Cortical Visual Impairment, Visual Function
Conditions
Keywords
Cortical Visual Impairment, Visual Function, Nasal Mesenchymal Exosome, Exosome
Brief summary
The goal of this observational study is to learn about the effects of nazally applied exosome treatment on visual functions in children with Phase 1 Cerebral visual impairment (CVİ). The main question it aims to answer is: Does exosome therapy administered via the nasal route for neurological disorders in children with Phase 1 CVI also show a beneficial effect on visual functions? Researchers will compare visual and visual function findings before and after the exosome application to determine whether the exosome application is also effective in visual function. Participants: * They will receive exosomes via the nasal route every month for 6 months. * They will visit the clinic every month for monitoring and tests.
Detailed description
Purpose Cortical visual impairment (CVI) denotes a pediatric visual deficit arising from non-ocular etiologies, purportedly linked to perturbations in visual cortical processing regions. This syndrome characteristically ensues from perinatal insults-such as asphyxia, prematurity, neonatal hypoglycemia, or hypoxia-inflicting damage upon retro-geniculate visual pathways and cortical centers. Empirical evidence underscores cerebral neuroplasticity, facilitating reorganization despite congenital retro-geniculate lesions; nonetheless, CVI manifests heterogeneous visual and cognitive sequelae. With 17% of neonates necessitating intensive care, advancements in neonatal care have augmented survival, concomitantly escalating the prevalence of neurodevelopmental disorders including CVI and cerebral palsy (CP), thereby spurring investigational reparative modalities such as stem cell and molecular therapeutics. Methods This investigation prospectively enrolled 32 children aged 0.6-13 years diagnosed with CVI, who received intranasal exosome therapy (5 × 10\^6 particles/dose) between 2023 and 2024. Administration occurred in 4-6 iterations at monthly intervals. Comprehensive neuro-ophthalmic evaluations encompassed dynamic retinoscopy, preferential looking assessments (LEA and Cardiff cards) for visual acuity and Visual Function Index, alongside surveillance of ventral stream deficits (e.g., delayed gaze, complexity aversion) and dorsal stream impairments (e.g., visuomotor orienting). Statistical analyses employed IBM SPSS Statistics version 25.0 (IBM Corp., Armonk, NY, USA).
Interventions
Derived from mesenchymal stem cells, exosomes are nano-scale vesicles characterized by their regenerative and anti-inflammatory capabilities. These vesicles can traverse the blood-brain barrier to transport functional cargo, including lipids, mRNA, and proteins, to target cells. Over the course of 12 months, volunteers were administered 5 million units of exosomes in 7 ml via nasal spray once a month for a total of 4-6 doses, with an infusion rate of 1 ml per hour.
Sponsors
Hatice Semrin Timlioglu İper
Study design
Observational model
COHORT
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
12 Months to 34 Months
Healthy volunteers
No
Inclusion criteria
* Phase I Cerebral Palsy and Cortical Visual Impairment * During the 12 months period recieved 4-6 times intranasal exosome
Exclusion criteria
* Irregular follow-up * Abondened the study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Whether exosome therapy combined with standardized neuro-visual rehabilitation improves functional vision outcomes compared to rehabilitation plus placebo. | Up to 1 year | Change in Visual Function Index (VFI) total score The total score for visual function is 15, comprising the sum of 13 functions, each worth 1 point, and fixation, which is worth 2 points. Missing functions are scored as 0. |
| Primary Objective ( Safety) | Up to 1 year | To evaluate the advers effects of repeated intranasal exosome administration in pediatric patients with CVI over a 12-week treatment period. Epileptic attack Allergic reactions Treatment discontinuation due to adverse events |
| Affected Visual fields (Totally impaired /delayed) | Up to 1 year | Impaired Visual Field Before, n (%) 0/1 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Exploratory Objectives (Neuroplasticity Mechanisms) | Up to 1 year | Quantification of "Delayed Field → Functional Field" transition rate |
Countries
Turkey (Türkiye)
Outcome results
None listed