Restoration vs. Compensation in Neurovisual Rehabilitation of Visual Field Defects

Overview

Visual field defects (VFD) are a frequent effect of cerebral lesions especially after posterior cerebral artery stroke. The present study was conducted to compare effects of vision restoration training (VRT) and compensation training (Visual Exploration Training, VET) on visual field performance.

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Treatment
    • Masking: Single (Outcomes Assessor)
  • Study Primary Completion Date: January 2005

Interventions

  • Behavioral: Vision Restoration Training (VRT)
  • Behavioral: Vision Exploration Training (VET)

Arms, Groups and Cohorts

  • Experimental: Vision Restoration Training (VRT)
    • home-based rehabilitation program which applies intense light stimulation via a PC-monitor to areas of residual vision with a duration of 1 hour daily/six days a week, subjects are asked to respond via button press upon appearance of light stimuli without eye movements
  • Active Comparator: Vision Exploration Training (VET)
    • home-based rehabilitation program to train eye movements upon visual stimuli presented via a PC-monitor with a duration of 1 hour daily/six days a week, subjects are asked to shift their gaze towards targets and respond via button press upon detection of targets

Clinical Trial Outcome Measures

Primary Measures

  • High Resolution Perimetry – Detectection performance change before vs. after training (%)
    • Time Frame: 3 months
  • Humphrey Field Analyzer (Static Perimetry) – Detectection performance change before vs. after training (%)
    • Time Frame: 3 months

Participating in This Clinical Trial

Inclusion Criteria

  • Visual field defects after brain damage – lesion age above 6 months – documented brain lesions due to ischemic stroke, hemorrhage or tumor demonstrated by computer tomography or by magnet resonance imaging Exclusion Criteria:

  • hemispatial neglect – complete blindness – severe psychotic diseases – serious drug abuse – chronic degenerative diseases (dementia, multiple sclerosis) – severe motor impairments – noticeable low intelligence influencing proper comprehension of diagnostic and training instructions – considerable impaired vision (visual acuity below 0.1 generated by amblyopia, opacity of cornea or lens, maculopathy and other retinal diseases where vision impairment is expected in the next month (e.g. subretinal neovascularisation, retinitis pigmentosa, diabetic retinopathy) – inability to fixate due to central scotoma, pathological nystagmus or other forms of fixation disabilities

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: 80 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • University of Magdeburg
  • Provider of Information About this Clinical Study
    • Principal Investigator: Bernhard A. Sabel, Professor, Head of Institute – University of Magdeburg

Citations Reporting on Results

Sabel BA, Gudlin J. Vision restoration training for glaucoma: a randomized clinical trial. JAMA Ophthalmol. 2014 Apr 1;132(4):381-9. doi: 10.1001/jamaophthalmol.2013.7963.

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