Low Vision Service, Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada.
Donald K. Johnson Eye Institute, Krembil Research Institute, University Health Network, Toronto, ON, Canada.
Am J Case Rep. 2021 Jun 9;22:e931079. doi: 10.12659/AJCR.931079.
BACKGROUND Homonymous hemianopia is a loss of conscious vision in one hemifield, strongly affecting everyday life. Audiovisual stimulation programs improve visual perception in the blind hemifield; however, they use large equipment operated in clinical settings. Such treatments require frequent visits at the clinic, hampering the patient's adherence and compliance. In one hemianopia patient, we tested a 4-week dynamic audiovisual rehabilitation program in the stand-alone, remotely controlled, virtual-reality, head-mounted display Oculus Go and measured the effect on visual perception. CASE REPORT A 15-year-old Caucasian male was diagnosed with a right homonymous hemianopia with splitting of central fixation after a traumatic occipital contusion at age 7 months. Visual assessment showed impaired binocular contrast sensitivity and retinal sensitivity. Fixation stability and visual fields were strongly affected. After a 4-week audiovisual rehabilitation program, including 3 hours 20 minutes of stimulation, the contrast sensitivity, fixation stability, and paracentral visual perception were significantly enhanced, improving quality of life. CONCLUSIONS This pioneering work reports the use of virtual-reality in a head-mounted display to provide an audiovisual stimulation protocol for low-vision rehabilitation in a hemianopia patient. Real-time data recording and remote control of the stimulation program demonstrate that such rehabilitation treatment can be performed by the patient at home without interruption of care, decreasing the burden of disease. Beneficial effects on visual function were measured according to clinical guidelines of low-vision assessment. Improvement in visual function and quality of life challenge the prevailing belief that post-acute vision loss is both permanent and unchangeable.
同侧偏盲是一种视野的损失，强烈影响日常生活。视听刺激程序可改善盲侧视野的视觉感知；然而，它们使用在临床环境中操作的大型设备。这种治疗需要频繁到诊所就诊，阻碍了患者的依从性。在一位同侧偏盲患者中，我们在独立的、远程控制的、虚拟现实、头戴式显示器 Oculus Go 中测试了一个为期 4 周的动态视听康复计划，并测量了其对视觉感知的影响。
一名 15 岁的白人男性，7 个月大时因外伤性枕部挫伤后被诊断为右侧同侧偏盲伴中心固定分裂。视觉评估显示双眼对比敏感度和视网膜敏感度受损。固视稳定性和视野受到严重影响。经过为期 4 周的视听康复计划，包括 3 小时 20 分钟的刺激，对比敏感度、固视稳定性和旁中心视觉感知显著增强，提高了生活质量。
这项开创性的工作报告了使用头戴式显示器中的虚拟现实为同侧偏盲患者提供低视力康复的视听刺激方案。实时数据记录和刺激程序的远程控制表明，这种康复治疗可以由患者在家中进行，而不会中断护理，减轻疾病负担。根据低视力评估的临床指南，测量了视觉功能的有益效果。视觉功能和生活质量的改善挑战了人们普遍认为的急性视力丧失既永久性又不可改变的观念。
