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Driving Simulation in the Clinic: Testing Visual Exploratory Behavior in Daily Life Activities in Patients with Visual Field Defects
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Interventions for visual field defects in people with stroke.

Alex Pollock1, Christine Hazelton, Fiona J Rowe

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Visual field defects after stroke impact daily life and quality of life. While scanning training may improve quality of life, evidence for other interventions remains limited, necessitating further research.

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Area of Science:

  • Neuroscience
  • Ophthalmology
  • Rehabilitation Medicine

Background:

  • Visual field defects affect a significant portion of stroke survivors, impacting daily activities, quality of life, and mental health.
  • Interventions aim to restore vision, compensate for loss through behavioral changes, or substitute with devices.

Purpose of the Study:

  • To evaluate the effectiveness of various interventions for visual field defects in post-stroke individuals.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials.
  • Searched multiple databases including Cochrane, MEDLINE, Embase, and clinical trial registries up to May 2018.
  • Included studies focused on interventions targeting visual field defects or coping strategies, with outcomes including functional ability and quality of life.

Main Results:

  • Limited evidence suggests scanning (compensatory) training may improve quality of life, but not visual field or functional abilities.
  • Restitutive and substitutive (prism) interventions showed insufficient evidence of effectiveness for most outcomes.
  • Prism interventions were associated with a low-quality evidence of increased adverse events like headaches.

Conclusions:

  • There is a significant lack of high-quality evidence regarding the effectiveness of interventions for visual field defects after stroke, particularly for functional daily living.
  • Compensatory scanning training shows a potential modest benefit for quality of life, but overall evidence remains limited and of low quality.
  • Further research is needed to establish the efficacy of restitutive, compensatory, and substitutive interventions for visual field defects post-stroke.