Visual Changes After Vision Restoration Therapy in Singapore: A Small Case Series Analysis

Introduction:

Visual field defects arising from post-geniculate lesions in the brain are considered by many clinicians untreatable. However, recent studies in humans have indicated that vision restoration therapy may increase the size of intact visual field.

Methods:

Case review of 8 (7 males; 1 female) patients (ages 20 to 66 years) who had post-geniculate visual loss and underwent vision restoration therapy between September 2005 and March 2006. 3 had visual field defects from strokes; the remaining 5 had surgery related or AVM hemorrhage related lesions. The following outcomes were measured :stimuli detection (SD) change on a high resolution perimetry (HRP) screen; fixation control and false positive reactions before and after each month of therapy.

Results:

Generalized estimating equations (GEE) with linear link, gaussian family and lagged-1 autoregressive correlation were used to ascertain if there was a significant improvement in stimulus detection and fixation over time, while adjusting for the baseline variables. GEE showed there was a significant upward trend in SD without a significant downward trend in fixation accuracy. The false positive reactions remained at less than 10% throughout the therapy period.

Conclusion:

Although limited in its small number of patients, the initial results showed that vision restoration therapy may be a useful form of visual rehabilitation for patients with post-geniculate visual field loss.