Kasten E, Wüst S, Behrens-Baumann W, Sabel B A
Institute of Medical Psychology, Otto-v.-Guericke University of Magdeburg, Medical Faculty, Germany.
Nat Med. 1998 Sep;4(9):1083-7. doi: 10.1038/2079.
Partial blindness after brain injury has been considered non-treatable. To evaluate whether patients with visual-field defects can profit from computer-based visual restitution training (VRT), two independent clinical trials were conducted using patients with optic nerve (n = 19) or post-chiasmatic brain injury (n = 19). In post-chiasma patients, VRT led to a significant improvement (29.4%) over baseline in the ability to detect visual stimuli; in optic nerve patients, the effects were even more pronounced (73.6% improvement). Visual-field enlargements were confirmed by the observation of a visual-field expansion of 4.9 degrees-5.8 degrees of visual angle and improved acuity in optic nerve patients. Ninety five percent of the VRT-treated patients showed improvements, 72.2% confirmed visual improvements subjectively. Patients receiving a placebo training did not show comparable improvements. In conclusion, VRT with a computer program improves vision in patients with visual-field defects and offers a new, cost-effective therapy for partial blindness.
脑损伤后的部分失明一直被认为是无法治疗的。为了评估视野缺损患者是否能从基于计算机的视觉恢复训练(VRT)中获益,针对视神经损伤患者(n = 19)和视交叉后脑部损伤患者(n = 19)进行了两项独立的临床试验。在视交叉后损伤的患者中,VRT使检测视觉刺激的能力较基线水平有显著提高(提高了29.4%);在视神经损伤患者中,效果更为显著(提高了73.6%)。通过观察到视神经损伤患者视野扩大了4.9度至5.8度视角以及视力提高,证实了视野扩大。接受VRT治疗的患者中有95%表现出改善,72.2%的患者主观上确认视力有所改善。接受安慰剂训练的患者没有表现出类似的改善。总之,使用计算机程序进行的VRT可改善视野缺损患者的视力,并为部分失明提供了一种新的、具有成本效益的治疗方法。