儿童时期的视力困难导致脑损伤,通常称为皮质或大脑视觉障碍(CVI),已经确立,但没有国际公认的定义。需要澄清其核心特征以推进研究和临床实践。本系统综述旨在确定原始科学文献中儿童CVI的定义,以描述和批判性地评估该疾病的共识定义。MEDLINE,EMBASE,心理信息,于2017年1月检索CINAHL和AMED数据库。如果研究(1)是发表的原创研究,(2)包含儿童CVI样本,(3)包含了CVI的定义和(4)描述了它们的CVI鉴定/诊断方法。主题分析确定了定义中的概念,并进行了叙述综合。在1150篇文章中,51符合纳入标准。定义根据细节进行了细分(描述性定义,描述未达到定义状态和诊断/操作标准)。关于视觉缺陷的三个主题,我们确定了眼睛健康和大脑完整性(每个包含子主题),并在定义中分别进行了分析.最常见的主题是“视力障碍”(n=20),“交叉后通路损害”(n=13)和“正常/接近正常的眼睛健康”(n=15)。这里确定的最一致的定义可能不是提高我们对CVI理解的最佳质量。我们主张另一种定义:CVI是一种可验证的视觉功能障碍,不能归因于前视觉通路的障碍或任何潜在的共同发生的眼部损害。我们提出报告指南,以允许跨研究进行比较,并增加更可靠的临床评估和诊断的证据基础。
The childhood condition of visual difficulties caused by brain damage, commonly termed cortical or cerebral visual impairment (CVI), is well established but has no internationally accepted definition. Clarification of its core features is required to advance research and clinical practice. This systematic review aimed to identify the definitions of childhood CVI in the original scientific literature to describe and critically appraise a consensual definition of the condition. MEDLINE, EMBASE, PsychINFO, CINAHL and AMED databases were searched in January 2017. Studies were included if they (1) were published original research, (2) contained a childhood CVI sample, (3) contained a definition of CVI and (4) described their CVI identification/diagnostic method. Thematic analysis identified concepts within definitions and narrative synthesis was conducted. Of 1150 articles, 51 met inclusion criteria. Definitions were subdivided according to detail (descriptive definition, description not reaching definition status and diagnostic/operationalising criteria). Three themes concerning visual deficits, eye health and brain integrity were identified (each containing subthemes) and analysed individually across definitions. The most common themes were \'visual impairment\' (n=20), \'retrochiasmatic pathway damage\'(n=13) and \'normal/near normal eye health\' (n=15). The most consensual definition identified here may not be the best quality for advancing our understanding of CVI. We argue for the alternative definition: CVI is a verifiable visual dysfunction which cannot be attributed to disorders of the anterior visual pathways or any potentially co-occurring ocular impairment. We propose reporting
guidelines to permit comparison across studies and increase the evidence base for more reliable clinical assessment and diagnosis.