Case Report: Visual Rehabilitation in Hemianopia Patients. Home-Based Visual Rehabilitation in Patients With Hemianopia Consecutive to Brain Tumor Treatment: Feasibility and Potential Effectiveness

Background/Objectives: Visual field loss is frequent in patients with brain tumors, worsening their daily life and exacerbating the burden of disease, and no supportive care strategies exist. In this case series, we sought to characterize the feasibility and potential effectiveness of a home-based visual rehabilitation program in hemianopia patients using immersive virtual-reality stimulation. Subjects/Methods: Two patients, one with homonymous hemianopia and the other with bitemporal hemianopia, consecutive to pediatric brain tumors, with no prior visual rehabilitation performed 15 min of home-based audiovisual stimulation every 2 days for 6 weeks (case 2) and 7 weeks (case 1) between February and August 2020. Patients used a virtual-reality, stand-alone, and remotely controlled device loaded with a non-commercial audiovisual stimulation program managed in real time from the laboratory. Standard visual outcomes assessed in usual care in visual rehabilitation were measured at the clinic. Following a mixed method approach in this pragmatic study of two cases, we collected quantitative and qualitative data on feasibility and potential effectiveness and compared the results pre- and post-treatment. Results: Implementation and wireless delivery of the audiovisual stimulation, remote data collection, and analysis for cases 1 and 2 who completed 19/20 and 20/20 audiovisual stimulation sessions at home, respectively, altogether indicated feasibility. Contrast sensitivity increased in both eyes for cases 1 and 2. Visual fields, measured by binocular Esterman and monocular Humphrey full-field analyses, improved in case 1. A minor increase was observed in case 2. Cases 1 and 2 enhanced reading speed. Case 2 strongly improved quality of life scores. Conclusion: This is the first report of a home-based virtual-reality visual rehabilitation program for adult patients with hemianopia consecutive to a pediatric brain tumor. We show the feasibility in real-world conditions and potential effectiveness of such technology on visual perception and quality of life.

[1]  R. van Ee,et al.  An immersive virtual reality game to train spatial attention orientation after stroke: A feasibility study , 2020, Applied neuropsychology. Adult.

[2]  C. Bertini,et al.  Shaping the visual system: cortical and subcortical plasticity in the intact and the lesioned brain , 2020, Neuropsychologia.

[3]  S. Leat.  2020 CAO Clinical Practice Guideline: Optometric Low Vision Rehabilitation FULL GUIDELINES , 2020 .

[4]  Sarah E. MacPherson,et al.  Validation of the Virtual Reality Neuroscience Questionnaire: Maximum Duration of Immersive Virtual Reality Sessions Without the Presence of Pertinent Adverse Symptomatology , 2019, Front. Hum. Neurosci..

[5]  B. Thompson,et al.  Binocular vision and fixational eye movements. , 2019, Journal of vision.

[6]  R. van Ee,et al.  Acceptance of immersive head-mounted virtual reality in older adults , 2019, Scientific Reports.

[7]  J. Peragallo.  Visual function in children with primary brain tumors , 2019, Current opinion in neurology.

[8]  B. Christie,et al.  Three-dimensional multiple object tracking in the pediatric population: the NeuroTracker and its promising role in the management of mild traumatic brain injury , 2018, Neuroreport.

[9]  H. Iwata,et al.  Differing effects of an immersive virtual reality programme on unilateral spatial neglect on activities of daily living , 2018, BMJ Case Reports.

[10]  H. Bridge,et al.  Subcortical pathways to extrastriate visual cortex underlie residual vision following bilateral damage to V1 , 2018, Neuropsychologia.

[11]  M. A. Basso,et al.  Circuits for Action and Cognition: A View from the Superior Colliculus. , 2017, Annual review of vision science.

[12]  J. Drake,et al.  Long-term visual outcomes of craniopharyngioma in children , 2018, Journal of Neuro-Oncology.

[13]  Hauke S. Meyerhoff,et al.  Studying visual attention using the multiple object tracking paradigm: A tutorial review , 2017, Attention, perception & psychophysics.

[14]  N. Nesaratnam,et al.  Stepping into the virtual unknown: feasibility study of a virtual reality-based test of ocular misalignment , 2017, Eye.

[15]  Sungmin Cho,et al.  Development and validation of virtual prism adaptation therapy , 2017, 2017 International Conference on Virtual Rehabilitation (ICVR).

[16]  P. Subramanian,et al.  Homonymous Hemianopia and Vision Restoration Therapy. , 2017, Neurologic clinics.

[17]  Susana T. L. Chung,et al.  Low Vision and Plasticity: Implications for Rehabilitation. , 2016, Annual review of vision science.

[18]  S. Kara,et al.  Repeatability of contrast sensitivity testing in patients with age-related macular degeneration, glaucoma, and cataract. , 2016, Arquivos brasileiros de oftalmologia.

[19]  S. Markowitz,et al.  State-of-the-art: low vision rehabilitation. , 2016, Canadian journal of ophthalmology. Journal canadien d'ophtalmologie.

[20]  M. Morrone,et al.  Visual Plasticity: Blindsight Bridges Anatomy and Function in the Visual System , 2016, Current Biology.

[21]  J. Peragallo,et al.  The Effects of Primary Brain Tumors on Vision and Quality of Life in Pediatric Patients , 2015, Seminars in Neurology.

[22]  S. Sivaprasad,et al.  Factors Affecting Reading Speed in Patients with Diabetic Macular Edema Treated with Laser Photocoagulation , 2014, PloS one.

