Preverbal visual assessment for screening cerebral visual impairment: Diagnostic accuracy and clinical utility.

IF 4.3 2区医学 Q1 CLINICAL NEUROLOGY

Developmental Medicine and Child Neurology Pub Date : 2025-10-06 DOI:10.1111/dmcn.70005

Karen L Harpster, Terry L Schwartz, Alaina Johnson, Reena Donofe, Li Lin, Melissa L Rice

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引用次数: 0

Abstract

Aim: To evaluate the relationship between Preverbal Visual Assessment (PreViAs) results and cerebral visual impairment (CVI) diagnosis.

Method: This single-center retrospective chart review included children who completed a CVI interdisciplinary clinic or occupational therapy vision evaluation between May 2018 and May 2023 and had a completed PreViAs. Data were extracted from the electronic medical record. Data analysis included sensitivity, specificity, area under the curve, and Fisher's exact test.

Results: Of the 205 charts screened, 98 met study criteria (81 with CVI, 17 without); ages ranged from 3 to 50 months. The mean age of children with CVI was 15.41 months (SD = 8.93) and without was 13.24 months (SD = 5.98). Among the PreViAs domains, visual processing showed the highest frequency of concern (CVI = 94%; non-CVI = 76%), while visual attention had the lowest (CVI = 72%; non-CVI = 41%). Visual processing demonstrated the highest sensitivity (93.8%), whereas visual attention showed the best balance of sensitivity (71.6%) and specificity (58.8%). Area under the curve ranged from 0.59 to 0.66. All domains demonstrated significant differences between children with and without CVI (Fisher's exact test, p < 0.05).

Interpretation: Effective screening tools are critical for detection of CVI. The PreViAs is a sensitive screening tool in children at high risk for CVI. Children with concerns on the PreViAs should be referred for an interdisciplinary CVI evaluation.

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言语前视觉评估筛查脑视觉障碍：诊断准确性和临床应用。

目的：探讨言语前视觉评估（PreViAs）结果与脑视觉障碍（CVI）诊断的关系。方法：本单中心回顾性图表回顾纳入2018年5月至2023年5月期间完成CVI跨学科临床或职业治疗视力评估并完成PreViAs的儿童。数据从电子病历中提取。数据分析包括敏感性、特异性、曲线下面积和Fisher精确检验。结果：205例病例中，98例符合研究标准（81例有CVI， 17例无CVI）；年龄从3到50个月不等。CVI患儿的平均年龄为15.41个月（SD = 8.93），无CVI患儿的平均年龄为13.24个月（SD = 5.98）。在PreViAs领域中，视觉加工的关注频率最高（CVI = 94%，非CVI = 76%），而视觉注意的关注频率最低（CVI = 72%，非CVI = 41%）。视觉处理的灵敏度最高（93.8%），而视觉注意在灵敏度（71.6%）和特异性（58.8%）之间的平衡最佳。曲线下面积为0.59 ~ 0.66。所有领域在患有和没有CVI的儿童之间显示出显著差异（Fisher精确检验，p）。解释：有效的筛查工具对于检测CVI至关重要。PreViAs是CVI高危儿童的敏感筛查工具。对PreViAs有顾虑的儿童应转诊进行跨学科的CVI评估。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Developmental Medicine and Child Neurology 医学-临床神经学

CiteScore

7.80

自引率

13.20%

发文量

338

审稿时长

3-6 weeks

期刊介绍： Wiley-Blackwell is pleased to publish Developmental Medicine & Child Neurology (DMCN), a Mac Keith Press publication and official journal of the American Academy for Cerebral Palsy and Developmental Medicine (AACPDM) and the British Paediatric Neurology Association (BPNA). For over 50 years, DMCN has defined the field of paediatric neurology and neurodisability and is one of the world’s leading journals in the whole field of paediatrics. DMCN disseminates a range of information worldwide to improve the lives of disabled children and their families. The high quality of published articles is maintained by expert review, including independent statistical assessment, before acceptance.