Childhood cerebral visual impairment subtype classification based on an extensive versus a limited test battery
PurposeTo classify CVI subtypes and compare the added value of an extensive test battery over a limited test battery in subtype classification of cerebral visual impairment (CVI) in children.MethodsSeventy-five children with a clinical diagnosis of CVI (median [IQR] age: 9 [7–12] years) were identif...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-10-01
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| Series: | Frontiers in Neuroscience |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnins.2023.1266201/full |
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| author | Jannet Philip Jannet Philip Bianca Huurneman Bianca Huurneman Nomdo M. Jansonius Nomdo M. Jansonius Antonius H. N. Cillessen Frouke N. Boonstra Frouke N. Boonstra Frouke N. Boonstra |
| author_facet | Jannet Philip Jannet Philip Bianca Huurneman Bianca Huurneman Nomdo M. Jansonius Nomdo M. Jansonius Antonius H. N. Cillessen Frouke N. Boonstra Frouke N. Boonstra Frouke N. Boonstra |
| author_sort | Jannet Philip |
| collection | DOAJ |
| description | PurposeTo classify CVI subtypes and compare the added value of an extensive test battery over a limited test battery in subtype classification of cerebral visual impairment (CVI) in children.MethodsSeventy-five children with a clinical diagnosis of CVI (median [IQR] age: 9 [7–12] years) were identified from the medical records. The extensive test battery included visual acuity, contrast sensitivity, ocular alignment, eye movement analysis, visual field analysis, optic nerve head evaluation, and evaluation of visual perception. The limited test battery included visual acuity, contrast sensitivity, ocular alignment, and evaluation of visual perception. Principal component analysis (PCA) followed by cluster analysis was done, for both test batteries separately, to determine the optimum subtype classification for CVI.ResultsFifty-one participants with an extensive test battery with mild to moderate visual impairment were included in the main analysis. This resulted in four CVI subtypes for the extensive test battery (subtle characteristics, higher-level visual function deficits, lower-level visual function deficits, and higher- and lower- level visual function deficits) and three CVI subtypes for the limited test battery (subtle characteristics, higher-level visual function deficits, and higher- and lower- level visual function deficits). There were significant differences between the subtypes for 9 out of 10 measures of the extensive and all 4 measures of the limited test battery (p < 0.05). The subtle characteristics subtype (extensive n = 19, limited n = 15) showed near normal lower and higher-level visual functions in both test batteries. The higher-level visual function deficits subtype (extensive n = 18, limited n = 24) showed near normal visual acuity combined with significant visual perceptual deficits in both test batteries; accompanied by visual pathways defects and abnormal eye movement behavior in the extensive test battery. The higher- and lower- level visual function deficits subtype (extensive n = 4, limited n = 12) showed both higher and lower-level visual function deficits in both test batteries, but application of the extensive test battery revealed additional visual pathways defects and abnormal eye movement behavior. The lower-level visual function deficits CVI subtype (extensive n = 10) was a new subtype identified by the extensive test battery. This subtype showed lower-level visual function deficits together with abnormal eye movement measures.ConclusionThis data-driven study has provided meaningful CVI subtype classifications based on the outcomes of various key functional and structural measures in CVI diagnosis. Comparison of the extensive test battery to the limited test battery revealed the added value of an extensive test battery in classifying CVI. The outcomes of this study, therefore, have provided a new direction in the area of CVI classification. |
| first_indexed | 2024-03-11T15:38:16Z |
| format | Article |
| id | doaj.art-91aa7d94d4724e8da3f8ddf21baf2f28 |
| institution | Directory Open Access Journal |
| issn | 1662-453X |
| language | English |
| last_indexed | 2024-03-11T15:38:16Z |
| publishDate | 2023-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neuroscience |
