June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Baseline mobility measures and patient perceptions in stroke induced hemianopia
Author Affiliations & Notes
  • Claire Howard
    Health Sciences Research, University of Liverpool, Liverpool, United Kingdom
  • Fiona J Rowe
    Health Sciences Research, University of Liverpool, Liverpool, United Kingdom
  • Footnotes
    Commercial Relationships   Claire Howard, None; Fiona Rowe, None
  • Footnotes
    Support  NIHR fellowship CDRF 2015-01-013
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 5130. doi:
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      Claire Howard, Fiona J Rowe; Baseline mobility measures and patient perceptions in stroke induced hemianopia. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5130.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To determine whether correlations exist between baseline mobility measures and patient perceptions when assessing levels of adaptation to post-stroke hemianopia.

Methods : Stroke survivors with homonymous hemianopia were identified within four weeks of onset. Subjects undertook the validated mobility assessment course (MAC) to measure the extent to which they scan the environment visually and identify hazards when navigating. The MAC consists of 24 visual markers on both sides of the visual world at varying heights, as well as obstacles for hazard perception. Subjects were timed, recording number of visual targets identified as well as obstacle collision and ability to follow directional arrows. Subjects’ perception of their level of adaptation to visual impairment was measured using direct questioning and activity of daily living questionnaires including visual function questionnaire NEI VFQ-25 and the EQ-5D tool.

Results : 5 subjects with mean age 70.8 years (SD=13.6) were assessed (2 male:3 female). During the MAC, for subjects with isolated hemianopia (n=4), the majority of targets (mean=83.5%, SD=11.8) were seen on the hemianopic side despite a subjective patient perception that they had not adapted to the loss of vision. Conversely, where inattention was also present (n=1), the subject missed the majority of targets on the affected side (8% of targets seen) despite reporting no symptoms.

Conclusions : Early recruitment results suggest that the MAC has potential as a clinical tool for the assessment of adaptation status to visual impairment. The course has not previously been used for this purpose. A person is said to have adapted to their visual defect when there is no evidence of impaired daily living as well as full awareness of the defect. However, the adaptation process has not been previously explored and requires investigation in order to understand its mechanisms. Our continued research will follow hemianopic subjects and we hypothesise that, over time, subjects showing successful adaptation will: 1) complete the timed MAC in a reduced time, 2) report a reduction in symptoms and 3) report a subjective expression of adaptation. We hypothesise that subjects with combined inattention and hemianopia who adapt over time will complete the MAC with increased identification of targets as they adapt.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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