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8
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Pilling RF, Little SM. Evaluation of the role of the colour tent in vision stimulation for children with complex disabilities and cerebral visual impairment: A feasibility study. BRITISH JOURNAL OF VISUAL IMPAIRMENT 2019. [DOI: 10.1177/0264619619871980] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Children with profound and multiple disabilities commonly have their visual impairment overlooked when seeking to meet their complex health needs. The act of surrounding a child with little or no apparent visual function by a monochromatic translucent tent can serve to ‘switch on’ a child’s visual system. The aim of the project was to investigate the role of using colour tents to bring about attentional responses in children with complex disabilities including cerebral visual impairment. The evaluation comprises three phases, repeated on four occasions over the space of 4 weeks. The child’s visual attention prior to entering the tent and during the 5 minutes after leaving the tent was recorded. Moreover, the child’s responses and behaviours while in the tent were recorded. Nine children participated in the evaluation, mean age 6 years (range: 5–9 years). All children showed a change in visual behaviour on at least one occasion while in the colour tent. Most children required more than one session before a change in visual behaviour was noted. Only two children showed increase in visual awareness after any session, and there was no sustained effect demonstrated. This feasibility study has demonstrated that a short series of sessions in a colour tent is insufficient to demonstrate the effectiveness of a colour tent in stimulating visual awareness in children with complex needs. The methodology was acceptable to parents and teachers and lessons have been learned which will inform future studies.
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9
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Cohen-Maitre SA, Haerich P. Visual Attention to Movement and Color in Children with Cortical Visual Impairment. JOURNAL OF VISUAL IMPAIRMENT & BLINDNESS 2019. [DOI: 10.1177/0145482x0509900702] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study investigated the ability of color and motion to elicit and maintain visual attention in a sample of children with cortical visual impairment (CVI). It found that colorful and moving objects may be used to engage children with CVI, increase their motivation to use their residual vision, and promote visual learning.
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Affiliation(s)
| | - Paul Haerich
- Brain Studies and Neurocognition, Department of Psychology, Loma Linda University, Loma Linda, CA, 92350
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10
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Roman C, Baker-Nobles L, Dutton GN, Luiselli TE, Flener BS, Jan JE, Lantzy A, Matsuba C, Mayer DL, Newcomb S, Nielsen AS. Statement on Cortical Visual Impairment. JOURNAL OF VISUAL IMPAIRMENT & BLINDNESS 2019. [DOI: 10.1177/0145482x1010400202] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Christine Roman
- Western Pennsylvania Hospital, CVI project leader, American Printing House for the Blind, and educational consultant; 25 Deer Spring Lane, Allison Park, PA 15101
| | - Linda Baker-Nobles
- University of Kansas, consultant, Rockhurst University, Kansas City, Missouri, and adjunct professor, University of Alabama–Birmingham; 9924 Catalina, Overland Park, KS 66207
| | - Gordon N. Dutton
- Royal Hospital for Sick Children, Glasgow, Scotland, and professor, Department of Vision Science, School of Life Sciences, Glasgow Caledonian University, Govan Mbeki Building, Cowcaddens Road, Glasgow, G4 0BA, Scotland, United Kingdom
| | - Tracy Evans Luiselli
- New England Center Deafblind Project, Perkins School for the Blind, 175 North Beacon Street, Watertown, MA 02472
| | - Betsy S. Flener
- Kentucky School for the Blind, GRREC, 230 Technology Way, Bowling Green, KY 42101
| | - James Emery Jan
- Departments of Pediatric Neurology, Developmental Pediatrics, and Neurophysiology; senior research scientist emeritus; University of British Columbia, Children's Hospital, 4480 Oak Street, Vancouver, BC, V6H 3V4, Canada
| | - Alan Lantzy
- Temple University School of Medicine, and chairman of pediatrics, Western Pennsylvania Hospital, 4800 Friendship Avenue, Pittsburgh, PA 15224
| | - Carey Matsuba
- British Columbia's Children's Hospital, 3644 Slocan Street, Vancouver, BC V5M 3E8, Canada
| | - D. Luisa Mayer
- British Columbia's Children's Hospital, 3644 Slocan Street, Vancouver, BC V5M 3E8, Canada
| | - Sandra Newcomb
- New England College of Optometry; affiliate clinical associate in ophthalmology, Children's Hospital; Harvard Medical School; New England Eye at Perkins School for the Blind, 175 North Beacon Street, Watertown, MA 02472
| | - Anne S. Nielsen
- Department of Special Education, University of Maryland, 1813 Piccard Drive, Rockville, MD 20850
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11
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Martín MBC, Santos-Lozano A, Martín-Hernández J, López-Miguel A, Maldonado M, Baladrón C, Bauer CM, Merabet LB. Cerebral versus Ocular Visual Impairment: The Impact on Developmental Neuroplasticity. Front Psychol 2016; 7:1958. [PMID: 28082927 PMCID: PMC5183596 DOI: 10.3389/fpsyg.2016.01958] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 11/30/2016] [Indexed: 11/13/2022] Open
Abstract
Cortical/cerebral visual impairment (CVI) is clinically defined as significant visual dysfunction caused by injury to visual pathways and structures occurring during early perinatal development. Depending on the location and extent of damage, children with CVI often present with a myriad of visual deficits including decreased visual acuity and impaired visual field function. Most striking, however, are impairments in visual processing and attention which have a significant impact on learning, development, and independence. Within the educational arena, current evidence suggests that strategies designed for individuals with ocular visual impairment are not effective in the case of CVI. We propose that this variance may be related to differences in compensatory neuroplasticity related to the type of visual impairment, as well as underlying alterations in brain structural connectivity. We discuss the etiology and nature of visual impairments related to CVI, and how advanced neuroimaging techniques (i.e., diffusion-based imaging) may help uncover differences between ocular and cerebral causes of visual dysfunction. Revealing these differences may help in developing future strategies for the education and rehabilitation of individuals living with visual impairment.
