Department of Biological and Vision Sciences, SUNY State College of Optometry, New York, NY, USA.
Optometry Service, Womack Army Medical Center, Fort Bragg, NC, USA.
NeuroRehabilitation. 2014;34(1):129-46. doi: 10.3233/NRE-131025.
Considering the extensive neural network of the oculomotor subsystems, traumatic brain injury (TBI) could affect oculomotor control and related reading dysfunction.
To evaluate comprehensively the effect of oculomotor-based vision rehabilitation (OBVR) in individuals with mTBI.
Twelve subjects with mTBI participated in a cross-over, interventional study involving oculomotor training (OMT) and sham training (ST). Each training was performed for 6 weeks, 2 sessions a week. During each training session, all three oculomotor subsystems (vergence/accommodation/version) were trained in a randomized order across sessions. All laboratory and clinical parameters were determined before and after OMT and ST. In addition, nearvision-related symptoms using the Convergence Insufficiency Symptom Survey (CISS) scale and subjective visual attention using the Visual Search and Attention Test (VSAT) were assessed.
Following the OMT, over 80% of the abnormal parameters significantly improved. Reading rate, along with the amplitudes of vergence and accommodation, improved markedly. Saccadic eye movements demonstrated enhanced rhythmicity and accuracy. The improved reading-related oculomotor behavior was reflected in reduced symptoms and increased visual attention. None of the parameters changed with ST.
OBVR had a strong positive effect on oculomotor control, reading rate, and overall reading ability. This oculomotor learning effect suggests considerable residual neuroplasticity following mTBI.
鉴于眼球运动子系统的广泛神经网络，创伤性脑损伤（TBI）可能会影响眼球运动控制和相关的阅读功能障碍。
全面评估基于眼球运动的视觉康复（OBVR）对 mTBI 患者的影响。
12 名 mTBI 患者参与了一项交叉、干预性研究，包括眼球运动训练（OMT）和假训练（ST）。每种训练持续 6 周，每周 2 次。在每次训练中，三个眼球运动子系统（聚散、调节和扫视）以随机顺序在各次训练中进行训练。所有实验室和临床参数均在 OMT 和 ST 前后进行测定。此外，使用集合不足症状调查（CISS）量表评估近视力相关症状，使用视觉搜索和注意测试（VSAT）评估主观视觉注意力。
在 OMT 之后，超过 80%的异常参数显著改善。阅读速度以及聚散和调节的幅度明显提高。扫视眼动的节奏性和准确性得到增强。阅读相关眼球运动行为的改善反映在症状减轻和视觉注意力增加上。ST 对任何参数都没有影响。
OBVR 对眼球运动控制、阅读速度和整体阅读能力有很强的积极影响。这种眼球运动学习效果表明，mTBI 后存在相当大的神经可塑性残留。
