扫视视觉搜索训练治疗同向偏盲

作     者：Pambakian A.L.M. Mannan S.K. Hodgson T.L. Kennard C. 夏峰 

作者机构：Department of Sensory Motor Systems Div. of Neurosci. and P sychol. Med. Imperial College School of Medicine London United Kingdom 

出 版 物：《世界核心医学期刊文摘（神经病学分册）》 (Digest of the World Core Medical Journals:Clinical Neurology)

年 卷 期：2005年第1卷第2期

页      面：37-37页

学科分类：1002[医学-临床医学] 100212[医学-眼科学] 10[医学] 

主　　题：同向偏盲 电视监视仪 代偿机制 眼球运动 功能改善情况 随访过程 搜索范围 客观评估 问卷调查 

摘      要：Objectives: We describe a novel rehabilitation tool for patients with homonymo us hemianopia based on a visual search (VS) paradigm that is portable, inexpensi ve, and easy to deploy. We hypothesised that by training patients to improve the efficiency of eye movements made in their blind field their disability would be alleviated. Methods: Twenty nine patients with homonymous visual field defects (HVFD) without neglect practised VS paradigms in 20 daily sessions over one mont h. Search fields comprising randomly positioned target and distracter elements, differing by a single feature, were displayed for three seconds on a dedicated t elevision monitor in the patientshomes. Improvements were assessed by examinin g response time (RT), error rates in VS, perimetric visual fields (VFs) and visu al search fields (VSFs), before and after treatment. Functional improvements wer e measured using objective visual tasks which represented activities of daily li ving (ADL) and a subjective questionnaire. Results: As a group the patients had significantly shorter mean RT in VS after training (p 0.001) and demonstrated a variety of mechanisms to account for this. Improvements were confined to the t raining period and maintained at follow up. Three patients had significantly lon ger RT after training. They had high initial error rates which improved with tra ining. Patients performed ADL tasks significantly faster after training and repo rted significant subjective improvements. There was no concomitant enlargement o f the VF, but there was a small but significant enlargement of the VSF. Conclusi on: Patients can improve VS with *** usually involves shorter RTs, but occasionally a longer RT in a complex speed accuracy trade off. These changes translate to improved overall visual function, assessed objectively and subject ively, suggesting that they represent robust training effects. The underlying me chanism may involve the adoption of compensatory eye movement strateg