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Park ASY, Wong GHT, Tan KWS, Cheung BWS, Oremus M, Cheong AMY, Thompson B. Efficacy of perceptual learning in low vision: A systematic review and meta-analysis. Optom Vis Sci 2024; 101:305-320. [PMID: 38990233 DOI: 10.1097/opx.0000000000002157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND Visual perceptual learning (PL) shows promise for enhancing visual functions in individuals with visual impairment. OBJECTIVE This systematic review aimed to evaluate the effectiveness of PL in improving visual function. STUDY ELIGIBILITY Eligible studies were those examining the efficacy of PL in individuals with low vision. STUDY APPRAISAL AND SYNTHESIS METHODS The review protocol was registered with the international Prospective Register of Systematic Reviews (ID CRD42022327545) and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Screened studies were synthesized using random-effects meta-analysis and narrative synthesis following Synthesis Without Meta-analysis guidelines. The quality of the evidence was assessed using the Cochrane risk-of-bias tool and the JBI Critical Appraisal Tool for Quasi-Experimental studies. RESULTS Fifty studies were included, covering various visual impairments and employing different PL interventions. Most studies had low risk of bias. Meta-analysis showed significant improvement in visual search for individuals with cortical blindness (Hedges' g = 0.71; 95% confidence interval, 0.48 to 0.93; p=0.002); all other analyses did not show significant improvements-reading in central vision loss and cortical blindness, and visual field in peripheral vision loss and cortical blindness. However, the narrative synthesis provided evidence showing effectiveness, particularly in individuals with central vision loss and cortical blindness, demonstrating positive effects on reading, contrast sensitivity, visual field, and motion perception. LIMITATIONS Variations in study design, PL protocols, outcome measures, and measurement methods introduced heterogeneity, limiting the analysis. CONCLUSIONS The efficacy of PL in vision rehabilitation remains uncertain. Although meta-analysis results were mostly inconclusive, the narrative synthesis indicated improved visual functions following PL, consistent with individual study findings. IMPLICATIONS OF KEY FINDINGS Future research should optimize intervention parameters, explore long-term effects, and assess generalizability across diverse populations and visual impairment etiologies. Larger randomized controlled trials using standardized outcome measures are needed to advance the field.
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Affiliation(s)
| | - Ginny H T Wong
- Centre for Eye & Vision Research, Hong Kong Science Park, Hong Kong, China
| | - Ken W S Tan
- Centre for Eye & Vision Research, Hong Kong Science Park, Hong Kong, China
| | - Blossom W S Cheung
- Centre for Eye & Vision Research, Hong Kong Science Park, Hong Kong, China
| | - Mark Oremus
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
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Tol S, de Haan GA, Postuma EMJL, Jansen JL, Heutink J. Reading Difficulties in Individuals with Homonymous Visual Field Defects: A Systematic Review of Reported Interventions. Neuropsychol Rev 2024:10.1007/s11065-024-09636-4. [PMID: 38639880 DOI: 10.1007/s11065-024-09636-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 02/20/2024] [Indexed: 04/20/2024]
Abstract
Reading difficulties are amongst the most commonly reported problems in individuals with homonymous visual field defects (HVFDs). To be able to provide guidance for healthcare professionals considering offering reading training, researchers in this field and interested individuals with HVFDs, this systematic review aims to (1) provide an overview of the contextual and intervention characteristics of all published HVFD interventions and (2) generate insights into the different reading outcome measures that these studies adopted. A search on PsycINFO, MEDLINE and Web of Science was conducted up to February 2, 2023. All intervention studies for HVFD in which reading was measured were included. Data was collected about the intervention type, session duration, number of sessions, the intensity, duration, circumstance of the interventions, country in which the intervention was studied and reading measures. Sixty records are included, describing 70 interventions in total of which 21 are specifically reading interventions. Overall, adjusted saccadic behaviour interventions occur most in the literature. A wide range within all intervention characteristics was observed. Forty-nine records reported task-performance reading measures, and 33 records reported self-reported reading measures. The majority of task-performance measures are based on self-developed paragraph reading tasks with a time-based outcome measure (e.g. words per minute). Future research could benefit from making use of validated reading tests, approaching the measurement of reading mixed-methods and providing participants the possibility to supply outcomes relevant to them.
