Evaluation of Behavioral Characteristics in Response to Visual Stimuli in Infants with Cerebral Visual Impairment.

Objectives: To evaluate the behavioral characteristics of infants with cerebral visual impairment (CVI) in response to visual stimuli and the frequency of these features.

Materials and methods: In this retrospective study, 32 infants aged 8-37 months who were referred to the low vision unit in 2019-2021 and diagnosed with CVI based on their demographic characteristics, systemic findings, and standard and functional visual examinations were evaluated. The frequency of ten behavioral characteristics exhibited by infants with CVI in response to visual stimuli as defined by Roman-Lantzy was examined in the patients.

Results: The mean age was 23.46±11.45 months, the mean birth weight was 2,550±944 g, and the mean gestational age at birth was 35.39±4.68 weeks. There was hypoxic-ischemic encephalopathy in 22%, prematurity in 59%, periventricular leukomalacia in 16%, cerebral palsy in 25%, epilepsy in 50%, and strabismus in 68.7% of the patients. Color preference for fixation was observed in 40% and visual field preference was observed in 46% of the patients. The most preferred color was red (69%) and the most preferred visual field was right visual field (47%). Difficulty with distance viewing was observed in 84% of patients, visual latency in 72%, need for movement in 69%, absence of visually guided reach in 69%, difficulty with visual complexity in 66%, difficulty with visual novelty in 50%, light-gazing/nonpurposeful gaze in 50%, and atypical visual reflexes in 47%. There was no fixation in 25% of the patients.

Conclusion: Behavioral characteristics in response to visual stimuli were observed in most infants with CVI. Knowing and recognizing these characteristic features by ophthalmologists will assist in early diagnosis, referral to visual habilitation, and planning habilitation techniques. These characteristic features are important in order to not miss this critical period in which the brain is still plastic and good responses to visual habilitation can be obtained.