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Affiliation(s)
- Maria B C Martín
- GIDFYS, European University Miguel de Cervantes Valladolid, Spain
| | - Alejandro Santos-Lozano
- GIDFYS, European University Miguel de CervantesValladolid, Spain; Research Institute of Hospital 12 de Octubre (i+12)Madrid, Spain
| | | | - Alberto López-Miguel
- Refractive Surgery and Visual Rehabilitation, Ophthalmology, Instituto Universitario de Oftalmobiología Aplicada, Eye Institute Valladolid, Spain
| | - Miguel Maldonado
- Refractive Surgery and Visual Rehabilitation, Ophthalmology, Instituto Universitario de Oftalmobiología Aplicada, Eye Institute Valladolid, Spain
| | - Carlos Baladrón
- GIDFYS, European University Miguel de Cervantes Valladolid, Spain
| | - Corinna M Bauer
- Laboratory for Visual Neuroplasticity, Massachusetts Eye and Ear Infirmary, Harvard Medical School Boston, MA, USA
| | - Lotfi B Merabet
- Laboratory for Visual Neuroplasticity, Massachusetts Eye and Ear Infirmary, Harvard Medical School Boston, MA, USA
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12
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Bianucci R, Perciaccante A, Appenzeller O. Boy with cortical visual impairment and unilateral hemiparesis in Jeff Huntington's "Slip" (2011). J Neurol Sci 2016; 370:45-46. [PMID: 27772784 DOI: 10.1016/j.jns.2016.09.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 08/24/2016] [Accepted: 09/07/2016] [Indexed: 11/30/2022]
Abstract
Face recognition is strongly associated with the human face and face perception is an important part in identifying health qualities of a person and is an integral part of so called spot diagnosis in clinical neurology. Neurology depends in part on observation, description and interpretation of visual information. Similar skills are required in visual art. Here we report a case of eye cortical visual impairment (CVI) and unilateral facial weakness in a boy depicted by the painter Jeff Huntington (2011). The corollary of this is that art serves medical clinical exercise. Art interpretation helps neurology students to apply the same skills they will use in clinical experience and to develop their observational and interpretive skills in non-clinical settings. Furthermore, the development of an increased awareness of emotional and character expression in the human face may facilitate successful doctor-patient relationships.
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Affiliation(s)
- R Bianucci
- Department of Public Health and Paediatric Sciences, Legal Medicine Section, University of Turin, Corso Galileo Galilei, 22 10126 Turin, Italy; UMR 7268, Laboratoire d'Anthropologie bio-culturelle, Droit, Etique & Santé (Adés), Faculté de Médecine de Marseille, Secteur Nord Batiment A - CS80011 Bd Pierre Dramard, 13344 Marseille Cedex 15, France.
