Training improves glaucoma-induced visual field defects

Repetitive activation of residual vision with training of the visual field borders and areas of residual vision can improve visual field defects caused by glaucoma and increase detection sensitivity, according to results from a randomized clinical trial published in JAMA Ophthalmology. A new rehabilitation treatment option for such patients may involve behavioural computer-based, online-controlled vision training.

Behavioural vision training has been shown to improve visual fields in hemianopia and optic nerve damage. For this prospective, double-blind, randomized, placebo-controlled clinical trial, researchers gathered a volunteer sample of patients with glaucoma in an ambulatory care and home training setting.

Patients were a mean age of 61.7 years, all with stable visual fields and well-controlled IOPs. Interventions consisted of computer-based vision restoration training for glaucoma (n = 15) or visual discrimination placebo training in the intact visual field (n = 15).

Vision restoration training brought about significant detection accuracy gains in high-resolution perimetry (P = 0.007) not found with white-on-white or blue-on-yellow perimetry. In addition, Pre- to post-differences after training were greater compared with placebo in all perimetry tests (P = 0.02 for high-resolution perimetry; P = 0.04 for both white-on-white and for blue-on-yellow). All results were independent of eye movements.

Vision restoration training for glaucoma but not placebo led to a faster reaction time (P = 0.009). Patients' vision-related quality of life was unaffected, but patients' health-related quality-of-life mental health domain increased in both the vision restoration training and placebo groups.

To view the abstract of this study, click here.