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  • Title: Visual impairment in children with spastic cerebral palsy measured by psychophysical and electrophysiological grating acuity tests.
    Author: Costa MF, Ventura DF.
    Journal: Dev Neurorehabil; 2012; 15(6):414-24. PubMed ID: 23030659.
    Abstract:
    BACKGROUND: This study measured grating visual acuity in 173 children between 6-48 months of age who had different types of spastic cerebral palsy (CP). METHOD: Behavioural acuity was measured with the Teller Acuity Cards (TAC) using a staircase psychophysical procedure. Electrophysiological visual acuity was estimated using the sweep VEP (sVEP). RESULTS: The percentage of children outside the superior tolerance limits was 44 of 63 (69%) and 50 of 55 (91%) of tetraplegic, 36 of 56 (64%) and 42 of 53 (79%) of diplegic, 10 of 48 (21%) and 12 of 40 (30%) of hemiplegic for sVEP and TAC, respectively. For the sVEP, the greater visual acuity deficit found in the tetraplegic group was significantly different from that of the hemiplegic group (p<0.001). In the TAC procedure the mean visual acuity deficits of the tetraplegic and diplegic groups were significantly different from that of hemiplegic group (p<0.001). The differences between sVEP and TAC means of visual acuity difference were statistically significant for the tetraplegic (p<0.001), diplegic (p<0.001), and hemiplegic group (p=0.004). DISCUSSION: Better visual acuities were obtained in both procedures for hemiplegic children compared to diplegic or tetraplegic. Tetraplegic and diplegic children showed greater discrepancies between the TAC and sVEP results. Inter-ocular acuity difference was more frequent in sVEP measurements. CONCLUSIONS: Electrophysiologically measured visual acuity is better than behavioural visual acuity in children with CP.
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