Should Visual Restoration Therapy be Used in Patients With Visual Field Loss?

Miller, Neil R.; Subramanian, Prem S.

doi:10.1097/wno.0000000000000252

Cited by 4 publications

(2 citation statements)

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“…The traditional compensatory approach included sensory rehabilitation, orientation, mobility, and environmental adaptations, which mainly helped with functional gains but not the visual function. On the other hand, visual restorative therapy (e.g., using light stimuli) is proven to improve or restore the vision through stimulation of remaining viable neurons adjacent to the damaged cerebral cortex, redirection of the visual processing via alternate pathways, or a combination of these processes based on the concept of neuroplasticity [5].…”

Section: Discussionmentioning

confidence: 99%

Post-traumatic Anton’s Syndrome and Its Rehabilitation Challenges: A Case Report

Andiappan

2021

IRJ

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Objectives: Anton’s syndrome is a rare clinical phenomenon characterized by acquired cortical blindness without the self-awareness of blindness. Patients with this syndrome tend to deny their visual deficits. The literature on the rehabilitation of individuals with Anton’s syndrome is sparse. Methods: We describe a 26-year-old patient who developed Anton’s syndrome in the background of anterior visual tract damage and multiple intracranial bleedings after traumatic brain injury. He presented with visual agnosia and confabulations that were only detected 2 months after trauma. He received 4 months of multidisciplinary rehabilitation care as an outpatient. His comprehensive program consisted of (a) compensatory strategies, (b) restorative strategies, and (c) counseling sessions. Although he showed significant improvement in terms of functional gain with rehabilitation, he still had visual deficits with occasional visual anosognosia that required 24-h supervision. Conclusion: Anton’s syndrome in traumatic brain injury should not be overlooked. A prompt diagnosis is vital to initiate appropriate rehabilitation measures.

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Section: Discussionmentioning

confidence: 99%

Post-traumatic Anton’s Syndrome and Its Rehabilitation Challenges: A Case Report

Andiappan

2021

IRJ

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“…[8][9][10][11][12][13][14] Other studies, in contrast, did not find (significant) effects and hypothesise about the potential influence of eye movements on the validity of visual field diagnosis [15][16][17][18] -hence the effect of neuropsychological trainings is still controversially discussed. [19][20][21][22][23] Thus, a reliable tool for visual field diagnostics is required to achieve robust and credible evidence for the effects of restitution trainings, in particular, and for the issue of neuroplasticity within the visual cortex, in general. Ideally, such a perimetric tool would be objective, highly reliable and it should preclude compensation strategies.…”

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confidence: 99%

Eye-tracking-based visual field analysis (EFA): a reliable and precise perimetric methodology for the assessment of visual field defects

et al. 2021

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ObjectiveSeveral studies report evidence for training-related neuroplasticity in the visual cortex, while other studies suggest that improvements simply reflect inadequate eye fixation control during perimetric prediagnostics and postdiagnostics.Methods and analysisTo improve diagnostics, a new eye-tracking-based methodology for visual field analysis (eye-tracking-based visual field analysis (EFA)) was developed. The EFA is based on static automated perimetry and additionally takes individual eye movements in real time into account and compensates for them. In the present study, an evaluation of the EFA with the help of blind spots of 58 healthy participants and the individual visual field defects of 23 clinical patients is provided. With the help of the EFA, optical coherence tomography, Goldmann perimetry and a Humphrey field analyser, these natural and acquired scotomas were diagnosed and the results were compared accordingly.ResultsThe EFA provides a SE of measurement of 0.38° for the right eye (OD) and 0.50° for the left eye (OS), leading to 0.44° of visual angle for both eyes (OU). Based on participants’ individual results, the EFA provides disattenuated correlation (validity) of 1.00 for both OD and OS. Results from patients suffering from cortical lesions and glaucoma further indicate that the EFA is capable of diagnosing acquired scotoma validly and is applicable for clinical use.ConclusionOutcomes indicate that the EFA is highly reliable and precise in diagnosing individual shape and location of scotoma and capable of recording changes of visual field defects (after intervention) with unprecedented precision. Test duration is comparable to established instruments and due to the high customisability of the EFA, assessment duration can be shortened by adapting the diagnostic procedure to the patients’ individual visual field characteristics. Therefore, the saccade-compensating methodology enables researchers and healthcare professionals to rule out eye movements as a source of inaccuracies in pre-, post-, and follow-up assessments.

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