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Affiliation(s)
- S Tol
- Clinical and Developmental Neuropsychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands.
| | - G A de Haan
- Clinical and Developmental Neuropsychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
- Royal Dutch Visio, Centre of Expertise for Blind and Partially Sighted People, Amersfoortsestraatweg 180, 1272 RR, Huizen, The Netherlands
| | - E M J L Postuma
- Clinical and Developmental Neuropsychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
| | - J L Jansen
- Clinical and Developmental Neuropsychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
| | - J Heutink
- Clinical and Developmental Neuropsychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
- Royal Dutch Visio, Centre of Expertise for Blind and Partially Sighted People, Amersfoortsestraatweg 180, 1272 RR, Huizen, The Netherlands
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Maeyama T, Okada H, Sakai S. The effects of rehabilitative interventions on reading disorders caused by homonymous visual field defects: a meta-analysis focusing on improvement in reading speed. Acta Neurol Belg 2024; 124:123-140. [PMID: 37572263 DOI: 10.1007/s13760-023-02327-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 06/27/2023] [Indexed: 08/14/2023]
Abstract
INTRODUCTION Reading disorders caused by homonymous visual field defects (HVFDs) have a significant impact on a patient's quality of life. However, no review has been conducted to evaluate the available evidence on the effects of rehabilitative interventions on reading disorders caused by HVFDs. Thus, the aim of this study was to systematically evaluate the effects of rehabilitative interventions on reading disorders caused by HVFDs. METHODS We searched the MEDLINE/PubMed, Cochrane Library, ClinicalTrials.gov, CINAHL, and ScienceDirect databases for relevant articles. Relevant search terms were used to identify reports of randomized controlled trials or randomized crossover trials published between January 1990 and December 2021. Only studies that included reading-speed-related outcomes were analyzed. Risk of bias was assessed using the PEDro scale. Meta-analysis was conducted using a random-effects model, and standardized mean differences (SMD) and 95% confidence intervals (CIs) were calculated. Heterogeneity was assessed using the Ι2 statistic. RESULTS Nine studies were included in the meta-analysis. The results showed that rehabilitative interventions significantly improved reading disorders caused by HVFDs (SMD = 0.30; 95% CI 0.08-0.51; P < 0.01; Ι2 = 0.0%). Subgroup analysis showed that reading training significantly improved reading disorders (SMD = 0.35; 95% CI 0.05-0.66; P = 0.02; Ι2 = 0.0%). CONCLUSION Reading disorders caused by HVFDs can be improved through rehabilitation. In addition, reading training for the improvement of eye movement and fixation to compensate for foveal and parafoveal visual field defects may improve reading speed.
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Affiliation(s)
- Takaya Maeyama
- Graduate School of Health Sciences, Hokkaido University, Kita 12-Jo Nishi 5-Chome, Kitaku, Sapporo, Hokkaido, Japan
| | - Hiroki Okada
- Department of Rehabilitation Sciences, Hokkaido University, Kita 12-Jo Nishi 5-Chome, Kita-Ku, Sapporo, Hokkaido, Japan.
| | - Shinya Sakai
- Department of Rehabilitation Sciences, Hokkaido University, Kita 12-Jo Nishi 5-Chome, Kita-Ku, Sapporo, Hokkaido, Japan
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Aging and the rehabilitation of homonymous hemianopia: The efficacy of compensatory eye-movement training techniques and a five-year follow up. AGING BRAIN 2021; 1:100012. [PMID: 36911515 PMCID: PMC9997164 DOI: 10.1016/j.nbas.2021.100012] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 02/26/2021] [Accepted: 03/02/2021] [Indexed: 11/24/2022] Open
Abstract
The specificity and effectiveness of eye-movement training to remedy impaired visual exploration and reading with particular consideration of age and co-morbidity was tested in a group of 97 patients with unilateral homonymous hemianopia using a single subject /n-of-1 design. Two groups received either scanning training followed by reading training, or vice versa. The third group acted as a control group and received non-specific detailed advice, followed by training of scanning and reading. Scanning and reading performance was assessed before and after the waiting period, before and after scanning and reading training, and at short-term (11 weeks on average) and long-term follow-up (5 years on average). Improvements after training were practice-dependent and task-specific. Scanning performance improved by ∼40%, reading by ∼45%, and was paralleled by a reduction of subjective complaints. The advice (=control) condition was without effect. All improvements occurred selectively in the training period, not in treatment-free intervals, and persisted in the short- and long-term follow-up over several years. Age had only a minor, although significant effect on improvement in reading after training; co-morbidity had no significant impact on the outcome of training. In conclusion, visual impairments associated with homonymous hemianopia can be successfully and durably reduced by systematic and specific training of compensatory eye-movement strategies. The improvements in compensation strategies were independent of subjects' age and of co-morbidity.
