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Vision restoration therapy

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Vision restoration therapy (VRT) is a noninvasive, nonsurgical form of vision therapy.[1] This therapy was developed by Bernhard Sabel, Ph.D. The phenomenon underlying the therapy is visual neuroplasticity.[2]

Description of therapy

Vision restoration therapy (VRT) is a computer-based treatment designed to help patients with visual field defects regain visual functions through repetitive light stimulation.[3][4] The therapy is cleared by the U.S. Food and Drug Administration (FDA) for "...the diagnosis and improvement of visual functions in patients with impaired vision that may result from trauma, stroke, inflammation, surgical removal of brain tumors or brain surgery, and may also be used to improve visual function in patients with amblyopia". Patterns of visual field loss depend on the injury, but the most common are hemianopia, loss of an entire hemisphere of vision; quadrantanopia, loss of a quadrant of vision; and scotoma, loss of an irregular section of vision.[5] The main characteristics of these visual field losses is that they persist in both eyes, and therefore, one eye cannot compensate for the deficit in the other eye.

Before the development of VRT, there was no therapy available to improve the range or sensitivity of the patient's affected field of vision – patients were often told they "had to live with" their deficits. However, similar to recovery from motor deficits after brain injury, where repetitive stimulation has proven effective in recovery of patient functions such as movements of lower limbs, systematic repetitive visual training can also lead to increased visual sensitivity and recovery of function. To date the concept of improving vision in patients with repeated stimulation has been confirmed by a number of independent laboratories, and extended to a range of techniques. These include using moving stimuli (Krystal Huxlin, University of Rochester); flickering dots stimuli at sighted/blind field borders (Laura Julkunen, University of Turku; And D P Bergsma, Utrecht), and flashing large patterns deep in the blind field (Arash Sahraie, University of Aberdeen). In addition, VRT has been shown effective in more than 20 clinical studies where the repeated stimulation of the blind and transition areas has led to improved visual sensitivity.[citation needed]

References

  1. ^ Caplan, L. R.; Firlik, A.; Newman, N. J.; Pless, M.; Romano, J. G.; Schatz, N. (2005). "Vision restoration therapy. [Letter]". British Journal of Ophthalmology. 89 (9): 1229–1229. doi:10.1136/bjo.2005.069773. PMC 1772830.
  2. ^ Frequently Asked Questions: Vision Restoration Therapy: Vision Rehab after Stroke or TBI. (2007). Retrieved November 12, 2010 from NovaVision, www.novavision.com: http://www.novavision.com
  3. ^ Kasten, E; Wuest, S; Behrens-Baumann, W; Sabel, BA (1998). "Computer-based training for the treatment of partial blindness". Nature Medicine. 4 (9): 1083–1087. doi:10.1038/2079.
  4. ^ Marshall RS, Ferrera JJ, Barnes A, Zhang X, O'Brien KA, Chmayssani M, Hirsch J, Lazar RM (2007). Brain activity associated with stimulation therapy of the visual border- zone in hemianopic stroke patients. Neurorehabilitation and Neural Repair; 22(2): 136-144
  5. ^ Cite error: The named reference A0A2 was invoked but never defined (see the help page).
  • Plow EB, Obretenova SN, Fregni F, Pascual-Leone A, Merabet LB (2012). Comparison of Visual Field Training for Hemianopia With Active Versus Sham Transcranial Direct Cortical Stimulation. Neurorehabilitation and Neural Repair; 20 (10): 1–11
  • Huxlin, KR; Martin, T; Kelly, K; Riley, M; Friedman, DI; Burgin, WS; Hayhoe, M (2009). "Perceptual relearning of complex visual motion after V1 damage in humans". The Journal of Neuroscience. 29 (13): 3981–91. doi:10.1523/jneurosci.4882-08.2009. PMC 2825043.
  • Das, A; Tadin, D; Huxlin, KR (2014). "Beyond blindsight: properties of visual relearning in cortically blind fields". The Journal of Neuroscience. 34 (35): 11652–64. doi:10.1523/jneurosci.1076-14.2014. PMC 4145170.
  • Julkunen, L; Tenovuo, O; Vorobyev, V; et al. (2006). "Functional brain imaging, clinical and neurophysiological outcome of visual rehabilitation in a chronic stroke patient". Restor Neurol Neurosci. 24: 123–132. {{cite journal}}: Explicit use of et al. in: |last4= (help)
  • Julkunen, L; Tenovuo, O; Jääskeläinen, S; Hämäläinen, H (2003). "Rehabilitation of chronic post-stroke visual field defect with computer-assisted training". Restor Neurol Neurosci. 21: 19–28.
  • Bergsma, DP; van der Wildt, G (2010). "Visual Training of Cerebral Blindness patients gradually enlarges the visual field". Br J Ophthalmol. 94: 88–96. doi:10.1136/bjo.2008.154336.
  • Raemaekers, M; Bergsma, DP; van Wezel, RJ; van der Wildt, GJ; et al. (2011). "Effects of vision restoration training on early visual cortex in patients with cerebral blindness investigated with functional magnetic resonance imaging". Journal of Neurophysiology. 105 (2): 872–82. doi:10.1152/jn.00308.2010. {{cite journal}}: Explicit use of et al. in: |last5= (help)
  • Trevethan, CT; Urquhart, J; Ward, R; Gentleman, D; Sahraie, A (2012). "Evidence for perceptual learning with repeated stimulation after partial and total cortical blindness". Advances in Cognitive Psychology. 8 (1): 29–37. doi:10.5709/acp-0099-8.
  • Sahraie, A (2010). "Improved detection following Neuro-Eye Therapy in patients with post-geniculate brain damage". Experimental Brain Research. 206 (1): 25–34. doi:10.1007/s00221-010-2395-z.
  • Romano, JG; Schulz, P; Kenkel, S; Todd, DP (2008). "Visual field changes after a rehabilitation intervention: Vision restoration therapy". Journal of the Neurological Sciences. 273 (1–2): 70–74. doi:10.1016/j.jns.2008.06.026.
  • Mueller, I; Mast, H; Sabel, BA (2007). "Recovery of visual field defects: A large clinical observational study using vision restoration therapy". Restor Neurol Neurosci. 25 (5–6): 563–572.
  • Reinhard, J; Schreiber, A; Schiefer, U; et al. (2005). "Does visual restitution training change absolute homonymous visual field defects? A fundus controlled study". Br J Ophthalmol. 89: 30–35. doi:10.1136/bjo.2003.040543. PMC 1772456. {{cite journal}}: Explicit use of et al. in: |last4= (help)
  • Horton, JC (2005). "Disappointing results from Nova Vision's visual restoration therapy". Br J Ophthalmol. 89 (1): 1–2. doi:10.1136/bjo.2004.058214. PMC 1772467. PMID 15615733.
  • Sabel, BA (2006). "Vision restoration therapy and raising red flags too early". Br. J. Ophthalmol. 90: 659–660.
  • Mueller, I; Poggel, DA; Kenkel, S; et al. (2003). "Vision Restoration Therapy after brain damage: subjective improvements of activities of daily life and their relationship to visual field enlargements". Visual Impairment Research. 5: 157–178. doi:10.1080/1388235039048692. {{cite journal}}: Explicit use of et al. in: |last4= (help)
  • Gall, C; et al. (2008). "Vision- and health-related quality of life before and after vision restoration training in cerebrally damaged patients". Restor Neurol Neurosci. 26: 341–353. {{cite journal}}: Explicit use of et al. in: |last2= (help)
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