Efficacy and predictors of recovery of function after eye movement training in 296 hemianopic patients

Funding Development of NeuroEyeCoachTM and completion of regulatory requirements were funded by NovaVision Inc and developed by Arash Sahraie and Josef Zihl with the help of a technical team (Insiso Ltd.). Acknowledgements We would like to acknowledge the help of Insiso Ltd., UK for software support and data download. AMHC is supported by a Biotechnology and Biological Sciences Research Council (BBSRC) [grant number BB/J01446X/1] Case Ph.D. Studentship awarded by East of Scotland Bioscience (EastBio) Doctoral Training Partnership in collaboration with NovaVision.Peer reviewedPublisher PD

Visual field changes after a rehabilitation intervention: Vision restoration therapy

The objective of this study was to determine the effect of a visual rehabilitation intervention on visual field defects in a US cohort. Vision Restoration Therapy (VRT) consists of a specific pattern of stimulation that is directed at the border of the blind field. This retrospective study evaluated individuals with homonymous visual field defect from retrochiasmatic lesions treated with 6 modules of VRT. Suprathreshold visual field testing of the central 43 × 32 was obtained at baseline and after each module. The main outcome measures were the change in stimuli detection and the shift in the position of the border of the blind field. The impact of age, time from injury and type of visual field defect were analyzed. Among 161 patients, the mean absolute improvement in stimuli detection was 12.8%. The average border shift was 4.87. Improvements of ≥ 3% was noted in 76% of patients. Absolute change in stimulus detection of ≥ 3% at mid-therapy was associated with a greater final improvement. Age, time from lesion and type of visual field defect did not influence the degree of field expansion. VRT improves stimulus detection and results in a shift of the position of the border of the blind field as measured on suprathreshold visual field testing. These results support prior reports and support VRT as a useful rehabilitative intervention for a proportion of patients with visual field defects from retrochiasmatic lesions

Efficacy and predictors of recovery of function after eye movement training in 296 hemianopic patients

Compensatory approaches to rehabilitation of vision loss as a result of brain injury are aimed at improving the efficacy of eye movements, enabling patients to bring the otherwise unseen stimuli into their sighted field. Eye movement training has shown promise in a large number of studies in small clinical populations. Nevertheless, there remain two problems; standardisation and wide accessibility. NeuroEyeCoach™ (NEC) has been developed to address both. The therapy is based on the visual search approach and is adaptive to the patient's level of disability and the task difficulty is varied systematically through a combination of set-size and target/distractor similarity. Importantly, the therapy can be accessed online or in clinical settings, to enhance accessibility. Here we have reported on the findings from the first 296 consecutive cases who have accessed and completed NEC online, the largest cohort of patients studied to date. Patients' performance on two objective (visual search times and errors) and one subjective (self-reported disability) measures of performance were assessed before and after therapy. The findings showed that patients improved in search time, had less errors and improved disability scores in 87% (255/294), 80% (236/294) and 66% (167/254) of all cases respectively. We examined factors age, sex, side of blindness, age at the onset of brain injury, and time elapsed between the brain injury and start of therapy as predictors of both objective and subjective measures of improvements. Age was a significant predictor of improved search errors with older patients showing larger improvements. Time between brain injury and intervention negatively influenced search reaction time, however, none of the factors could predict improved subjective reports of disability