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Sahraie A, Cederblad AMH, Kenkel S, Romano JG. Efficacy and predictors of recovery of function after eye movement training in 296 hemianopic patients. Cortex 2020; 125:149-160. [DOI: 10.1016/j.cortex.2019.12.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 08/08/2019] [Accepted: 12/02/2019] [Indexed: 11/29/2022]
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Metzler MJ, Maiani M, Jamieson B, Dukelow SP. Clinical provision of compensatory visual training after neurological injury: example of a multisite outpatient program. Disabil Rehabil 2019; 43:118-125. [PMID: 31120310 DOI: 10.1080/09638288.2019.1616835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
AIM Treatment efficacy is established via controlled research trials, but treatment in real-world clinical environments is typically highly variable and may differ from research protocols by necessity. Here, we examined provision of visual retraining for adults after neurological injury at an outpatient rehabilitation program in Calgary, Canada. METHODS Retrospective chart audits extracted demographic data, assessment outcomes, and details related to provision of training. RESULTS Treatment was provided to individuals with both visual field and visual-perceptual impairments due to neurological injury (mostly stroke). Tools and techniques of visual retraining at this program are discussed, the common denominator being repetitive practice of compensatory visual behaviors. Across this multisite program, there was significant variability in the number of treatment sessions, 13.00 (±10.21) sessions for those with visual-perceptual impairments and 14.41 (±9.63) sessions for those with field loss. Descriptive statistics and confidence intervals suggest improved outcomes on some measures for those with visual field and visual perceptual impairments. CONCLUSIONS Our data suggest that visual retraining is feasible in this clinical outpatient setting. Implications for rehabilitation This program of visual retraining was provided to individuals with visual impairment (e.g., hemianopia) and visual perceptual impairment (e.g., unilateral spatial neglect) as a result of neurological injury. In this outpatient program, visual rehabilitation was feasible and appeared to improve outcomes among a heterogeneous clinical population. Fundamental characteristics of visual compensatory training at this program included repetitive practice of adaptive scanning behaviors across multiple contexts to promote automaticity and generalization of skills.
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Affiliation(s)
- Megan J Metzler
- Department of Clinical Neurosciences, Alberta Children's Hospital, Calgary, Canada
| | - Meghan Maiani
- Community Accessible Rehabilitation, Alberta Health Services, Calgary, Canada
| | - Brittany Jamieson
- Community Accessible Rehabilitation, Alberta Health Services, Calgary, Canada
| | - Sean P Dukelow
- Department of Clinical Neurosciences, University of Calgary, Calgary, Canada
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Waddington J, Linehan C, Gerling K, Williams C, Robson L, Ellis R, Hodgson T. Evaluation of Eyelander, a Video Game Designed to Engage Children and Young People with Homonymous Visual Field Loss in Compensatory Training. JOURNAL OF VISUAL IMPAIRMENT & BLINDNESS 2018. [DOI: 10.1177/0145482x1811200607] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction Rehabilitation can improve visual outcomes for adults with acquired homonymous visual field loss. It is unclear, however, whether rehabilitation improves visual outcomes for children because previous training schedules have been tiresome, uninteresting, and have failed to keep them engaged. In this study, we assessed whether children and young people with homonymous visual field loss would adhere to six weeks of unsupervised compensatory training using a specialized video game. Methods Participants aged between 7 and 25 years with homonymous visual field loss completed tabletop assessments of visual search across four site visits. Two baseline assessments separated by four weeks evaluated spontaneous improvements before training began. Participants were then given a copy of the video game to use unsupervised at home for six weeks. Two follow-up assessments separated by four weeks were then conducted to evaluate immediate and acutely maintained effects of training. Results Fifteen candidates met the inclusion-exclusion criteria, nine participated, and eight completed the study. Participants completed an average of 5.6 hours of unsupervised training over the six weeks. Improvements on in-game metrics plateaued during week three of training. The time taken to find objects during tabletop activities improved by an average of 24%–95% CI (2%, 46%)—after training. Discussion The findings demonstrate that children and young people with homonymous visual field loss will engage with gamified compensatory training, and it can improve visual outcomes with less of a time commitment than has been required of adults participating in non-gamified training in previous studies. Appropriately powered, randomized controlled trials are required to evaluate the validity and generalizability of observed training effects. Implications for practitioners Rehabilitation specialists can use specialist video games and gamification technique to engage children and young people with homonymous visual field loss in long-term unsupervised training schedules.
