December 2002
Volume 43, Issue 13
Free
ARVO Annual Meeting Abstract  |   December 2002
Visual Restitution Training (VRT) in Patients With Homonymous Field Defects: Improvements of Subjective Vision and Their Relation to Reaction Time, Visual Field Enlargements and Eye Movements
Author Affiliations & Notes
  • BA Sabel
    Institute Medical Psychology University Magdeburg Med Sch Magdeburg Germany
  • S Kenkel
    Institute Medical Psychology University Magdeburg Med Sch Magdeburg Germany
  • A Schreiber
    University Eye Hospital Tuebingen Germany
  • U Schiefer
    University Eye Hospital Tuebingen Germany
  • J Reinhard
    University Eye Hospital Tuebingen Germany
  • S Trauzettel-Klosinski
    University Eye Hospital Tuebingen Germany
  • C Connert
    University Eye Hospital Tuebingen Germany
  • E Kasten
    Institute Medical Psychology University Magdeburg Med Sch Magdeburg Germany
  • Footnotes
    Commercial Relationships    B.A. Sabel, NovaVision AG P; S. Kenkel, NovaVision AG E; A. Schreiber, None; U. Schiefer, None; J. Reinhard, None; S. Trauzettel-Klosinski, None; C. Connert, None; E. Kasten, NovaVision AG P. Grant Identification: DFG KA1409/1-1 and BMBF
Investigative Ophthalmology & Visual Science December 2002, Vol.43, 229. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      BA Sabel, S Kenkel, A Schreiber, U Schiefer, J Reinhard, S Trauzettel-Klosinski, C Connert, E Kasten; Visual Restitution Training (VRT) in Patients With Homonymous Field Defects: Improvements of Subjective Vision and Their Relation to Reaction Time, Visual Field Enlargements and Eye Movements . Invest. Ophthalmol. Vis. Sci. 2002;43(13):229.

      Download citation file:


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

      ×
  • Supplements
Abstract

Abstract: : Purpose: Visual field defects (VFD) after brain damage have been considered to be non-treatable, but training residual vision using visual restitution training (VRT, Kasten et al., Nature med. 4, 1998, p. 1083) reportedly enlarge the visual field. We now studied whether VRT has benefits in every day life as subjectively reported by patients. Methods: 17 patients with homonymeous VFD were included in an open pilot trial. VFD were caused by cerebral ischemia or haemorrhage (lesion age ≷1 yr.). To assess subjective vision before and after a 6- months VRT-training (daily for 1 hr.), patients were asked to fill out a standardized questionnaire, and semi-structured interviews were conducted by two independent observers. These results were correlated with perimetric/campimetric procedures (see Kasten, Schreiber and Reinhard abstracts, ARVO 2002). Results: In 14 patients questionnaires revealed subjective improvements due to VRT. In the interviews, 13 patients reported highly specific improvements of activities of daily life such as reading, watching TV, driving a car, shopping in supermarkets etc. Subjective improvements did not correlate with performance gains in campimetry, (r= 0.43, trend at p=0.12) nor with fixation accuracy as assessed by detection of minor color changes of the fixation point (r= -0.176, p=0.5). The latter finding is at variance with the proposal that eye movements alone cause apparent visual field enlargements. Reaction significantly improved due to VRT from 435 ms to 409 ms, which correlated significantly with subjective improvements (r=0.55, p<0.03). Conclusion: Patients benefit subjectively from visual restitution training in every day life. Because these improvements correlate only slightly with increased detection ability in campimetry but more with improved reaction times, we now propose that the primary effect of VRT is to improve temporal processing of residual vision. This may explain why patients without visual field enlargements sometimes still experience subjective improvements of vision. Thus, restoration of vision is primarly mediated by plasticity of neuronal processing in time.

Keywords: 485 neuro-ophthalmology: cortical function/rehabilitation • 624 visual fields • 511 perimetry 
×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×