<b>A conceptual model for vision rehabilitation</b>

Roberts, Pamela; Rizzo, John Ross; Hreha, Kimberly; Wertheimer, Jeffrey; Kaldenberg, Jennifer; Hironaka, Dawn; Riggs, Richard V.; Colenbrander, August

doi:10.1682/jrrd.2015.06.0113

Cited by 28 publications

(36 citation statements)

References 64 publications

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“…Traumatic brain injury (TBI) is a significant cause of death and disability, with an estimated worldwide incidence of about 10 million cases per year [1–3]. The ocular and vision damage has been reported previously as a consequence of TBI, and approximately 20–40% of people with brain injury experience related vision disorders [4], as part of the post-concussion syndrome [5–8]. The incidence of TBI and the symptoms of photo-sensitivity, blurred vision, double vision, decreased visual acuity, and visual field defects in the US has increased markedly in recent decades [1,9].…”

Section: Introductionmentioning

confidence: 99%

An augmentation in histone dimethylation at lysine nine residues elicits vision impairment following traumatic brain injury

Gupta

Saha

Sen

et al. 2019

Free Radical Biology and Medicine

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Traumatic Brain Injury (TBI) affects more than 1.7 million Americans each year and about 30% of TBI-patients having visual impairments. The loss of retinal ganglion cells (RGC) in the retina and axonal degeneration in the optic nerve have been attributed to vision impairment following TBI; however, the molecular mechanism has not been elucidated. Here we have shown that an increase in histone di-methylation at lysine 9 residue (H3K9Me2), synthesized by the catalytic activity of a histone methyltransferase, G9a is responsible for RGC loss and axonal degeneration in the optic nerve following TBI. To elucidate the molecular mechanism, we found that an increase in H3K9Me2 results in the induction of oxidative stress both in the RGC and optic nerve by decreasing the mRNA level of antioxidants such as Superoxide dismutase (sod) and catalase through impairing the transcriptional activity of Nuclear factor E2-related factor 2 (Nrf2) via direct interaction. The induction of oxidative stress is associated with death in RGC and oligodendrocyte precursor cells (OPCs). The death in OPCs is correlated with a reduction in myelination, and the expression of myelin binding protein (MBP) in association with degeneration of neurofilaments in the optic nerve. This event allied to an impairment of the retrograde transport of axons and loss of nerve fiber layer in the optic nerve following TBI. An administration of G9a inhibitor, UNC0638 attenuates the induction of H3K9Me2 both in RGC and optic nerve and subsequently activates Nrf2 to reduce oxidative stress. This event was concomitant with the rescue in the loss of retinal thickness, attenuation in optic nerve degeneration and improvement in the retrograde transport of axons following TBI.

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Section: Introductionmentioning

confidence: 99%

An augmentation in histone dimethylation at lysine nine residues elicits vision impairment following traumatic brain injury

Gupta

Saha

Sen

et al. 2019

Free Radical Biology and Medicine

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“…The competence to perform objective assessments is usually found outside the neuro‐rehabilitation units. The importance of integrating a vision specialist in the neuro‐rehabilitation team for further development of vision rehabilitation has been address in several articles (Roberts et al., 2016; Rowe et al., 2015), and the American Congress of Rehabilitation Medicine, ACMR, has described such a rehabilitation model in their article A conceptual model for vision rehabilitation (Roberts et al., 2016). Different roles of the vision specialists and the neuro‐rehabilitation team were described and how to interact and, thus, be able to develop vision assessment and rehabilitation after ABI.…”

Section: Discussionmentioning

confidence: 99%

How to assess visual function in acquired brain injury—Asking is not enough

et al. 2020

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Background Acquired brain injury affects many brain areas and causes a range of dysfunctions including vision‐related issues. These issues can have negative impacts on rehabilitation progress and activities of daily life but may easily be overlooked. There is no common recommendation about how to assess visual impairments after ABI. The purpose of this study was to estimate the frequency of objectively measures oculomotor dysfunctions, and also how these findings are related to two inventories intended to support detection of visual impairment. Methods The study was cross‐sectional and included 73 outpatients. In addition to the standard evaluation program, the patients went through a comprehensive optometric examination. The inventories used were the Vision Interview (VI) and the Convergence Insufficiency Symptom Survey (CISS). Results All three types of examinations showed a high proportion vision‐related symptoms. Fusion vergence was the most common objectively measured finding, 83%. There were seven statistically significant associations between five VI items and five visual deficits. The strength of associations was moderate (Phi 0.261–0.487, p < .05). The sensitivity and specificity of the CISS were moderate. Conclusion We found high percentages of the patients with visual symptoms and dysfunctions. Due to the complexity of visual symptoms and functional deficits in ABI, we find it necessary to combine both symptom assessment and vision examination in order to capture visual function issues.

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“…Rehabilitation for visuo-spatial neglect is necessitated for digital therapeutics. Although visual impairments following stroke have profound effects on patients, a standard systematic approach for comprehensive visual rehabilitation does not exist in contrast to cognitive, speech, and motor rehabilitation [66]. Visual rehabilitation following stroke focuses on the visual field defect, strabismus and ocular motility, central vision impairment, visuo-spatial neglect, and visual perceptual deficits [67].…”

Section: Interventions For Visionmentioning

confidence: 99%

Digital Therapeutics: Emerging New Therapy for Neurologic Deficits after Stroke

Choi

Kim

Nah³

et al. 2019

J Stroke

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Digital therapeutics is an evidence-based intervention using high-quality software, with the sole purpose of treatment. As many healthcare systems are encountering high demands of quality outcomes, the need for digital therapeutics is gradually increasing in the clinical field. We conducted review of the implications of digital therapeutics in the treatment of neurological deficits for stroke patients. The implications of digital therapeutics have been discussed in four domains: cognition, speech and aphasia, motor, and vision. It was evident that different forms of digital therapeutics such as online platforms, virtual reality trainings, and iPad applications have been investigated in many trials to test its feasibility in clinical use. Although digital therapeutics may deliver high-quality solutions to healthcare services, the medicalization of digital therapeutics is accompanied with many limitations. Clinically validated digital therapeutics should be developed to prove its efficacy in stroke rehabilitation.

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A conceptual model for vision rehabilitation

Cited by 28 publications

References 64 publications

An augmentation in histone dimethylation at lysine nine residues elicits vision impairment following traumatic brain injury

An augmentation in histone dimethylation at lysine nine residues elicits vision impairment following traumatic brain injury

How to assess visual function in acquired brain injury—Asking is not enough

Digital Therapeutics: Emerging New Therapy for Neurologic Deficits after Stroke

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