Article

OBJECTIVE: To examine whether increased visual functioning after
vision-restoration training (VRT) coincides with improved reading abilities.
DESIGN: Prospective noncontrolled open-label trial. SETTING: Controlled
laboratory setting for all diagnostic procedures that were conducted before and
after 6 months of home-based VRT with telemedicine support. PATIENTS: Eleven
subjects who had experienced a posterior-parietal stroke and have homonymous
visual field defects. INTERVENTIONS: Six months of VRT (1 hour daily repeated
light stimulation in the partially damaged visual field). MAIN OUTCOME
MEASUREMENTS: VRT outcome measures were the number of detected light stimuli in
eye-tracker controlled high-resolution perimetry and the spared visual field
within the affected hemifield up to the relative and absolute defect visual field
border (square degrees). Enlargements of spared visual field within the affected
hemifield were correlated with changes of reading speed after VRT. RESULTS: After
VRT, the number of detected light stimuli increased by 5.02 +/- 4.31% (mean +/-
SD; P = .03). The spared visual field up to the relative defect visual field
border increased from 18.09 +/- 32.35 square degrees before to 137.40 +/- 53.32
after VRT (P = .006), as well as for the absolute defect visual field border from
36.95 +/- 33.77 square degrees before VRT to 152.02 +/- 49.70 after VRT (P =
.005). Reading speed increased from 108.95 +/- 33.95 words per minute before VRT
to 122.26 +/- 30.35 after VRT (P = .017), which significantly correlated with
increased spared visual field up to the relative defect visual field border (r =
0.73, P = .016). Measures of eye movement variability did not correlate with VRT
outcome. CONCLUSIONS: VRT improved visual fields in parafoveal areas, which are
most relevant for reading. This finding cannot be explained by changes in eye
movement behavior. Because of a significant association between improvements of
parafoveal vision and reading speed, we propose that patients with homonymous
visual field defects who have reading deficits may benefit from visual
stimulation by training.
CI - Copyright (c) 2012 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS