Visual field loss from glaucoma can be reversed to some extent with behavioural, computer-based, online controlled vision training, according to a study published byJAMA Ophthalmology.
Professors Bernhard A. Sabel and Julia Gudlin from the University of Magdeburg in Germany, conducted a prospective, double-blind, randomised, placebo-controlled clinical trial. The aim was to determine whether behavioral activation of areas of residual vision, using daily one hour vision restoration training for glaucoma over a period of three months, improved detection accuracy.
The study enrolled volunteer patients with glaucoma (mean age, 61.7 years), but stable visual fields and well-controlled intraocular pressure, to either a computer-based vision restoration training for glaucoma (15 subjects) or visual discrimination placebo training in the intact visual field (15 subjects). After randomisation, four patients withdrew.
The researchers found that vision restoration training was tied to significant detection accuracy gains in high-resolution perimetry (P = 0.007), which were not found with white-on-white or blue-on-yellow perimetry. After this training, the pre-post differences were greater in all perimetry tests (P = 0.02 for high-resolution perimetry; P = 0.04 for white on white; and P = 0.04 for blue on yellow), compared with placebo.
The researchers found that vision restoration training was tied to significant detection accuracy gains in high-resolution perimetry
They reported that the results were independent of eye movements. Faster reaction time (P = 0.009) was also achieved with vision restoration training, but not placebo. While vision-related quality of life was unchanged, the health-related quality-of-life mental health domain increased in both groups.
The authors concluded that, “Visual field defects caused by glaucoma can be improved by repetitively activating residual vision through training the visual field borders and areas of residual vision, thereby increasing their detection sensitivity”.
They reported that the randomised clinical trial had “revealed evidence that visual field loss is in part reversible by behavioral, computer-based, online controlled vision training, comprising a new rehabilitation treatment option in glaucoma. Neuroplasticity of the visual cortex or higher cortical areas is the proposed mechanism of action”.
