Huurneman Bianca, Boonstra F Nienke, Goossens Jeroen
Radboud University Medical Centre Donders Institute for Brain, Cognition and Behaviour, Cognitive Neuroscience Department, Nijmegen, The Netherlands.
Radboud University Medical Centre Donders Institute for Brain, Cognition and Behaviour, Cognitive Neuroscience Department, Nijmegen, The Netherlands 2Bartiméus, Institute for the Visually Impaired, Zeist, The Netherlands.
Invest Ophthalmol Vis Sci. 2016 Aug 1;57(10):4216-28. doi: 10.1167/iovs.16-19554.
To evaluate whether computerized training with a crowded or uncrowded letter-discrimination task reduces visual impairment (VI) in 6- to 11-year-old children with infantile nystagmus (IN) who suffer from increased foveal crowding, reduced visual acuity, and reduced stereopsis.
Thirty-six children with IN were included. Eighteen had idiopathic IN and 18 had oculocutaneous albinism. These children were divided in two training groups matched on age and diagnosis: a crowded training group (n = 18) and an uncrowded training group (n = 18). Training occurred two times per week during 5 weeks (3500 trials per training). Eleven age-matched children with normal vision were included to assess baseline differences in task performance and test-retest learning. Main outcome measures were task-specific performance, distance and near visual acuity (DVA and NVA), intensity and extent of (foveal) crowding at 5 m and 40 cm, and stereopsis.
Training resulted in task-specific improvements. Both training groups also showed uncrowded and crowded DVA improvements (0.10 ± 0.02 and 0.11 ± 0.02 logMAR) and improved stereopsis (670 ± 249″). Crowded NVA improved only in the crowded training group (0.15 ± 0.02 logMAR), which was also the only group showing a reduction in near crowding intensity (0.08 ± 0.03 logMAR). Effects were not due to test-retest learning.
Perceptual learning with or without distractors reduces the extent of crowding and improves visual acuity in children with IN. Training with distractors improves near vision more than training with single optotypes. Perceptual learning also transfers to DVA and NVA under uncrowded and crowded conditions and even stereopsis. Learning curves indicated that improvements may be larger after longer training.
评估针对患有中央凹拥挤、视力下降和立体视锐度降低的6至11岁婴儿型眼球震颤（IN）儿童，进行有或无干扰字母辨别任务的计算机化训练是否能降低视力损害（VI）。
纳入36名患有IN的儿童。其中18名患有特发性IN，18名患有眼皮肤白化病。这些儿童按年龄和诊断分为两个训练组：拥挤训练组（n = 18）和非拥挤训练组（n = 18）。训练在5周内每周进行两次（每次训练3500次试验）。纳入11名年龄匹配的视力正常儿童，以评估任务表现和重测学习方面的基线差异。主要结局指标包括特定任务表现、远视力和近视力（DVA和NVA）、5米和40厘米处（中央凹）拥挤的强度和范围以及立体视锐度。
训练带来了特定任务的改善。两个训练组的非拥挤和拥挤DVA均有改善（分别为0.10±0.02和0.11±0.02 logMAR），立体视锐度也有所提高（670±249″）。拥挤NVA仅在拥挤训练组有所改善（0.15±0.02 logMAR），该组也是唯一显示近拥挤强度降低的组（0.08±0.03 logMAR）。这些效果并非由重测学习导致。
有或无干扰物的知觉学习均可降低IN儿童的拥挤程度并提高视力。有干扰物的训练比单视标训练对近视力的改善更大。知觉学习还可转移至非拥挤和拥挤条件下的DVA和NVA，甚至立体视锐度。学习曲线表明，更长时间的训练后改善可能更大。