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Affiliation(s)
- Jonathan Waddington
- Research and Development Department, WESC Foundation,
Topsham Road, Countess Wear, Exeter, EX2 6HA, UK
| | - Conor Linehan
- School of Applied Psychology, University College Cork,
Enterprise Centre, North Mall, Cork, T23 TK30, Ireland
| | - Kathrin Gerling
- Department of Computer Science, Katholieke
Universiteit Leuven, Andreas Vesaliusstraat 13, 3000 Leuven, Belgium
| | - Cathy Williams
- Bristol Population Health Science Institute, Bristol
University, Whiteladies Road, Bristol, BS8 1NU, UK
| | - Leonie Robson
- Orthoptic Department, United Lincolnshire Hospitals
NHS Trust, Lincoln County Hospital, Greetwell Road, Lincoln, LN2 5QY, UK
| | | | - Timothy Hodgson
- School of Psychology, University of Lincoln, Brayford
Way, Brayford Pool, Lincoln, LN6 7TS, UK
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Howard C, Rowe FJ. Adaptation to poststroke visual field loss: A systematic review. Brain Behav 2018; 8:e01041. [PMID: 30004186 PMCID: PMC6086007 DOI: 10.1002/brb3.1041] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 06/01/2018] [Accepted: 06/06/2018] [Indexed: 11/08/2022] Open
Abstract
AIM To provide a systematic overview of the factors that influence how a person adapts to visual field loss following stroke. METHOD A systematic review was undertaken (data search period 1861-2016) inclusive of systematic reviews, randomized controlled trials, controlled trials, cohort studies, observational studies, and case controlled studies. Studies including adult subjects with hemifield visual field loss, which occured as a direct consequence of stroke, were included. Search terms included a range of MESH terms as well as alternative terms relating to stroke, visual field loss, visual functions, visual perception, and adaptation. Articles were selected by two authors independently, and data were extracted by one author, being verified by the second. All included articles were assessed for risk of bias and quality using checklists appropriate to the study design. RESULTS Forty-seven articles (2,900 participants) were included in the overall review, categorized into two sections. Section one included seventeen studies where the reviewers were able to identify a factor they considered as likely to be important for the process of adaptation to poststroke visual field loss. Section two included thirty studies detailing interventions for visual field loss that the reviewers deemed likely to have an influence on the adaptation process. There were no studies identified which specifically investigated and summarized the factors that influence how a person adapts to visual field loss following stroke. CONCLUSION There is a substantial amount of evidence that patients can be supported to compensate and adapt to visual field loss following stroke using a range of strategies and methods. However, this systematic review highlights the fact that many unanswered questions in the area of adaptation to visual field loss remain. Further research is required on strategies and methods to improve adaptation to aid clinicians in supporting these patients along their rehabilitation journey.
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Affiliation(s)
- Claire Howard
- Department of Health Services Research, University of Liverpool, Liverpool, UK.,Department of Orthoptics, Salford Royal NHS Foundation Trust, Manchester, UK
| | - Fiona J Rowe
- Department of Health Services Research, University of Liverpool, Liverpool, UK
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Review of rehabilitation and habilitation strategies for children and young people with homonymous visual field loss caused by cerebral vision impairment. BRITISH JOURNAL OF VISUAL IMPAIRMENT 2017. [DOI: 10.1177/0264619617706100] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Partial and homonymous visual field loss (HVFL) is a common consequence of post-chiasmatic injury to the primary visual pathway or injury to the primary visual cortex. Different approaches to rehabilitation have been reported for older adults with HVFL and there is evidence to support the use of compensatory training over other proposed therapies. We reviewed the literature to investigate the current state of the art of rehabilitation and habilitation strategies for children and young people with HVFL, and whether there is enough evidence to support the use of these strategies in the paediatric population. We have provided an overview of the existing literature on children and young people with HVFL, a brief overview of rehabilitation strategies for adults with HVFL, and evidence on whether these different interventions have been applied with children and young people effectively. We found that there have been very few studies to investigate these strategies with children and young people, and the quality of evidence is currently low. New research is required to evaluate which strategies are effective for children and young people with HVFL and whether new strategies need to be developed.
