title: Recovery from poststroke visual impairment: evidence from a clinical trials resource.
abstract: BACKGROUND
  Limited evidence suggests that visual impairments may influence outcome after stroke. The degree of recovery from these impairments is poorly characterized.
  
  
  OBJECTIVE
  To describe recovery and to determine whether visual impairments influence functional outcome and quality of life.
  
  
  METHODS
  We extracted demographic and outcome data from the Virtual International Stroke Trials Archive (VISTA). We examined horizontal eye movement disorders and hemianopia using the Best Gaze and Visual domains of the National Institutes of Health Stroke Scale (NIHSS) and described recovery at 30 and 90 days. Proportional odds modelling was used to examine the association between impairments at baseline, modified Rankin Scale (mRS), and European Quality of Life Score (EQ-5D) at 90 days.
  
  
  RESULTS
  Visual impairments were reported in 7,204/11,900 (60.5%) patients at baseline. Complete recovery occurred in 1,398/3,285 (42.6%) and 3,243/7,204 (45.0%) patients by 30 and 90 days respectively. The burden of persistent visual impairment in survivors was 1,135/4,028 (28.2%) at 30 days and 1,915/9,338 (20.5%) at 90 days. Partial gaze palsy (P < .0001; OR = 0.81; 95% CI = 0.74-0.87), forced deviation (P < .0001; OR = 0.48; 95% CI = 0.43-0.53), and complete homonymous hemianopia (P < .0001; OR = 0.67; 95% CI = 0.62-0.73) at baseline were associated with poor mRS at 90 days.
  
  
  CONCLUSIONS
  The rate of recovery was greater in the first month after stroke, suggesting a potential time frame for interventions. The associations between visual impairments and poor mRS suggest that these impairments should be considered in multidisciplinary assessments and interventions.
authors.affiliation: Glasgow Caledonian University, Glasgow, UK. Myzoon.ali@gcu.ac.uk
authors.forename: Myzoon
authors.initials: M
authors.lastname: Ali
authors.forename: Christine
authors.initials: C
authors.lastname: Hazelton
authors.forename: Patrick
authors.initials: P
authors.lastname: Lyden
authors.forename: Alex
authors.initials: A
authors.lastname: Pollock
authors.forename: Marian
authors.initials: M
authors.lastname: Brady
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011788:Quality of Life; D020127:Recovery of Function / Q000502:physiology*; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications*; D013997:Time Factors; D016896:Treatment Outcome; D063367:Virtual Reality Exposure Therapy / Q000379:methods*; D014786:Vision Disorders / Q000209:etiology* / Q000534:rehabilitation*