visual rehabilitation

视觉康复
  • 文章类型: Journal Article
    背景:评估MP-3微周边生物反馈固定训练(MBFT)在患有中心性视力丧失的黄斑疾病的低视力患者的视力康复中的疗效。
    方法:17只眼(7例年龄相关性黄斑变性,17例患者中的10例近视性黄斑病变)被纳入本前瞻性研究,介入研究。通过全面的眼底镜检查包括眼底照相来确定首选的视网膜位置,自发荧光,光学相干层析成像,和显微视野。康复包括每只眼睛进行三次10分钟的疗程,每周两次,连续20周,使用MP-3微周长。最佳矫正视力(BCVA),阅读速度,平均中央灵敏度,指定区域内固定点的百分比,在训练前后记录双变量轮廓椭圆面积(BCEA)和25项国家眼科研究所视觉功能问卷(NEI-VFQ-25)。
    结果:最终的BCVA,康复后阅读速度和平均中枢敏感度均有显著改善(分别为P<0.0001,P=0.0013和P=0.0002).训练后,位于2°和4°直径圆圈内的固定点百分比均显着增加(分别为P=0.0008和P=0.0007)。包含68.2、95.4、99.6%的固定点的BCEA在训练后均显着降低(分别为P=0.0038,P=0.0022和P=0.0021)。康复训练结束时NEI-VFQ-25评分明显升高(P<0.0001)。
    结论:使用MP-3MBFT进行康复治疗是改善视觉功能的一种用户友好的治疗选择,固定稳定性,和晚期黄斑疾病的生活质量。
    背景:前瞻性研究已在中国临床试验注册中心注册(http://www.chictr.org.cn/)。
    背景:ChiCTR2000029586。注册日期:05/02/2020。
    BACKGROUND: To evaluate the efficacy of MP-3 microperimeter biofeedback fixation training (MBFT) in vision rehabilitation of low-vision patients affected by macular disease with central vision loss.
    METHODS: Seventeen eyes (7 age-related macular degeneration, 10 myopic maculopathy) of 17 patients were included in this prospective, interventional study. The preferred retinal locus was determined by comprehensive ophthalmoscopic fundus evaluation including fundus photography, autofluorescence, optical coherence tomography, and microperimetry. The rehabilitation consisted of three 10-min sessions per eye to be performed twice per week for 20 consecutive weeks using the MP-3 microperimeter. Best corrected visual acuity (BCVA), reading speed, mean central sensitivity, the percentages of fixation points within specified regions, bivariate contour ellipse area (BCEA) and the 25-item National Eye Institute visual function questionnaire (NEI-VFQ-25) were recorded pre- and post-training.
    RESULTS: The final BCVA, reading speed and mean central sensitivity all showed significant improvements after rehabilitation (P <  0.0001, P = 0.0013, and P = 0.0002, respectively). The percentages of fixation points located within 2° and 4° diameter circles both significantly increased after training (P = 0.0008 and P = 0.0007, respectively). The BCEA encompassing 68.2, 95.4, 99.6% of fixation points were all significantly decreased after training (P = 0.0038, P = 0.0022, and P = 0.0021, respectively). The NEI-VFQ-25 scores were significantly increased at the end of the rehabilitation training (P <  0.0001).
    CONCLUSIONS: Rehabilitation with MP-3 MBFT is a user-friendly therapeutic option for improving visual function, fixation stability, and quality of life in advanced macular disease.
    BACKGROUND: The prospective study was registered with the Chinese Clinical Trial Registry ( http://www.chictr.org.cn/ ).
    BACKGROUND: ChiCTR2000029586 . Date of registration: 05/02/2020.
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  • 文章类型: Editorial
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  • 文章类型: Journal Article
    背景:剥夺性弱视在阻塞视轴的增生性持续性瞳孔膜(PPM)中是一个非常值得关注的问题。其他眼部异常可能伴随并进一步阻碍婴儿的视觉发育。我们评估了早期手术干预和及时视觉康复治疗的密集PPM和其他相关异常患者的长期视觉预后和并发症。
    方法:回顾性回顾了2000年至2020年手术切除PPM并接受视觉康复的患者的病历。除了视轴阻塞PPM,纳入合并其他弱视危险因素或眼部异常的患者。由于如果存在潜在的白内障,为随后的晶状体摘除做准备,包括器械和伤口方向在内的手术设置与白内障手术相似.所有患者均尽快纳入视觉康复计划。结果包括性别,年龄,操作时间,初始和最终视力,屈光不正,并记录并发症。
    结果:本病例系列包括5例患者中的7例。手术的平均年龄为42.3±21.1个月(范围,5至66个月),术后随访期为4.9年(范围,1.2至8.2年)。手术时患者年龄为2.5个月至2.5岁(平均,14个月)。术后平均随访5.3年(范围,2.5-8年)。没有术中和术后并发症。最终BCVA的平均值为0.29logMAR(范围,0到1logMAR)。屈光不正和斜视的相关眼部异常导致最佳的视觉预后。
    结论:在PPM患者中,使用我们的技术,所有患者均无明显并发症.手术设置更容易处理并且更熟悉儿科外科医生。除了修补剥夺之外,对于有屈光不正性和斜视性弱视风险的患者,早期PPM干预和及时的视觉康复可达到最佳的视觉预后。
    背景:本次回顾展,介入病例系列研究于2000年4月1日至2020年4月31日在中国医科大学附属医院进行。(IRB编号:CMUH109-REC2-069)。
    BACKGROUND: Deprivation amblyopia is a great concern in hyperplastic persistent pupillary membranes (PPM) which blocked visual axis. Other ocular abnormality may accompany and further hinder the visual development of the infants. We evaluate the long-term visual prognosis and complications in patients with dense PPM and other associated abnormalities treated with early surgical intervention and timely visual rehabilitation.