| | - A Perciaccante
- Department of Medicine, "San Giovanni di Dio" Hospital, Via Fatebenefratelli, 34, Gorizia, Italy
| | - O Appenzeller
- New Mexico Health Enhancement and Marathon Clinics Research Foundation, 361 Ridge Horne, Albuquerque, NM, USA; New Mexico Museum of Natural History and Science, 1801 Mountain Road NW, Albuquerque, NM, USA
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13
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Tsai LT, Meng LF, Wu WC, Jang Y, Su YC. Effects of visual rehabilitation on a child with severe visual impairment. Am J Occup Ther 2013; 67:437-47. [PMID: 23791319 DOI: 10.5014/ajot.2013.007054] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We examined the effects of visual rehabilitation, including a chromatic luminance discrimination program and a fixation training program, on a 6-yr-old boy with severe visual impairment. Single-subject ABA and AB designs were used. The programs were conducted 2×/wk and included 6 to 7 sessions for the baseline phase and 10 to 11 sessions for the intervention phase. Play was integrated into the visual training programs. Goggle visual evoked potential (VEP) testing was used to evaluate neural activity in the primary visual cortex. Correct responses increased and response times were shortened after training in luminance discrimination. The total and maximum fixation time also improved, as did P100 latency and amplitude of VEPs. While walking, the boy was able to detect obstacles he had not noticed before training. The results indicate the value of visual training and the possibility of brain plasticity in a child with severe visual impairment.
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Affiliation(s)
- Li-Ting Tsai
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei
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14
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Chau V, Taylor MJ, Miller SP. Visual function in preterm infants: visualizing the brain to improve prognosis. Doc Ophthalmol 2013; 127:41-55. [PMID: 23761036 DOI: 10.1007/s10633-013-9397-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Accepted: 06/05/2013] [Indexed: 11/28/2022]
Abstract
Considerable development of the visual system occurs in the third trimester of life, a time when very preterm-born infants are in a neonatal intensive care unit (NICU). Their very early birth during a period of rapid and marked neurodevelopment and their clinical course makes them a very high-risk population. A range of different events impacts brain development and the visual system, leading to significant long-term visual dysfunction. Improved neuroimaging techniques provide an important window on the early brain and visual system development of these vulnerable infants. Greater understanding of the etiology of visual impairment subsequent to preterm birth and the timing of critical processes will allow early recognition and the earlier implementations of interventions. In the longer term, this will help clinicians optimize NICU practice to reduce the incidence of visual dysfunction in these children.
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Affiliation(s)
- Vann Chau
- Department of Pediatrics (Neurology), University of British Columbia, Vancouver, Canada
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15
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Abstract
This chapter deals with neuro-ophthalmological diseases at different levels of the afferent visual pathways with special regard to visual field defects, their functional impact, and their rehabilitation. The nature of these impairments and their significance for activities of daily living can be quite varied; an exact assessment of the residual function is required to determine specific rehabilitation approaches. Rehabilitation aims to compensate for the visual deficits by means of specific training and visual aids. Visual field defects in the center cause reading disability. Preconditions for reading are a sufficient size of the reading visual field or perceptual span and sufficient resolution of the retinal area used for reading. In central scotoma, as in macular or optic nerve disease, reading ability can be regained by eccentric fixation plus text magnification. In hemianopia, reading depends on the amount of sparing in the center, the side of the defect, and adaptive strategies. Field defects in the periphery cause orientation and mobility problems. In constricted fields, tactile training with a cane is indicated; in hemianopia, explorative saccadic training is effective. With the appropriate technique, rehabilitation can be very successful, and quality of life can be regained in most patients.
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16
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Kuba M, Liláková D, Hejcmanová D, Kremláček J, Langrová J, Kubová Z. Ophthalmological examination and VEPs in preterm children with perinatal CNS involvement. Doc Ophthalmol 2008; 117:137-45. [DOI: 10.1007/s10633-008-9115-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2007] [Accepted: 01/14/2008] [Indexed: 01/28/2023]
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17
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Dalens H, Solé M, Neyrial M. [Cerebral visual impairment in brain-damaged children - four case studies]. J Fr Ophtalmol 2006; 29:24-31. [PMID: 16465120 DOI: 10.1016/s0181-5512(06)73743-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Cerebral visual impairment is one of the main causes of childhood visual impairment in developed countries. These disorders are often linked with pre- or perinatal hypoxic brain injuries. The patterns of brain injuries depend on the severity and duration of hypoxia and the child's age. In premature children, periventricular leukomalacia affects the optic radiations and the subcortical visual brain. In full-term newborn babies, chronic hypoxia leads to the damage of the visual cortex and acute hypoxia damages the basal ganglia. They recover from cortical blindness in variable ways. Visual dysfunction is characterized by fixation troubles, subnormal acuity (crowding), difficulty with perceiving visual fields, movements, depth, cognitive defects (agnosia of images, objects or faces, visuospatial disorders), ocular motility disorders (tonic gaze deviation, strabismus, nystagmus). Accompanying these cerebral injuries, there are accommodation defects and optic disk abnormalities that vary according to the gestational age at the time of hypoxia.
