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Vision- and health-related quality of life before and after vision restoration training in cerebrally damaged patients

Issue title: Visual Plasticity, Restoration and Rehabilitation

Article type: Research Article

Authors: Gall, Carolin | Mueller, Iris | Gudlin, Julia | Lindig, Anja | Schlueter, Dorothee | Jobke, Sandra | Franke, Gabriele H. | Sabel, Bernhard A.

Affiliations: Otto-von-Guericke University of Magdeburg, Medical Faculty, Institute of Medical Psychology, Magdeburg, Germany | NovaVision AG, Magdeburg, Germany | University of Applied Sciences Magdeburg-Stendal, AHW, Department of Rehabilitation Psychology, Stendal, Germany

Note: [] Address for correspondence: Carolin Gall, Institute of Medical Psychology, Leipziger Str. 44, 39120 Magdeburg, Germany. Tel.: +49 391 6721807; Fax: +49 391 6721803; E-mail: [email protected]

Keywords: Quality of life, visual field defect, National Eye Institute Visual Function Questionnaire (NEI-VFQ)

Journal: Restorative Neurology and Neuroscience, vol. 26, no. 4-5, pp. 341-353, 2008

Received 24 October 2008
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Accepted 24 October 2008
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Published: 2008
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Abstract

Purpose: The aim of the study was to examine if improvements of stimulus detection performance in visual field tests after intensive visual training of the visual field border zone in patients with visual field defects are associated with changes in self-reported vision- and health-related quality of life (QoL).

Methods: We studied a clinical sample of 85 patients suffering from visual field loss after brain damage that underwent repetitive, daily light stimulation (vision restoration training, VRT) of the visual field border and the blind visual field for up to 75 hrs (N = 16) or 150 hrs (N = 69). Stimulus detection was quantified in the central visual field with a campimetric method before and after intervention. Health-related QoL was assessed by the Health-Survey SF-36 and vision-related QoL by the 39-item National Eye Institute Visual Function Questionnaire (NEI-VFQ).

Results: Both vision- and health-related QoL measures improved after VRT. Significant increases were found in 8 out of 12 NEI-VFQ and 3 out of 8 SF-36 subscales. Of the 85 participants 6% showed a decrease in stimulus detection performance, 42% showed an increase of less than 5% detected stimuli, 24% showed an increase of 5–10% detected stimuli and 28% of more than 10% detected stimuli. Changes in campimetric stimulus detection rates were related to NEI-VFQ subscales point differences general vision (3 points), difficulty with near vision activities (4 points), limitations in social functioning due to vision (4 points) and driving problems (12 points). There was no relation of visual field changes to changes in SF-36 component and subscale scores.

Conclusions: The NEI-VFQ is a valuable measure of self-reported visual impairment in patients with visual field defects. Stimulation of the visual field by training may lead to improvements of vision-related QoL which were correlated with the extent of visual field enlargements.

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