Subjective and objective outcome measures of computer-based vision restoration training

Abstract

Objective: To determine the relationship of objective and subjective outcome measures of Vision Restoration Training (VRT) for visual field recovery in partially blind patients. This is of interest because the patient's subjective improvement cannot be inferred from objective changes in visual field charts. Design: Nineteen patients with visual system lesions underwent visual field tests (objective measure) before and after six months of VRT. Subjective outcome was determined by pre-and post-training interviews (open narration, questions on activities of daily living, ratings). Interview content was quantified by determining the response frequency for relevant content categories. Drawings of perceived visual field size were used as a subjective topographical measure. Subjective training results were compared to objective visual field size (perimetry). Results: Visual field size increased significantly over the training period. Patients' subjective evaluations depended on the size and location of regained areas, but also on specific evaluation of safe navigation, mobility, reading, and communication. Patients with objective increase of visual field size also reported subjective improvements in daily life. Conclusions: Computer-based training can improve visual field size as well as subjective visual performance. The patients' subjective experience should be included in treatment evaluation to ensure the meaningfulness of training beyond perimetric measures.

Functional Connectivity of the Precuneus Reflects Effectiveness of Visual Restitution Training in Chronic Hemianopia

“…as a full field measure, since it is relevant to the visual field used in daily life activities (as reflected with GAS). Other studies have also reported subjective improvements, after evaluating patients' scores on Quality of Life and Activities of Daily Life assessments (Gall et al, 2010;Mueller et al, 2007;Poggel et al, 2004;Poggel et al, 2010;. These findings highlight the clinical relevance of VRT training.…”

Extrastriate visual cortex reorganizes despite sequential bilateral occipital stroke: implications for vision recovery

“…Over the last few decades, a number of research groups postulated that deficits caused by acquired visual pathway injury in adulthood were potentially reversible through visual training strategies. Researchers demonstrated evidence of visual field recovery in people with stable lesions, often with lesions that were many years old (Kasten et al, 1999 , 2006 , 2007 ; Poggel et al, 2004 , 2006 , 2010 ; Henriksson et al, 2007 ; Chokron et al, 2008 ; Mueller et al, 2008 ; Jobke et al, 2009 ; Raemaekers et al, 2011 ). Visual Restoration Therapy (VRT) has been promoted by a number of researchers as a means of “striate system restoration” (Sabel and Kasten, 2000 ).…”

Personality and stress influence vision restoration and recovery in glaucoma and optic neuropathy following alternating current stimulation: implications for personalized neuromodulation and rehabilitation

“…However, contrary to this traditional paradigm, there is considerable recovery potential. Vision loss can not only spontaneoulsy recover to some degree [1,2], but recovery can be initiated or potentiated by vision training [2][3][4][5][6][7][8][9][10] and non-invasive alternating current stimulation (ACS) [11][12][13][14][15][16][17][18][19][20][21]. For example, in a multicenter trial with patients suffering from optic nerve damage, transorbital ACS treatment resulted in 24% recovery of visual fields, measured by super-threshold perimetry.…”