Persistence of higher visual function deficits in adults with early-onset cerebral visual impairment: A comparative study

Cerebral Visual Impairment (CVI) of early onset has primarily been studied in children, but little is known about its progression into adulthood, despite CVI being recognized as a lifelong condition. This study investigates higher visual function deficits (HVFDs) in adults with early-onset CVI through a prospective controlled design. We first assessed the feasibility of an adapted HVF Question Inventory (HVFQI-59Q) in detecting HVFDs in adults with CVI compared to neurotypical (NT) adults (ANTs, n = 67). We then compared HVFD patterns in adults with early-onset CVI (A-Early Onset, n = 29), adults with late-onset brain injury (A-Late Onset, n = 22), and a previously interviewed cohort of children with CVI (n = 92) and child neurotypicals (n = 120). The HVFQI-59Q was used to evaluate the spectrum and severity of HVFDs across the adult groups. Results showed HVFDs are present in A-Early Onset, with similarities and distinct differences compared to children. The A-Late Onset group exhibited a broader range of deficits and lower median values, suggesting more variability in visual impairments. These findings confirm that HVFDs persist into adulthood and that late-onset brain injuries may result in HVFDs similar to CVI, challenging previous assumptions about localized effects and the need for a review of terminology for A-Late Onset, highlighting the need for further research in the adult group. The study underscores the importance of continuous CVI evaluation across the lifespan and supports the HVFQI-59Q as an effective clinical tool for detecting HVFDs.