title: Computer based vision restoration therapy in glaucoma patients: a small open pilot study.
abstract: OBJECTIVE
  Several studies have shown that computer-based visual stimulation improves detection performance in brain damaged patients with post-chiasmatic lesions after stroke or trauma. Because it is not known whether visual field defects after retinal lesions can also be modified by visual stimulation we explored if visual field enlargements are possible in patients with glaucoma.
  
  
  METHODS
  Five patients with primary open angle glaucoma (POAG) performed Vision Restoration Training (VRT), a computer-based vision training for a total of 6 months in two 3-months blocks with a 3-months training-free interval between the two training periods. Perimetric testing was performed with High Resolution Perimetry (HRP) as well as with 30 degrees and 70 degrees white/white (W/W) and 30 degrees blue/yellow (B/Y) conventional automatic perimetry (Oculus Twinfield).
  
  
  RESULTS
  After the first 3 months of training the average detection performance significantly increased in HRP (Z= -2.023, p<0.05) and in 30 degrees W/W perimetry (Z= -2.023, p<0.05), but not in B/Y perimetry (Z= -1.214, p=0.225) or in the 70 degrees W/W perimetry, which included more peripheral, non-trained areas (Z= -0.406, p=0.684). Visual improvements remained stable after the training-free interval. Measured by HRP after the second VRT period 3 patients achieved an increase in the ability to detect visual stimuli, however, this improvement did not reach significance (Z= -1.826, p=0.068).
  
  
  CONCLUSIONS
  While a small patient sample does not permit general conclusions on visual field recovery after glaucoma, this pilot study suggests that visual field defects caused by retinal lesion may be improved by systematic vision stimulation. A larger sample, randomized clinical trial is now warranted.
authors.affiliation: Otto-von-Guericke University of Magdeburg, Medical Faculty, Institute of Medical Psychology, Magdeburg, Germany.
authors.forename: Julia
authors.initials: J
authors.lastname: Gudlin
authors.forename: Iris
authors.initials: I
authors.lastname: Mueller
authors.forename: Solon
authors.initials: S
authors.lastname: Thanos
authors.forename: Bernhard A
authors.initials: BA
authors.lastname: Sabel
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005901:Glaucoma / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010775:Photic Stimulation / Q000379:methods*; D010865:Pilot Projects; D020127:Recovery of Function / Q000502:physiology*; D013813:Therapy, Computer-Assisted; D013997:Time Factors; D058609:Visual Field Tests / Q000379:methods; D014794:Visual Fields / Q000502:physiology