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Affiliation(s)
- H Dalens
- Service d'Ophtalmologie, Hôpital Gabriel Montpied, CHU, BP 69, 63003 Clermont-Ferrand Cedex.
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Ma L, Harada T, Harada C, Romero M, Hebert JM, McConnell SK, Parada LF. Neurotrophin-3 is required for appropriate establishment of thalamocortical connections. Neuron 2002; 36:623-34. [PMID: 12441052 DOI: 10.1016/s0896-6273(02)01021-8] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
In the vertebrate brain, the thalamus serves as a relay and integration station for diverse neuronal information en route from the periphery to the cortex. Formation of the thalamocortical tract occurs during pre- and postnatal development, with distinct thalamic nuclei projecting to specific cortical regions. The molecular forces that underlie the invasion by axons into specific cortical layers followed by activity-dependent maturation of synapses are poorly understood. We show that genetic ablation of neurotrophin-3 (NT-3) in the mouse neocortex results in reduction of a set of anatomically distinct axonal bundles projecting from thalamus through cortical white matter. These bundles include thalamocortical axons that normally establish connections with retrosplenial and visual cortex, sites of early postnatal NT-3 expression. These results implicate neurotrophins in the critical stage of precise thalamocortical connections.
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Affiliation(s)
- Long Ma
- Center for Developmental Biology and Kent Waldrep Foundation Center for Basic Research on Nerve Growth and Regeneration, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
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Sakai S, Hirayama K, Iwasaki S, Yamadori A, Sato N, Ito A, Kato M, Sudo M, Tsuburaya K. Contrast sensitivity of patients with severe motor and intellectual disabilities and cerebral visual impairment. J Child Neurol 2002; 17:731-7. [PMID: 12546426 DOI: 10.1177/08830738020170101201] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We attempt to evaluate the residual visual capacities of nine patients (seven males and two females; age range 4 to 35 years, mean 13.8 +/- 9.98) with cerebral visual impairment coupled with severe motor and intellectual disabilities by their contrast sensitivities to sine-wave gratings. Two methods were used for detecting the occurrence of ocular responses to stimuli: (1) detection of optokinetic nystagmus to drifting sinusoidal gratings by naked-eye observation and electronystagmography and (2) detection of ocular pursuit for a drifting Gabor patch by naked-eye observation. We succeeded in measuring the sensitivities of eight cases. For the remaining one case, only the Gabor method could be applied. Most cases showed low contrast sensitivity in both higher (2 and 4 cycles/degree) and lower (0.125 and 0.25 cycles/degree) spatial frequencies and relatively high contrast sensitivity in the middle (0.5 and 1 cycle/degree) range of spatial frequencies. We conclude that the residual visual capacities of patients with severe motor and intellectual disabilities and cerebral visual impairment can be measured fairly accurately by these behavioral methods.
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Affiliation(s)
- Shinya Sakai
- Division of Neuropsychology, Department of Disability Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
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Affiliation(s)
- M A Afshari
- Harvard Medical School, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA 02114, USA
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Huo R, Burden SK, Hoyt CS, Good WV. Chronic cortical visual impairment in children: aetiology, prognosis, and associated neurological deficits. Br J Ophthalmol 1999; 83:670-5. [PMID: 10340973 PMCID: PMC1723072 DOI: 10.1136/bjo.83.6.670] [Citation(s) in RCA: 127] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND/AIMS To evaluate prevalence, aetiology, prognosis, and associated neurological and ophthalmological problems in children with cortical visual impairment (CVI). METHODS The records of 7200 outpatients seen in the paediatric ophthalmology practice over the past 15 years were reviewed in order to compile data concerning CVI. In addition, the authors devised and applied a system for grading visual recovery in order to assess prognosis. RESULTS CVI occurred in 2.4% of all patients examined. The four most common causes of CVI were perinatal hypoxia (22%), cerebral vascular accident (14%), meningitis (12%), and acquired hypoxia (10%). Most children with CVI had associated neurological abnormalities. The most common were seizures (53%), cerebral palsy (26%) hemiparesis (12%), and hypotonia (5%). Associated ophthalmological problems were esotropia (19%), exotropia (18%), optic nerve atrophy (16%), ocular motor apraxia (15%), nystagmus (11%), and retinal disease (3%). On average, CVI patients improved by two levels as measured by the authors' scale. CONCLUSION The majority of children with CVI showed at least some recovery. In this group of children, CVI is often accompanied by additional ophthalmological problems and is nearly always associated with other, serious neurological abnormalities.
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Affiliation(s)
- R Huo
- Department of Ophthalmology, University of California, San Francisco, CA, USA
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