Abstract
Purpose:
To evaluate the benefit of visual training on the central visual field using luminance variance designed to up regulate non-magnocellular function in patients with central field deficits secondary to cortical neuronal damage in the form of an easily accessible video game made for athletic enhancement.
Methods:
A PC-based baseball batting video game was modified by overlying an algorithm designed to focus on depression of the central 10 degrees of the visual field. Specifically, the baseball became a red stimulus, and using technology based on static perimetry methodology, a binary staircase bracketing was used to vary luminance of the red baseball stimulus against a blue or green background. Visual fields were performed by patient A, an 89 year old patient with a visual acuity of OD 20/20-2, OS 20/25 and a stable left homonymous quadrantanopsia secondary to a right occipital lobe cerebrovascular attack. Visual fields were also performed by patient B, a 66 year old patient with a visual acuity of OD HM, OS 20/25- and junctional scotoma secondary to craniopharyngioma resection. They were instructed to play the modified baseball games daily for 30 minutes for 3 months. Subjective visual improvement and repeat visual fields were performed at three month follow-up.
Results:
Both patients expressed subjective visual improvement in their central vision especially in darker environments compared to brightly lit environments. Visual acuity in patient A changed to OU 20/30, but the visual field parameters and individual central performance improved on repeat visual field. PSD improved from 14.89dB to 12.22dB. Visual acuity in patient B changed to OD CF 8’, OS 20/40+2. Visual field parameters and central performance also improved for this patient. PSD improved from 14.18dB to 13.38dB.
Conclusions:
Our early results from this 3 month follow-up indicate central field depression using luminance variance to up regulate non-magnocellular function may increase contrast sensitivity and visual perception in areas of prior cortical visual loss. Central visual acuity may decrease although it is hard to elucidate in this early comparison, but patient’s overall subjective functional vision improved with the use of this algorithm overlaid in a easy to play, home PC-based batting video game.
Keywords: 759 visual impairment: neuro-ophthalmological disease •
611 neuro-ophthalmology: cortical function/rehabilitation •
584 low vision