Preliminary Study of Short-Term Visual Perceptual Training Based on Virtual Reality and Augmented Reality in Postoperative Strabismic Patients

Yang, Xubo; Fan, Yuchen; Chu, Hsin‐Sen; Li, Yan; Wiederhold, Brenda K.; Wiederhold, Mark D.; Liao, Yong-chuan

doi:10.1089/cyber.2022.0113

Cited by 6 publications

(5 citation statements)

References 37 publications

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“…Based on previous findings and our subgroup results, we suggest that functional alterations after strabismus surgery differ across individuals and surgery alone may not be sufficient to induce functional plasticity in some patients. Previous prospective studies of perceptual training after surgery demonstrated more improvement in stereoacuity when compared with surgery alone [ 65 , 66 ]. Therefore, the combination of surgical correction with some newly-developed strategies may be promising to promote functional plasticity in higher-level visual areas [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Cortical Deficits are Correlated with Impaired Stereopsis in Patients with Strabismus

Zhou

Yao

et al. 2022

Neurosci. Bull.

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In this study, we explored the neural mechanism underlying impaired stereopsis and possible functional plasticity after strabismus surgery. We enrolled 18 stereo-deficient patients with intermittent exotropia before and after surgery, along with 18 healthy controls. Functional magnetic resonance imaging data were collected when participants viewed three-dimensional stimuli. Compared with controls, preoperative patients showed hypoactivation in higher-level dorsal (visual and parietal) areas and ventral visual areas. Pre- and postoperative activation did not significantly differ in patients overall; patients with improved stereopsis showed stronger postoperative activation than preoperative activation in the right V3A and left intraparietal sulcus. Worse stereopsis and fusional control were correlated with preoperative hypoactivation, suggesting that cortical deficits along the two streams might reflect impaired stereopsis in intermittent exotropia. The correlation between improved stereopsis and activation in the right V3A after surgery indicates that functional plasticity may underlie the improvement of stereopsis. Thus, additional postoperative strategies are needed to promote functional plasticity and enhance the recovery of stereopsis.

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Section: Discussionmentioning

confidence: 99%

Cortical Deficits are Correlated with Impaired Stereopsis in Patients with Strabismus

Zhou

Yao

et al. 2022

Neurosci. Bull.

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“…The sample size was calculated based on the primary outcome (stereopsis at distance), the mean difference of stereoacuity at distance was expected to be 0.3 log arcsec between two groups with a common standard deviation of 0.2 log arcsec from previous studies [ 7 , 16 , 17 ]. After allowing for a maximum dropout rate of 20% during the 6 months follow-up, a sample size of 12 per group calculated using PASS 2021 (NCSS, LLC, Kaysville, UT, USA) was required to achieve 80% power at a two-sided significance level of 0.05 based on a two-sample t test.…”

Section: Methodsmentioning

confidence: 99%

“…Some studies had revealed that although surgery corrected the eye position, a subset of patients did not experience restoration of binocular functions such as fusion and stereopsis [3][4][5][6], highlighting the need for postoperative visual function rehabilitation. Traditional vision training methods, which typically utilized devices such as synoptophore, vectorgrams, and stereoscopes, were criticized for being repetitive and dull, leading to low adherence among patients [7].…”

Section: Introductionmentioning

confidence: 99%

“…Tan et al demonstrated that virtual reality-based binocular dichoptic training could ameliorate the perceptual eye position in children who had accepted strabismus surgery for correcting intermittent exotropia, indicating the potential of this intervention for improving binocular visual functions [ 6 ]. Similarly, Yang et al found that short-term visual training using virtual reality or augmented reality could effectively improve stereopsis in patients with strabismus postoperatively, though the longevity of these improvements has yet to be determined [ 7 ]. Moreover, integrating video games into the training paradigms in these studies has rendered the process more captivating and engaging, offering an interactive and motivational platform for treatment.…”

