Case Report: Visual Rehabilitation in Hemianopia Patients. Home-Based Visual Rehabilitation in Patients With Hemianopia Consecutive to Brain Tumor Treatment: Feasibility and Potential Effectiveness

Daibert-Nido, Monica; Pyatova, Yulia; Cheung, Kyle; Nayomi, Camilus; Markowitz, Samuel N.; Bouffet, Éric; Reber, Michaël

doi:10.3389/fneur.2021.680211

Cited by 8 publications

(13 citation statements)

References 60 publications

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“…This could be the consequence of the improvements observed in paracentral fields sensitivity and fixation stability. Such increase in contrast sensitivity was observed in other studies using high-contrast visual stimulation ( 26 , 27 ).…”

Section: Discussionsupporting

confidence: 85%

Innovative vision rehabilitation method for hemianopsia: Comparing pre- and post audio-luminous biofeedback training for ocular motility improving visual functions and quality of life

et al. 2023

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BackgroundHomonymous hemianopsia (HH) corresponds to vision loss in one hemi-field secondary to retro-chiasmal injury. Patients with HH experience difficulties in scanning and orientation in their environment. Near vision daily activities such as reading can also be impaired. There is an unmet need for standardized vision rehabilitation protocols for HH. We investigated the effectiveness of biofeedback training (BT), used for vision rehabilitation in patients with central vision loss, in individuals with HH.MethodsIn this prospective pilot pre/post study, 12 participants, with HH consecutive to brain injury, performed 5 weekly BT sessions for 20 min each under supervision using the Macular Integrity Assessment microperimeter. BT consisted of relocation of the retinal locus 1–4° toward the blind hemi-field. Outcomes measured post-BT were paracentral retinal sensitivity, visual acuity (near vision), fixation stability, contrast sensitivity, reading speed, and visual functioning questionnaire. Statistical analysis was performed using Bayesian paired t-tests.ResultsParacentral retinal sensitivity significantly increased by 2.7 ± 0.9 dB in the treated eye in 9/11 of the participants. Significant improvements with medium-to-large effect size were observed for fixation stability (8/12 participants), contrast sensitivity (6/12 participants) and near vision visual acuity (10/12 participants). Reading speed increased by 32.5 ± 32.4 words per minute in 10/11 participants. Quality of vision scores improved significantly with large effect size for visual ability, visual information and mobility.ConclusionBT led to encouraging improvements in visual functions and functional vision in individuals with HH. Further confirmation with larger trials is required.

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Section: Discussionsupporting

confidence: 85%

Innovative vision rehabilitation method for hemianopsia: Comparing pre- and post audio-luminous biofeedback training for ocular motility improving visual functions and quality of life

et al. 2023

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“…Participants were given training for street crossing under virtual conditions and were found to have results similar to those who underwent real street training 40 . Virtual reality has also been used in visual rehabilitation of patients with hemianopia who underwent telerehabilitation that showed improved visual performance 41 . VR-based training has also demonstrated benefits in sports medicine, traumatic brain injury, and for eye-hand coordination in trainee surgeons 42 .…”

Section: Discussionmentioning

confidence: 99%

“…Another weakness is the inability to compare real-world and virtual world performance on the same tasks by our subjects. However, from other studies that used virtual reality 40,41 it can be fairly assumed that there is a significant correlation between realworld and virtual world performance. A third possible weakness is that the weight of the VR headset (~ 0.8 kg) could make it hard to conduct prolonged rehabilitation sessions with subjects.…”

Section: Discussionmentioning

confidence: 99%

Measuring visual information gathering in individuals with ultra low vision using virtual reality