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Use of NeuroEyeCoach™ to Improve Eye Movement Efficacy in Patients with Homonymous Visual Field Loss. BIOMED RESEARCH INTERNATIONAL 2016; 2016:5186461. [PMID: 27703974 PMCID: PMC5040783 DOI: 10.1155/2016/5186461] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 07/21/2016] [Accepted: 08/03/2016] [Indexed: 11/18/2022]
Abstract
Visual field deficits are common in patients with damaged retinogeniculostriate pathways. The patient's eye movements are often affected leading to inefficient visual search. Systematic eye movement training also called compensatory therapy is needed to allow patients to develop effective coping strategies. There is a lack of evidence-based, clinical gold-standard registered medical device accessible to patients at home or in clinical settings and NeuroEyeCoach (NEC) is developed to address this need. In three experiments, we report on performance of patients on NEC compared to the data obtained previously on the earlier versions of the search task (n = 32); we assessed whether the self-administered computerised tasks can be used to monitor the progress (n = 24) and compared the findings in a subgroup of patients to a healthy control group. Performance on cancellation tasks, simple visual search, and self-reported responses on activities of daily living was compared, before and after training. Patients performed similarly well on NEC as on previous versions of the therapy; the inbuilt functionality for pre- and postevaluation functions was sensitive to allowing assessment of improvements; and improvements in patients were significantly greater than those in a group of healthy adults. In conclusion, NeuroEyeCoach can be used as an effective rehabilitation tool to develop compensatory strategies in patients with visual field deficits after brain injury.
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Bowers AR. Driving with homonymous visual field loss: a review of the literature. Clin Exp Optom 2016; 99:402-18. [PMID: 27535208 DOI: 10.1111/cxo.12425] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Revised: 02/02/2016] [Accepted: 02/26/2016] [Indexed: 01/13/2023] Open
Abstract
Driving is an important rehabilitation goal for patients with homonymous field defects (HFDs); however, whether or not people with HFDs should be permitted to drive is not clear. Over the last 15 years, there has been a marked increase in the number of studies evaluating the effects of HFDs on driving performance. This review of the literature provides a much-needed summary for practitioners and researchers, addressing the following topics: regulations pertaining to driving with HFDs, self-reported driving difficulties, pass rates in on-road tests, the effects of HFDs on lane position and steering stability, the effects of HFDs on scanning and detection of potential hazards, screening for potential fitness to drive, evaluating practical fitness to drive and the efficacy of interventions to improve driving of persons with HFDs. Although there is clear evidence from on-road studies that some people with HFDs may be rated as safe to drive, others are reported to have significant deficits in skills important for safe driving, including taking a lane position too close to one side of the travel lane, unstable steering and inadequate viewing (scanning) behaviour. Driving simulator studies have provided strong evidence of a wide range in compensatory scanning abilities and detection performance, despite similar amounts of visual field loss. Conventional measurements of visual field extent (in which eye movements are not permitted) do not measure such compensatory abilities and are not predictive of on-road driving performance. Thus, there is a need to develop better tests to screen people with HFDs for visual fitness to drive. We are not yet at a point where we can predict which HFD patient is likely to be a safe driver. Therefore, it seems only fair to provide an opportunity for individualised assessments of practical fitness to drive either on the road and/or in a driving simulator.
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Affiliation(s)
- Alex R Bowers
- Schepens Eye Research Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA.
