Sahraie Arash
Vision Research Laboratories, School of Psychology, University of Aberdeen, UK.
Curr Opin Neurol. 2007 Dec;20(6):661-6. doi: 10.1097/WCO.0b013e3282f1c70f.
Postgeniculate lesions commonly result in visual field loss. These areas of blindness at the chronic stage were thought to be permanent and irreversible. Recent evidence demonstrating changes in visual sensitivity within the field defect following training is reviewed.
It was previously demonstrated in animal models that visual deficits following brain injury are transient and less severe than those found in human patients. Previous attempts at visual rehabilitation, prompted by findings in the animal models, were successful in helping hemianopic patients to develop coping strategies. Nevertheless, these were criticized because some of the findings could be accounted for by imprecise or uncontrolled eye movements. More encouraging is recent research showing that repeated stimulation of the field defect, using a wide range of visual targets, may lead to increased visual sensitivity within the blind field. These findings are in accordance with our current understanding of visual pathways.
Recent rehabilitation interventions, should they be proven effective in large-scale clinical trials using appropriate controls, could lead to an overhaul of the current therapeutic management of this condition.
膝状体后病变通常会导致视野缺损。在慢性期,这些失明区域被认为是永久性且不可逆转的。本文综述了近期有关训练后视野缺损内视觉敏感度发生变化的证据。
此前在动物模型中已证实,脑损伤后的视觉缺陷是短暂的,且不如人类患者严重。受动物模型研究结果的启发,以往的视觉康复尝试成功地帮助偏盲患者制定了应对策略。然而,这些尝试受到了批评,因为其中一些结果可能是由不精确或不受控制的眼球运动导致的。更令人鼓舞的是,最近的研究表明,使用多种视觉目标对视野缺损进行反复刺激,可能会提高盲区的视觉敏感度。这些发现与我们目前对视觉通路的理解一致。
如果近期的康复干预措施在使用适当对照的大规模临床试验中被证明有效,可能会彻底改变目前对这种疾病的治疗管理方式。