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Does visual restitution training change absolute homonymous visual field defects? A fundus controlled study.

J Reinhard1, A Schreiber, U Schiefer

  • 1University Eye Hospital, Schleichstrasse 12-16, 72076 Tübingen, Germany. jens.reinhard@med.uni-tuebingen.de

The British Journal of Ophthalmology
|December 24, 2004
PubMed
Summary

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Visual restitution training (VRT) did not significantly alter absolute homonymous field defects in hemianopia patients. A small, non-homonymous visual field improvement was noted in only one eye after training.

Area of Science:

  • Ophthalmology
  • Neuroscience
  • Visual Rehabilitation

Background:

  • Homonymous hemianopia is a visual field defect resulting from brain damage.
  • Visual field defects significantly impact daily functioning and quality of life.
  • Current treatments for homonymous hemianopia have limited efficacy.

Purpose of the Study:

  • To evaluate the effectiveness of visual restitution training (VRT) in altering absolute homonymous field defects.
  • To assess changes in visual field defects using fundus-controlled microperimetry.
  • To quantify the training effect on visual field restoration in hemianopic patients.

Main Methods:

  • A cohort of 17 patients with stable homonymous visual field defects participated.
  • Visual fields were assessed before and after a 6-month VRT period using scanning laser ophthalmoscopy (SLO).

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  • Fixation stability was monitored via SLO fundus imaging; defect size was quantified by ratio of absolute defects to test points.

    • Main Results:

    • The mean training effect (E) was minimal, with E = 0.025 (SD 0.052) for right eyes and E = 0.008 (SD 0.034) for left eyes.
    • A slight, non-homonymous visual field improvement along the horizontal meridian was observed in one patient's eye.
    • No significant or explicit homonymous changes in the absolute field defect border were detected post-training.

    Conclusions:

    • Visual restitution training (VRT) demonstrated no significant efficacy in changing absolute homonymous field defects.
    • A minor, non-specific visual field improvement occurred in one eye of a single patient.
    • The study suggests VRT is not effective for restoring homonymous visual field defects in hemianopia.