Clinical and epidemiological characterization of visually impaired patients due to neuro-ophthalmologic alterations

Background
Several neurological pathologies affect visual functions (transitorily or permanently). However, the magnitude and epidemiological behavior of these as potential causes of low vision and blindness are unknown. This study aims to characterize patients clinically and epidemiologically with visual impairment secondary to neuro-ophthalmologic alterations treated in neuro-ophthalmologic consultation in a reference center in Medellín.

Methodology
A retrospective cross-disciplinary study that assesses the patients with visual impairment secondary to neuro-ophthalmologic alterations treated in neuro-ophthalmologic consultation between 2015 and 2018.

Results
Of 3313 clinical records reviewed, 140 patients met the eligibility criteria. Median age of diagnosis was 47 years of age (RI: 37.5–45.7) due to its heterogeneous distribution it was determined to group them into those under 18 years of age (35/140; 25%) and adults (105/140; 75%). 108/140 (77.1%) patients had non-ophthalmologic comorbidities, being the cardiovascular disease the most frequent. The main and more prevalent neuro-ophthalmologic diagnosis was optic atrophy (112/140; 80%). According to the visual deficiency category, the majority (61/140; 43.6%) presented a moderate visual deficiency. In adults, moderate visual deficiency was the most frequent, while in the group under 18 years of age, it was blindness. 41/140 (29.3%) were on a visual rehabilitation process and only 3/140 (2.1%) of them had disability certificates.

Conclusion
In this cohort, it is observed that neurological alterations are etiologies of permanent visual deficiencies leading to visual impairment, being optic atrophy, the main neuro-ophthalmologic cause identified, causing in most cases, moderate visual deficiency in adults and blindness in individuals under 18 years of age.