Section: Introductionmentioning

confidence: 99%

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Impact of Online Video Game-Based Dichoptic Training on Binocular Vision Rehabilitation in Post-surgical Patients with Intermittent Exotropia

Qiu,

Zhou,

et al. 2024

Ophthalmol Ther

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Introduction Dichoptic training has emerged as a promising rehabilitation approach for improving binocular visual function in patients with strabismus. A prospective observational study design was employed to assess the effectiveness of online video game-based dichoptic training in rehabilitating binocular visual function in patients who had undergone an operation for intermittent exotropia. Methods A total of 64 patients who had undergone an operation for intermittent exotropia were recruited and divided into the training group and the control group based on whether they would receive the dichoptic training. The dichoptic training was conducted for 3 months in the training group and the control group would not accept any form of orthoptic therapy. Assessments of binocular visual functions and deviation were conducted at baseline, 3-month and 6-month follow-up. Results Twenty-nine participants in the training group (mean 9.69 ± 2.66 years old) and 26 participants in the control group (mean 8.41 ± 2.64 years old) completed follow-up. At both 3- and 6-month follow-ups, the training group showed superior distance stereopsis compared to the control group, with near stereopsis only showing significant difference at the 6-month follow-up. Additionally, the training group exhibited significantly less distance exo-deviation drift than the control group at these times, and no significant difference was observed in near exo-deviation drift between the groups. The control group had a significantly higher rate of suboptimal surgical outcomes at both the 3- and 6-month follow-up. However, no significant differences were observed in simultaneous perception and fusion functions between the two groups. Conclusions Online video game-based dichoptic training has the potential to become a novel postoperative rehabilitation strategy for patients with intermittent exotropia. Supplementary Information The online version contains supplementary material available at 10.1007/s40123-024-00978-z.

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“…XR has also recently been applied to the treatment of strabismus. A feasibility study of 20 minutes of VR and AR training of binocular vision in postoperative strabismus ( Yang et al, 2022 ) resulted in a small (3%–6%) improvement in stereoacuity, which is not clinically significant. A 6-month study of dichoptic VR training resulted in improved eye position (measured both subjectively and objectively), and in some patients acquisition of stereopsis ( Li et al, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

Applications and implications for extended reality to improve binocular vision and stereopsis

Levi

2023

Journal of Vision

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Extended reality (XR) devices, including virtual reality (VR), augmented reality (AR), and mixed reality (MR) devices, are immersive technologies that can swap or merge the natural environment with virtual content (e.g., videogames, movies, or other content). Although these devices are widely used for playing videogames and other applications, they have one distinct feature that makes them potentially very useful for the measurement and treatment of binocular vision anomalies—they can deliver different content to the two eyes simultaneously. Indeed, horizontally shifting the images in the two eyes (thereby creating binocular disparity) can provide the user with a compelling percept of depth through stereopsis. Because these devices are stereoscopic, they can also be used as high-tech synoptophores, in which the images to the two eyes differ in contrast, luminance, size, position, and content for measuring and treating binocular anomalies. The inclusion of eye tracking in VR adds an additional dimension to its utility in measuring and treating binocular vision anomalies, as well as other conditions. This paper describes the essential requirements for testing and treating binocular anomalies and reviews current studies in which XR devices have been used to measure and treat binocular vision anomalies.

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Preliminary Study of Short-Term Visual Perceptual Training Based on Virtual Reality and Augmented Reality in Postoperative Strabismic Patients

Cited by 6 publications

References 37 publications

Cortical Deficits are Correlated with Impaired Stereopsis in Patients with Strabismus

Cortical Deficits are Correlated with Impaired Stereopsis in Patients with Strabismus

Impact of Online Video Game-Based Dichoptic Training on Binocular Vision Rehabilitation in Post-surgical Patients with Intermittent Exotropia

Applications and implications for extended reality to improve binocular vision and stereopsis

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