Cortical Visual Impairment has a multifactorial etiology and how it affects the dorsal and ventral visual systems determines the clinical outcome.

1. PATHOLOGY IN CVI
Dr. B.A.Maithri
Senior Resident
Dept of Ophthalmology
CMC,Vellore

8. Causes of “insult” to brain
■ Development of CVI depends on:
1. Stage of brain development when the insult happens
2. Severity of the insult
3. Duration of the insult

9. ■ Hypoxic-ischemia
■ Pre-maturity
■ Epilepsy
■ Localised infarction
■ Chromosomal/Metabolic disorders
■ Congenital brain malformations – Holoprosencephaly, Hydrocephalus,
Septo-optic dysplasia
■ Neonatal hypoglycemia
■ Trauma
■ Infections – Meningitis, Encephalitis

10. ■ Vascular supply in an infant: Major cerebral arteries,
■ Watershed areas lie at the interfaces between the major
cerebral arterial distributions.
■ Mild degrees of hypoxic-ischemic injury produce watershed
infarctions in the arterial border zones, injuring both gray and
white matter and resulting in cortical visual loss.

11. White Matter Disease of Immaturity
■ Ischaemic brain injury
■ Mostly affects pre-term infants
■ White matter gliosis
■ Seen around the ventricles
■ Spastic cerebral palsy with or without epilepsy

12. DecreasedO2 to brain
Disappearance/degeneration
of brain tissue (grey/white
matter)
Replaced by cystic fluid filled
areas
PVL/Encephalomalacia/WMDI Cerebral atrophy

13. Intellectual
disability Microcephaly
Spastic
di/tri/quadriplegia
CVI

14. Normal PVL

16. Encephalomalacia

17. PolymicrogyriaNormal

18. Parietal lobe scarring

19. Cortical atrophy

20. Cerebral infarct

21. Holoprosencephaly

23. Take Home
■ CVI depends on time, severity and duration of insult to brain
■ Clinical features depend on location of insult
■ Knowing the pathogenesis will help in targeted therapy

24. THANKYOU