| spelling | doaj.art-91aa7d94d4724e8da3f8ddf21baf2f282023-10-26T13:19:58ZengFrontiers Media S.A.Frontiers in Neuroscience1662-453X2023-10-011710.3389/fnins.2023.12662011266201Childhood cerebral visual impairment subtype classification based on an extensive versus a limited test batteryJannet Philip0Jannet Philip1Bianca Huurneman2Bianca Huurneman3Nomdo M. Jansonius4Nomdo M. Jansonius5Antonius H. N. Cillessen6Frouke N. Boonstra7Frouke N. Boonstra8Frouke N. Boonstra9Royal Dutch Visio, National Foundation for the Visually Impaired and Blind, Huizen, NetherlandsBehavioural Science Institute, Radboud University, Nijmegen, NetherlandsRoyal Dutch Visio, National Foundation for the Visually Impaired and Blind, Huizen, NetherlandsDepartment of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, NetherlandsDepartment of Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, NetherlandsGraduate School of Medical Science, University Medical Center Groningen, University of Groningen, Groningen, NetherlandsBehavioural Science Institute, Radboud University, Nijmegen, NetherlandsRoyal Dutch Visio, National Foundation for the Visually Impaired and Blind, Huizen, NetherlandsBehavioural Science Institute, Radboud University, Nijmegen, NetherlandsDepartment of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, NetherlandsPurposeTo classify CVI subtypes and compare the added value of an extensive test battery over a limited test battery in subtype classification of cerebral visual impairment (CVI) in children.MethodsSeventy-five children with a clinical diagnosis of CVI (median [IQR] age: 9 [7–12] years) were identified from the medical records. The extensive test battery included visual acuity, contrast sensitivity, ocular alignment, eye movement analysis, visual field analysis, optic nerve head evaluation, and evaluation of visual perception. The limited test battery included visual acuity, contrast sensitivity, ocular alignment, and evaluation of visual perception. Principal component analysis (PCA) followed by cluster analysis was done, for both test batteries separately, to determine the optimum subtype classification for CVI.ResultsFifty-one participants with an extensive test battery with mild to moderate visual impairment were included in the main analysis. This resulted in four CVI subtypes for the extensive test battery (subtle characteristics, higher-level visual function deficits, lower-level visual function deficits, and higher- and lower- level visual function deficits) and three CVI subtypes for the limited test battery (subtle characteristics, higher-level visual function deficits, and higher- and lower- level visual function deficits). There were significant differences between the subtypes for 9 out of 10 measures of the extensive and all 4 measures of the limited test battery (p < 0.05). The subtle characteristics subtype (extensive n = 19, limited n = 15) showed near normal lower and higher-level visual functions in both test batteries. The higher-level visual function deficits subtype (extensive n = 18, limited n = 24) showed near normal visual acuity combined with significant visual perceptual deficits in both test batteries; accompanied by visual pathways defects and abnormal eye movement behavior in the extensive test battery. The higher- and lower- level visual function deficits subtype (extensive n = 4, limited n = 12) showed both higher and lower-level visual function deficits in both test batteries, but application of the extensive test battery revealed additional visual pathways defects and abnormal eye movement behavior. The lower-level visual function deficits CVI subtype (extensive n = 10) was a new subtype identified by the extensive test battery. This subtype showed lower-level visual function deficits together with abnormal eye movement measures.ConclusionThis data-driven study has provided meaningful CVI subtype classifications based on the outcomes of various key functional and structural measures in CVI diagnosis. Comparison of the extensive test battery to the limited test battery revealed the added value of an extensive test battery in classifying CVI. The outcomes of this study, therefore, have provided a new direction in the area of CVI classification.https://www.frontiersin.org/articles/10.3389/fnins.2023.1266201/fullcerebral visual impairmentchildhoodsubtypingclassificationvisual functioneye movements |
| spellingShingle | Jannet Philip Jannet Philip Bianca Huurneman Bianca Huurneman Nomdo M. Jansonius Nomdo M. Jansonius Antonius H. N. Cillessen Frouke N. Boonstra Frouke N. Boonstra Frouke N. Boonstra Childhood cerebral visual impairment subtype classification based on an extensive versus a limited test battery Frontiers in Neuroscience cerebral visual impairment childhood subtyping classification visual function eye movements |
| title | Childhood cerebral visual impairment subtype classification based on an extensive versus a limited test battery |
| title_full | Childhood cerebral visual impairment subtype classification based on an extensive versus a limited test battery |
| title_fullStr | Childhood cerebral visual impairment subtype classification based on an extensive versus a limited test battery |
| title_full_unstemmed | Childhood cerebral visual impairment subtype classification based on an extensive versus a limited test battery |
| title_short | Childhood cerebral visual impairment subtype classification based on an extensive versus a limited test battery |
| title_sort | childhood cerebral visual impairment subtype classification based on an extensive versus a limited test battery |
| topic | cerebral visual impairment childhood subtyping classification visual function eye movements |
| url | https://www.frontiersin.org/articles/10.3389/fnins.2023.1266201/full |
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