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Dundon NM, Bertini C, Làdavas E, Sabel BA, Gall C. Visual rehabilitation: visual scanning, multisensory stimulation and vision restoration trainings. Front Behav Neurosci 2015; 9:192. [PMID: 26283935 PMCID: PMC4515568 DOI: 10.3389/fnbeh.2015.00192] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Accepted: 07/09/2015] [Indexed: 12/16/2022] Open
Abstract
Neuropsychological training methods of visual rehabilitation for homonymous vision loss caused by postchiasmatic damage fall into two fundamental paradigms: “compensation” and “restoration”. Existing methods can be classified into three groups: Visual Scanning Training (VST), Audio-Visual Scanning Training (AViST) and Vision Restoration Training (VRT). VST and AViST aim at compensating vision loss by training eye scanning movements, whereas VRT aims at improving lost vision by activating residual visual functions by training light detection and discrimination of visual stimuli. This review discusses the rationale underlying these paradigms and summarizes the available evidence with respect to treatment efficacy. The issues raised in our review should help guide clinical care and stimulate new ideas for future research uncovering the underlying neural correlates of the different treatment paradigms. We propose that both local “within-system” interactions (i.e., relying on plasticity within peri-lesional spared tissue) and changes in more global “between-system” networks (i.e., recruiting alternative visual pathways) contribute to both vision restoration and compensatory rehabilitation, which ultimately have implications for the rehabilitation of cognitive functions.
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Affiliation(s)
- Neil M Dundon
- Department of Psychology, University of Bologna Bologna, Italy ; Centre for Studies and Research in Cognitive Neuroscience, University of Bologna Cesena, Italy
| | - Caterina Bertini
- Department of Psychology, University of Bologna Bologna, Italy ; Centre for Studies and Research in Cognitive Neuroscience, University of Bologna Cesena, Italy
| | - Elisabetta Làdavas
- Department of Psychology, University of Bologna Bologna, Italy ; Centre for Studies and Research in Cognitive Neuroscience, University of Bologna Cesena, Italy
| | - Bernhard A Sabel
- Medical Faculty, Institute of Medical Psychology, Otto-von-Guericke University of Magdeburg Magdeburg, Germany
| | - Carolin Gall
- Medical Faculty, Institute of Medical Psychology, Otto-von-Guericke University of Magdeburg Magdeburg, Germany
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Woodhead ZVJ, Ong YH, Leff AP. Web-based therapy for hemianopic alexia is syndrome-specific. ACTA ACUST UNITED AC 2015. [DOI: 10.1136/bmjinnov-2015-000041] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Inter-hemispheric wave propagation failures in traumatic brain injury are indicative of callosal damage. Vision Res 2015; 109:38-44. [DOI: 10.1016/j.visres.2015.02.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 02/20/2015] [Accepted: 02/26/2015] [Indexed: 11/22/2022]
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Alberti CF, Peli E, Bowers AR. Driving with hemianopia: III. Detection of stationary and approaching pedestrians in a simulator. Invest Ophthalmol Vis Sci 2014; 55:368-74. [PMID: 24346175 DOI: 10.1167/iovs.13-12737] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To compare blind-side detection performance of drivers with homonymous hemianopia (HH) for stationary and approaching pedestrians, initially appearing at small (4°) or large (14°) eccentricities in a driving simulator. While the stationary pedestrians did not represent an imminent threat, as their eccentricity increased rapidly as the vehicle advanced, the approaching pedestrians maintained a collision course with approximately constant eccentricity, walking or running, toward the travel lane as if to cross. METHODS Twelve participants with complete HH and without spatial neglect pressed the horn whenever they detected a pedestrian while driving along predetermined routes in two driving simulator sessions. Miss rates and reaction times were analyzed for 52 stationary and 52 approaching pedestrians. RESULTS Miss rates were higher and reaction times longer on the blind than the seeing side (P < 0.01). On the blind side, miss rates were lower for approaching than stationary pedestrians (16% vs. 29%, P = 0.01), especially at larger eccentricities (20% vs. 54%, P = 0.005), but reaction times for approaching pedestrians were longer (1.72 vs. 1.41 seconds; P = 0.03). Overall, the proportion of potential blind-side collisions (missed and late responses) was not different for the two paradigms (41% vs. 35%, P = 0.48), and significantly higher than for the seeing side (3%, P = 0.002). CONCLUSIONS In a realistic pedestrian detection task, drivers with HH exhibited significant blind-side detection deficits. Even when approaching pedestrians were detected, responses were often too late to avoid a potential collision.
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Affiliation(s)
- Concetta F Alberti
- Schepens Eye Research Institute, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
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