Abstract:
Cerebral Visual Impairment (CVI) is a common condition in the UK. Patients with conditions associated with CVI are frequently seen in paediatric ophthalmology clinics offering eye care professionals an opportunity to identify children proactively. In most cases CVI occurs as part of a neurodevelopmental condition or as a feature of multiple and complex disabilities. However, CVI can also be seen in children with apparently typical development. In some cases, high contrast visual acuity is normal and in other cases severely impaired. As such, identification of CVI requires evaluation of aspects of visual performance beyond high contrast acuity and consideration that visual function of those with CVI may fluctuate. Few paediatric ophthalmologists have received formal training in CVI. The detection and diagnosis of CVI varies across the UK and patients report hugely different experiences. A diagnosis of CVI is made based on professional clinical judgement and it is recognised that individual perspectives and local practice in the specific methodologies of assessment will vary. A systematic review and survey of professionals is underway to attempt to reach agreement on diagnostic criteria. Nonetheless, established pathways and published protocols can offer guidance on how a paediatric ophthalmology service can approach assessment of the child with suspected CVI. The purpose of this paper is to present a summary of research and clinical practice methods for detecting and diagnosing CVI in a paediatric ophthalmology outpatient setting. It represents current understanding of the topic and acknowledges the evolving nature of both practice and the evidence-base. A rapid literature review was undertaken to identify articles relating to clinical investigation of children with CVI. A focus group of QTVI and subject matter experts from sight loss charities was undertaken to address areas which were not covered by the literature review.
摘要: 脑源性视力障碍(CVI)是英国的常见疾病。患有CVI相关疾病的患者经常在儿科眼科诊所就诊, 为眼科护理专业人员提供了主动识别儿童CVI的机会。多数情况下, CVI为神经发育疾病的一部分, 或作为多种复杂残疾的一种临床体征。然而, CVI也可见于发育正常的儿童。在某些情况下, 高对比度视力可以正常, 而在其他情况下则严重受损。因此, CVI的识别需要评价高对比度视力以外的视觉表现方面, 并考虑CVI患者的视觉功能波动的可能性。很少有儿科眼科医生接受过CVI的正式培训。CVI 的检测和诊断在英国各不相同, 患者报告的体验差异很大。CVI的诊断是基于专业的临床判断, 并且需认识到特定评估方法中的个体观点和当地实践有所不同。目前正在对专业人员进行系统审核和调查, 以试图就诊断标准达成一致。尽管如此, 已确立的途径和已发表的方案可为针对如何处理疑似CVI儿童的儿科眼科治疗评估提供指导。本文旨在对在儿科眼科门诊检测和诊断CVI的研究和临床实践方法进行总结。它代表了目前对这一专题的理解, 并承认了实践和证据基础的演变特性。本文进行了快速文献回顾, 以识别与CVI儿童临床研究相关的文章。我们成立了聚焦于QTVI 的专家小组并组织关心视力丧失的慈善机构专家以解决文献综述未涵盖的领域。.