Vision restoration after brain and retina damage: The “residual vision activation theory”

Sabel, Bernhard A.; Henrich‐Noack, Petra; Fedorov, A.; Gall, Carolin

doi:10.1016/b978-0-444-53355-5.00013-0

Cited by 144 publications

(160 citation statements)

References 269 publications

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“…Upper panels: To assess the visual fields with high-resolution computer-based perimetry, suprathreshold stimuli were presented at random locations, from which simple detection charts were created. White indicates intact visual field sector; black, regions of absolute blindness; and gray, areas where response accuracy is inconsistent, which are known as areas of residual vision 6 or relative defects.…”

Section: Within-group Analysis Of Detection Performancementioning

confidence: 99%

“…25 Furthermore, vision loss after visual system damage can spontaneously recover in animals 26,27 and patients, 28 and stimulating visual field borders in patients with cortical or optic nerve lesions improves detection accuracy and enlarges visual fields, 19,[29][30][31][32][33][34][35][36] which are stable and improve activities of daily living. 29,37,38 Evidence also indicates that areas of residual vision (ARVs) contain fibers spared by the lesion that can activate the plastic cortex 6 as suggested by the following observations: (1) 10%…”

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confidence: 93%

“…6,[43][44][45] A pilot trial also showed that training improved detection accuracy in 4 of 5 patients with glaucoma, 46 but definitive evidence of vision restoration training efficacy in glaucoma is still lacking.…”

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confidence: 99%

“…6,[20][21][22] Evidence exists that visual system plasticity is behaviorally meaningful: regular practice in normal perceptual learning 23, 2 4 can improve visual acuity and contrast sensitivity. 25 Furthermore, vision loss after visual system damage can spontaneously recover in animals 26,27 and patients, 28 and stimulating visual field borders in patients with cortical or optic nerve lesions improves detection accuracy and enlarges visual fields, 19,[29][30][31][32][33][34][35][36] which are stable and improve activities of daily living.…”

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confidence: 99%

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Vision Restoration Training for Glaucoma

Sabel

Gudlin

2014

JAMA Ophthalmol

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IMPORTANCE Visual field loss due to retinal damage is considered irreversible, and methods are needed to achieve vision restoration. Behavioral vision training, shown to improve visual fields in hemianopia and optic nerve damage, might comprise such a method. OBJECTIVE To determine if behavioral activation of areas of residual vision using daily 1-hour vision restoration training for glaucoma for 3 months improves detection accuracy compared with placebo. DESIGN AND SETTING Prospective, double-blind, randomized, placebo-controlled clinical trial in an ambulatory care and home training setting. PARTICIPANTS Volunteer sample of patients with glaucoma (mean age, 61.7 years; age range, 39-79 years) with stable visual fields and well-controlled intraocular pressure. After randomization, 4 patients withdrew from the trial because of mild headaches (n = 2) or lack of time to complete the schedule (n = 2). INTERVENTIONS Computer-based vision restoration training for glaucoma (n = 15) or visual discrimination placebo training in the intact visual field (n = 15). MAIN OUTCOMES AND MEASURESThe primary end point was change in detection accuracy in high-resolution perimetry. Secondary end points were 30°white-on-white and 30°b lue-on-yellow near-threshold perimetry, as well as reaction time, eye movements, and vision-related and health-related quality of life.RESULTS Vision restoration training for glaucoma led to significant detection accuracy gains in high-resolution perimetry (P = .007), which were not found with white-on-white or blue-on-yellow perimetry. Furthermore, the pre-post differences after vision restoration training for glaucoma were greater compared with placebo in all perimetry tests (P = .02 for high-resolution perimetry, P = .04 for white on white, and P = .04 for blue on yellow), and these results were independent of eye movements. Vision restoration training for glaucoma (but not placebo) also led to faster reaction time (P = .009). Vision-related quality of life was unaffected, but the health-related quality-of-life mental health domain increased in both groups.CONCLUSIONS AND RELEVANCE Visual field defects caused by glaucoma can be improved by repetitively activating residual vision through training the visual field borders and areas of residual vision, thereby increasing their detection sensitivity. Our randomized clinical trial revealed evidence that visual field loss is in part reversible by behavioral, computer-based, online controlled vision training, comprising a new rehabilitation treatment option in glaucoma. Neuroplasticity of the visual cortex or higher cortical areas is the proposed mechanism of action.TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01799707.

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Section: Within-group Analysis Of Detection Performancementioning

confidence: 99%

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confidence: 93%

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confidence: 99%

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confidence: 99%

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Vision Restoration Training for Glaucoma

Sabel

Gudlin

2014

JAMA Ophthalmol

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“…Since the scotoma size does not always match well with the subjective vision loss, as measured by vision-related quality of life questionnaires [4,22], other factors than scotoma size may contribute to the patients subjective estimates of visual functions and the perceptual impairment in the seeing field may offer a possible explanation for this (for a discussion of the ''mismatchproblem'', see [4]). …”

Section: Clinical Relevance Of the Intact Field Perceptual Deficitsmentioning

confidence: 99%

The second face of blindness: Processing speed deficits in the intact visual field after pre- and post-chiasmatic lesions

Bola

Gall

Sabel

2013

Journal of the Neurological Sciences

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Purpose: Damage along the visual pathway results in a visual field defect (scotoma), which retinotopically corresponds to the damaged neural tissue. Other parts of the visual field, processed by the uninjured tissue, are considered to be intact. However, perceptual deficits have been observed in the ''intact'' visual field, but these functional impairments are poorly understood. We now studied temporal processing deficits in the intact visual field of patients with either pre-or postchiasmatic lesions to better understand the functional consequences of partial blindness.Methods: Patients with pre-(n = 53) or post-chiasmatic lesions (n = 98) were tested with high resolution perimetry -a method used to map visual fields with supra-threshold light stimuli. Reaction time of detections in the intact visual field was then analyzed as an indicator of processing speed and correlated with features of the visual field defect.

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Charles Bonnet syndrome in an elderly blind man with recurrent pituitary macroadenoma and optic nerve atrophy: A case report

Aslan,

Ngajilo,

Nyundo

2023

Clinical Case Reports

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Key Clinical MessageCharles Bonnet syndrome presents with complex visual hallucinations in a visually impaired or blind person. The case highlights complex neuropsychiatric manifestations due to pituitary macroadenoma in geriatrics requiring multi‐collaborative care.AbstractAn 81‐year‐old man presented with a 3‐year history of vivid visual hallucinations preceded by visual impairment and recurrence of a pituitary macroadenoma. Remission of hallucination occurred within 2 weeks of 1.5 mg of haloperidol per oral once daily; this is a rare case of Charles Bonnet syndrome after recurrent pituitary macroadenoma.

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Vision restoration after brain and retina damage: The “residual vision activation theory”

Cited by 144 publications

References 269 publications

Vision Restoration Training for Glaucoma

Vision Restoration Training for Glaucoma

The second face of blindness: Processing speed deficits in the intact visual field after pre- and post-chiasmatic lesions

Charles Bonnet syndrome in an elderly blind man with recurrent pituitary macroadenoma and optic nerve atrophy: A case report

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