[23]  Denise Goodwin,et al.  Homonymous hemianopia: challenges and solutions , 2014, Clinical ophthalmology.

[24]  R. Kammer,et al.  Low Vision Rehabilitation , 2014 .

[25]  Torbjörn Falkmer,et al.  The Case for Using the Repeatability Coefficient When Calculating Test–Retest Reliability , 2013, PloS one.

[26]  Robert W. Kentridge,et al.  Auditory-visual localization in hemianopia. , 2013, Neuropsychology.

[27]  T. Tihan,et al.  Optic pathway gliomas: a review. , 2013, CNS oncology.

[28]  Jocelyn Faubert,et al.  Perceptual-cognitive training improves biological motion perception: evidence for transferability of training in healthy aging , 2012, Neuroreport.

[29]  S. Trauzettel-Klosinski.  Current methods of visual rehabilitation. , 2011, Deutsches Arzteblatt international.

[30]  Jennifer H. Acton,et al.  Comparing the Nidek MP-1 and Humphrey Field Analyzer in Normal Subjects , 2011, Optometry and vision science : official publication of the American Academy of Optometry.

[31]  D. Sagi.  Perceptual learning in Vision Research , 2011, Vision Research.

[32]  M. Steinbach,et al.  Fixation stability during binocular viewing in patients with age-related macular degeneration. , 2011, Investigative ophthalmology & visual science.

[33]  S. Markowitz.  A practice template for low-vision rehabilitation. , 2009, Canadian journal of ophthalmology. Journal canadien d'ophtalmologie.

[34]  Caterina Bertini,et al.  Audio-visual stimulation improves oculomotor patterns in patients with hemianopia , 2009, Neuropsychologia.

[35]  Aaron R. Seitz,et al.  Benefits of multisensory learning , 2008, Trends in Cognitive Sciences.

[36]  K. Huxlin.  Perceptual plasticity in damaged adult visual systems , 2008, Vision Research.

[37]  Shahina Pardhan,et al.  The Repeatability of MNREAD Acuity Charts and Variability at Different Test Distances , 2006, Optometry and vision science : official publication of the American Academy of Optometry.

[38]  Robert W Massof,et al.  Measuring outcomes of vision rehabilitation with the Veterans Affairs Low Vision Visual Functioning Questionnaire. , 2006, Investigative ophthalmology & visual science.

[39]  Nadia Bolognini,et al.  Visual search improvement in hemianopic patients after audio-visual stimulation , 2005 .

[40]  Shaul Hochstein,et al.  Effects of eye dominance in visual perception , 2005 .

[41]  Nadia Bolognini,et al.  Audiovisual Integration in Patients with Visual Deficit , 2005, Journal of Cognitive Neuroscience.

[42]  E. Levy,et al.  Reduced Bile Flow Associated With Parenteral Nutrition Is Independent of Oxidant Load and Parenteral Multivitamins , 2005, Journal of pediatric gastroenterology and nutrition.

[43]  E. Kasten,et al.  Does visual restitution training change absolute homonymous visual field defects? A fundus controlled study , 2004, British Journal of Ophthalmology.

[44]  G T Plant,et al.  A work out for hemianopia , 2004, British Journal of Ophthalmology.

[45]  J. Horton,et al.  Disappointing results from Nova Vision’s visual restoration therapy , 2004, British Journal of Ophthalmology.

[46]  D. Altman,et al.  Applying the right statistics: analyses of measurement studies , 2003, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology.

[47]  R. Harrad,et al.  The Effect of Ocular Dominance on Visual Field Testing , 2002, Optometry and vision science : official publication of the American Academy of Optometry.

[48]  Heleen Beckerman,et al.  Smallest real difference, a link between reproducibility and responsiveness , 2001, Quality of Life Research.

[49]  J. Zihl,et al.  Visual scanning behavior in patients with homonymous hemianopia , 1995, Neuropsychologia.

[50]  GORDON E. LEGGE,et al.  Psychophysics of Reading. VIII. The Minnesota Low- Vision Reading Test , 1989, Optometry and vision science : official publication of the American Academy of Optometry.

[51]  B. Stein,et al.  Interactions among converging sensory inputs in the superior colliculus. , 1983, Science.

[52]  H. Levitt.  Transformed up-down methods in psychoacoustics. , 1971, The Journal of the Acoustical Society of America.

[53]  R. C. Macridis.  A review , 1963 .

[54]  J. Peragallo.  Effects of Brain Tumors on Vision in Children , 2018, International ophthalmology clinics.

[55]  Jocelyn Faubert,et al.  3D-Multiple Object Tracking training task improves passing decision-making accuracy in soccer players , 2016 .

[56]  Ieee Staff,et al.  2013 International Conference on Virtual Rehabilitation (ICVR) , 2013 .

[57]  P. Henrich-Noack,et al.  Vision restoration after brain and retina damage: the "residual vision activation theory". , 2011, Progress in brain research.

[58]  D. Blayney,et al.  Challenges and solutions. , 2007, Journal of oncology practice.

[59]  S. Markowitz,et al.  Principles of modern low vision rehabilitation. , 2006, Canadian journal of ophthalmology. Journal canadien d'ophtalmologie.

[60]  Z. Pylyshyn,et al.  Dynamics of target selection in multiple object tracking (MOT). , 2006, Spatial vision.

[61]  W. Feuer,et al.  Pseudo-loss of fixation in automated perimetry. , 1991, Ophthalmology.

[62]  J. Affeldt,et al.  The feasibility study , 2019, The Information System Consultant’s Handbook.