    METHODS: Medical records of patients with surgical removal of PPM from 2000 to 2020 and also receiving visual rehabilitation were retrospectively reviewed. Besides visual axis blocked PPM, patients combined with other amblyopic risk factors or ocular abnormalities were included. Due to preparation for subsequent lens extraction if an underlying cataract was present, the surgical settings including the instruments and wound direction were similar to cataract surgery. All patients were enrolled in a visual rehabilitation program as soon as possible. The results including sex, age, timing of operation, initial and final visual acuity, refractive errors, and complications were recorded.
    RESULTS: Seven cases of five patients were included in this case series. Mean age at surgery was 42.3 ± 21.1 months (range, 5 to 66 months) and the post-operative follow-up period was 4.9 years (range, 1.2 to 8.2 years). The patient age at time of surgery ranged from 2.5 months to 2.5 years (mean, 14 months). Mean postoperative follow-up was 5.3 years (range, 2.5-8 years). There were no intra-operative and post-operative complications. Final BCVA varied with a mean value of 0.29 logMAR (range, 0 to 1 logMAR). An associated ocular abnormality of ametropia and strabismus led to the best visual prognosis.
    CONCLUSIONS: In patients with PPM, there were no significant complications in any patient using our technique. The surgical settings are easier to handle and more familiar with pediatric surgeons. Besides deprivation with patching, early PPM intervention and timely visual rehabilitation achieve the best visual prognosis in patients associated with risk of ametropic and strabismic amblyopia.
    BACKGROUND: This retrospective, interventional case series study was conducted at China Medical University Hospital between April 1, 2000 and April 31, 2020. (IRB number: CMUH109-REC2-069 ).
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  • 文章类型: Journal Article
    Neuroscience, especially visual neuroscience, is a burgeoning field that has greatly shaped the format and efficacy of education. Moreover, findings from visual neuroscience are an ongoing source of great progress in pedagogy. In this mini-review, I review existing evidence and areas of active research to describe the fundamental questions and general applications for visual neuroscience as it applies to education. First, I categorize the research questions and future directions for the role of visual neuroscience in education. Second, I juxtapose opposing views on the roles of neuroscience in education and reveal the \"neuromyths\" propagated under the guise of educational neuroscience. Third, I summarize the policies and practices applied in different countries and for different age ranges. Fourth, I address and discuss the merits of visual neuroscience in art education and of visual perception theories (e.g., those concerned with perceptual organization with respect to space and time) in reading education. I consider how vision-deprived students could benefit from current knowledge of brain plasticity and visual rehabilitation methods involving compensation from other sensory systems. I also consider the potential educational value of instructional methods based on statistical learning in the visual domain. Finally, I outline the accepted translational framework for applying findings from educational neuroscience to pedagogical theory.
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  • 文章类型: Journal Article
    To investigate the effectiveness, safety and tolerance of rigid gas-permeable contact lenses (RGP CLs) in the visual rehabilitation of unilateral aphakic children in China.
    Records of 36 children (36 eyes) with RGP CLs to unilateral aphakia between 2014 and 2018 were evaluated. Each enrolled child underwent vision assessment (visual acuity, fixation, and deviation) at each follow-up visit and their caregivers completed a questionnaire designed to find out the reasons for RGP CLs dropout. The fit characteristics and adverse events were also evaluated.
    The mean age was 7.0 months (interquartile range, 5.0-12.8 months). The final mean logMAR visual acuity (VA) of the treated eyes was 1.2 ± 0.7 for 12 patients who cooperated in visual assessments and 6 out of these subjects had a VA of better than 1.0 logMAR. The proportion of treated eyes which could be recorded the visual results increased significantly after RGP CLs intervention (5.6% vs. 33.3%, P < 0.001). The final VA assessed for the fellow eyes and both eyes were 0.7 ± 0.4 and 0.6 ± 0.3, respectively. Of the 36 patients, 24 had strabismus. There was no severe lens-related adverse event except only one patient had mild conjunctivitis. At the end of the follow-up it was found that 25 eyes are still using RGP CLs (69%). Indications to discontinue contact lens wear included difficult manipulation of RGP CL, loss of motivation, unstable lens, and eye irritation.
    RGP contact lenses provide an effective and safe alternative method for visual rehabilitation and can be well tolerated in pediatric aphakia.
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  • 文章类型: Journal Article
    OBJECTIVE: To present the results of implantation of Iakymenko keratoprosthesis in five patients with vascularized corneal leukoma caused by severe ocular injury.
    METHODS: Iakymenko keratoprosthesis was implanted into 5 eyes of 5 patients: 4 patients were suffered from chemical burns and 1 patient from explosive injury. The preoperative visual acuity ranged from light perception to hand motion. The implantation surgery was composed of two-stage procedures. The follow-up period was from 9 months to 11 years. The outcome measures were visual acuity, retention, and complications of the keratoprosthesis.
    RESULTS: Vision improvements were achieved in most patients. All keratoprosthesis were retained within the follow-up period. Corneal melting occurred in one patient and fibrous closure in another patient, both of which were successfully treated. Retinal detachment occurred in one patient after surgery.
    CONCLUSIONS: Iakymenko keratoprosthesis seems to be a promising alternative for the patients with severe corneal injury, but further investigation is needed to evaluate the role of Iakymenko keratoprosthesis.
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