Houston Kevin E, Bowers Alex R, Fu Xianping, Liu Rui, Goldstein Robert B, Churchill Jeff, Wiegand Jean-Paul, Soo Tim, Tang Qu, Peli Eli
Schepens Eye Research Institute, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.
Schepens Eye Research Institute, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA ; Information Science and Technology College, Dalian Maritime University, Dalian, China.
Transl Vis Sci Technol. 2016 Feb 22;5(1):9. doi: 10.1167/tvst.5.1.9. eCollection 2016 Feb.
Peripheral prisms (p-prisms) shift peripheral portions of the visual field of one eye, providing visual field expansion for patients with hemianopia. However, patients rarely show adaption to the shift, incorrectly localizing objects viewed within the p-prisms. A pilot evaluation of a novel computerized perceptual-motor training program aiming to promote p-prism adaption was conducted.
Thirteen patients with hemianopia fitted with 57Δ oblique p-prisms completed the training protocol. They attended six 1-hour visits reaching and touching peripheral checkerboard stimuli presented over videos of driving scenes while fixating a central target. Performance was measured at each visit and after 3 months.
There was a significant reduction in touch error ( = 0.01) for p-prism zone stimuli from pretraining median of 16.6° (IQR 12.1°-19.6°) to 2.7° ( IQR 1.0°-8.5°) at the end of training. P-prism zone reaction times did not change significantly with training ( > 0.05). P-prism zone detection improved significantly ( = 0.01) from a pretraining median 70% (IQR 50%-88%) to 95% at the end of training (IQR 73%-98%). Three months after training improvements had regressed but performance was still better than pretraining.
Improved pointing accuracy for stimuli detected in prism-expanded vision of patients with hemianopia wearing 57Δ oblique p-prisms is possible and training appears to further improve detection.
This is the first use of this novel software to train adaptation of visual direction in patients with hemianopia wearing peripheral prisms.
周边棱镜（p - 棱镜）可使一只眼睛视野的周边部分发生偏移，为偏盲患者提供视野扩展。然而，患者很少能适应这种偏移，会错误地定位在p - 棱镜内看到的物体。对一种旨在促进p - 棱镜适应的新型计算机化感知 - 运动训练程序进行了初步评估。
13名佩戴57Δ斜向p - 棱镜的偏盲患者完成了训练方案。他们参加了6次每次1小时的就诊，在注视中央目标的同时，伸手触摸在驾驶场景视频中呈现的周边棋盘格刺激。在每次就诊时以及3个月后测量表现。
对于p - 棱镜区域刺激，触摸误差从训练前的中位数16.6°（四分位间距12.1° - 19.6°）显著降低（P = 0.01）至训练结束时的2.7°（四分位间距1.0° - 8.5°）。p - 棱镜区域的反应时间在训练后没有显著变化（P>0.05）。p - 棱镜区域的检测从训练前的中位数70%（四分位间距50% - 88%）显著改善（P = 0.01）至训练结束时的95%（四分位间距73% - 98%）。训练3个月后改善有所消退，但表现仍优于训练前。
对于佩戴57Δ斜向p - 棱镜的偏盲患者，在棱镜扩展视野中检测到的刺激，提高指向准确性是可能的，并且训练似乎能进一步改善检测。
这是首次使用这种新型软件训练佩戴周边棱镜的偏盲患者的视觉方向适应。
