Visual function in anterior ischemic optic neuropathy: effect of Vision Restoration Therapy--a pilot study.
OBJECTIVE
To evaluate the effects of Vision Restoration Therapy (VRT) on the visual function of patients with anterior ischemic optic neuropathy.


METHODS
Randomized controlled double-blind pilot trial.


METHODS
10 patients with stable anterior ischemic optic neuropathy (AION).


METHODS
All patients were evaluated before VRT and after 3 and 6 months of treatment by Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity, contrast sensitivity, reading speed, 24-2 SITA-standard Humphrey visual field (HVF), High Resolution Perimetry (HRP) (perimetry obtained during VRT), and vision-based quality of life questionnaire. Patients were randomized between two VRT strategies (5 in each group): I) VRT in which stimulation was performed in the seeing VF of the affected eye ("seeing field-VRT"); II) VRT in which stimulation was performed along the area of central fixation and in the ARV (areas of residual vision) of the affected eye ("ARV-VRT").


METHODS
The results of the HRP, HVF, and clinical assessment of visual function were compared for each patient and between the two groups at each evaluation.


RESULTS
Visual acuity qualitatively improved in the ARV-VRT group, however the change was not statistically significant (p=0.28). Binocular reading speed significantly improved in the ARV-VRT group (p=0.03). HVF foveal sensitivity increased mildly in both groups (p=0.059). HRP analysis showed a similar increase in stimulus accuracy in both groups (mean improvement of about 15%). All patients reported functional improvement after VRT.


CONCLUSIONS
Despite a small sample, the study showed a trend toward improvement of visual function in the ARV-VRT group. Improvement of HRP in both groups may reflect diffusely increased visual attention (neuronal activation), or improvement of an underlying sub-clinical abnormality in the "seeing" visual field of patients with optic neuropathies.
Jung
Cecilia S
CS
Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA, USA.
Bruce
Beau
B
Newman
Nancy J
NJ
Biousse
Valérie
V
D000328:Adult; D000368:Aged; D015350:Contrast Sensitivity / Q000502:physiology*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018917:Optic Neuropathy, Ischemic / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D010775:Photic Stimulation / Q000379:methods*; D010865:Pilot Projects; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013813:Therapy, Computer-Assisted / Q000379:methods*; D014792:Visual Acuity / Q000502:physiology*; D058609:Visual Field Tests / Q000379:methods; D014794:Visual Fields / Q000502:physiology*