University of Rochester Flaum Eye Institute, Rochester, New York 14642, USA.
Neuroscientist. 2010 Aug;16(4):374-87. doi: 10.1177/1073858409356112. Epub 2010 Jan 25.
Cortical blindness is a chronic loss of vision following damage to the primary visual cortex (V1) or its postchiasmal afferents. Such damage is followed by a brief period of spontaneous plasticity that rarely lasts beyond 6 months. Following this initial phase, the visual deficit is thought to be stable, intractable, and permanent. Cortically blind subjects demonstrate spontaneous oculomotor adaptations to their deficits that can be further improved by saccadic localization training. However, saccadic training does not improve visual sensitivity in the blind field. In contrast, recent studies by a number of independent groups suggest that localized, repetitive perceptual training can improve visual sensitivity in the blind field, although mechanisms underlying the observed recovery remain unclear. This review discusses the current literature on rehabilitative strategies used for cortical blindness with emphasis on the use of perceptual training methods. The putative mechanisms that underlie the resulting, training-induced visual improvements are then outlined, along with the special challenges posed to their elucidation by the great variability in the extent and sometimes nature of the V1 damage sustained in different individuals.
皮质盲是初级视皮层（V1）或其视交叉后传入纤维损伤后导致的慢性视力丧失。这种损伤后会出现短暂的自发性可塑性，很少持续超过 6 个月。在初始阶段之后，认为视觉缺陷是稳定的、难治的和永久性的。皮质盲患者表现出对其缺陷的自发性眼球运动适应性，这些适应性可以通过扫视定位训练进一步改善。然而，扫视训练并不能提高盲区内的视觉敏感度。相比之下，最近一些独立研究小组的研究表明，局部、重复的知觉训练可以提高盲区内的视觉敏感度，尽管观察到的恢复的机制尚不清楚。本文综述了皮质盲康复策略的最新文献，重点介绍了知觉训练方法的应用。然后概述了潜在的机制，这些机制解释了训练引起的视觉改善，以及由不同个体中 V1 损伤的程度和有时性质的巨大变异性对其阐明所带来的特殊挑战。