Kartha

Sadeghi

Bradley

et al. 2023

Sci Rep

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People with ULV (visual acuity ≤ 20/1600 or 1.9 logMAR) lack form vision but have rudimentary levels of vision that can be used for a range of activities in daily life. However, current clinical tests are designed to assess form vision and do not provide information about the range of visually guided activities that can be performed in daily life using ULV. This is important to know given the growing number of clinical trials that recruit individuals with ULV (e.g., gene therapy, stem cell therapy) or restore vision to the ULV range in the blind (visual prosthesis). In this study, we develop a set of 19 activities (items) in virtual reality involving spatial localization/detection, motion detection, and direction of motion that can be used to assess visual performance in people with ULV. We estimated measures of item difficulty and person ability on a relative d prime (d′) axis using a signal detection theory based analysis for latent variables. The items represented a range of difficulty levels (− 1.09 to 0.39 in relative d′) in a heterogeneous group of individuals with ULV (− 0.74 to 2.2 in relative d′) showing the instrument’s utility as an outcome measure in clinical trials.

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“…However, the benefits are not sustained after discontinuation of the drug and there is potential toxicity [9][10][11][12] . In our previous case series 13,14 , we used immersive virtual-reality (IVR) in the Oculus Go headset to deliver a personalized, remotely controlled, dynamic audiovisual stimulation in young adult patients with stable hemianopia (> 18 months) consecutive to a paediatric brain tumour. We demonstrated, after 6 weeks of repeated, home-based audiovisual stimulation, a clinically and statistically significant improvement in visual perception in the blind hemifield (note that 2 patients followed home-based stimulation remotely controlled from the laboratory during the 2020-2021 COVID-19 pandemic) 13,14 .…”

Section: Introductionmentioning

confidence: 99%

A telerehabilitation program to improve visual perception in children and adolescents with hemianopia consecutive to a brain tumour: a single-arm feasibility and proof-of-concept trial

Misawa,

Bajin,

Zhang

et al. 2024

Preprint

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Background. Brain tumour in children can induce hemianopia, a loss of conscious vision, profoundly impacting their development and future prospects, yet no effective intervention exists for this pediatric population. This study aims to explore the feasibility, safety, and potential effectiveness of a home-based audiovisual stimulation in immersive virtual-reality (3D-MOT-IVR) to restore visual perception. Method. In a phase 2a, open-labeled, nonrandomized, single arm study, 10 children and adolescents with stable hemianopia were enrolled to perform 20-minute sessions of 3D-MOT-IVR every other day for six weeks from home. We assessed feasibility by monitoring completion rates, remote data transfer, qualitative feedback. Safety was evaluated using validated cybersickness questionnaires. Comprehensive vision assessments were conducted pre- and post-intervention, with follow-ups at 1- and 6-month intervals. Results. The home-based 3D-MOT-IVR intervention proved both feasible and safe, with no reported adverse events. All participants completed the prescribed stimulations and the pre- and post-intervention assessment points, 90% completed the follow-ups. Remarkably, the outcomes revealed significant improvements post-intervention: 50% of participants showed enhanced visual perception in their blind field, while 70% exhibited increased reading speed. Importantly, these positive effects were sustained at the 6-month follow-up. A robust correlation emerged between 3D-MOT-IVR performance and improved visual perception in the blind field, emphasizing the intervention's effectiveness. Conclusion. Our findings underscore the feasibility and safety of home-based 3D-MOT-IVR as a potential intervention for hemianopia in children. These promising results lay a strong foundation for a larger randomized controlled trial, offering hope for a meaningful breakthrough in visual rehabilitation for this vulnerable population.

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Case Report: Visual Rehabilitation in Hemianopia Patients. Home-Based Visual Rehabilitation in Patients With Hemianopia Consecutive to Brain Tumor Treatment: Feasibility and Potential Effectiveness

Cited by 8 publications

References 60 publications

Innovative vision rehabilitation method for hemianopsia: Comparing pre- and post audio-luminous biofeedback training for ocular motility improving visual functions and quality of life

Innovative vision rehabilitation method for hemianopsia: Comparing pre- and post audio-luminous biofeedback training for ocular motility improving visual functions and quality of life

Measuring visual information gathering in individuals with ultra low vision using virtual reality

A telerehabilitation program to improve visual perception in children and adolescents with hemianopia consecutive to a brain tumour: a single-arm feasibility and proof-of-concept trial

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