Affiliations: Institute of Medical Psychology, Medical Faculty,
Otto-von-Guericke University of Magdeburg, Magdeburg, Germany | Department of Neurology, Bergmannstrost Halle/Saale,
Germany | Tananbaum Stroke Center, Neurological Institute, New
York, USA | Div. Stroke Medicine, City Hospital, University of
Nottingham, Nottingham, UK
Note: [] Corresponding author: Iris Mueller, Institute of Medical
Psychology, Otto-von-Guericke University of Magdeburg, Leipziger Str. 44,
D-39120 Magdeburg, Germany. Tel.: +49 391 611 7100; Fax: +49 391 611 7103;
E-mail: [email protected]
Abstract: Purpose: In small experimental trials, vision restoration therapy
(VRT), a home-based rehabilitation method, has shown to enlarge the visual
field and improve reaction times in patients with lesion involving the CNS. We
now evaluated the outcome of VRT in a large sample of clinical patients and
studied factors contributing to subjective and objective measures of visual
field alterations. Methods: Clinical observational analysis of visual
fields of 302 patients before and after being treated with computer-based
vision restoration therapy for a period of 6 months at eight clinical centers
in central Europe. The visual field defects were due to ischemia, hemorrhage,
head trauma, tumor removal or anterior ischemic optic neuropathy. Primary
outcome measure was a visual field assessment with super-threshold perimetry.
Additionally, conventional near-threshold perimetry, eye movements and
subjective reports of daily life activities were assessed in a subset of the
patients. Results: VRT improved patients' ability to detect
super-threshold stimuli in the previously deficient area of the visual field by
17.2% and these detection gains were not significantly correlated with eye
movements. Notable improvements were seen in 70.9% of the patients. Efficacy
was independent of lesion age and etiology, but patients with larger areas of
residual vision at baseline and patients > 65 years old benefited most.
Conventional perimetry validated visual field enlargements and patient
testimonials confirmed the improvement in every day visual functions. Conclusions: VRT improves visual functions in a large clinical sample of
patients with visual field defects involving the CNS, confirming former
experimental studies.
