ABSTRACT
PURPOSE: The definition of eccentric viewing (EV) is using non-foveal preferred retinal loci (PRL) for viewing. The purpose of the present study was to investigate the clinical effect of EV training for low vision rehabilitation in patients with central scotomas. METHODS: The direction of EV was monitored in 30 low vision patients with central scotomas by moving the patient's view. The PRL was found by using a direct ophthalmoscope and retinal camera; the preserved visual field was identified using a kinetic visual field analyzer. The relationships between EV, PRL, and visual field were evaluated. The patients and their guardians were educated regarding EV. After 2 weeks of self-training, maintenance of EV was checked and changes in best-corrected visual acuity (BCVA), reading speed, and satisfaction questionnaire were evaluated. RESULTS: A relationship between EV, PRL, and visual field was in accordance in half of the patients. There were no significant differences in demographics and basic visual characteristics in patients where the relationship was not in accordance. EV was maintained in two-thirds of the patients, but there were no significant differences in demographics and basic visual characteristics in patients who discontinued EV. There were no significant improvements in BCVA; however, reading speed and the satisfaction scores increased significantly with EV. CONCLUSIONS: The direction of EV was effectively detected by convenient access using an inexpensive method. Functional vision and satisfaction significantly improved following EV training. EV training can be used as an effective method for low vision rehabilitation in patients with central scotomas.
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Patient Satisfaction , Surveys and Questionnaires , Reading , Rehabilitation/methods , Scotoma/physiopathology , Vision, Low/physiopathology , Visual Acuity/physiologyABSTRACT
El objetivo de nuestro estudio es conocer la prevalencia de alteraciones en el campo visual de pacientes con migraña, determinar si la pérdida del campo visual es transitoria o permanente y evaluar la existencia de una correlación anatómica que explique la alteración del campo visual en esta entidad. Se evaluaron 35 pacientes con migraña y un grupo control de 35 pacientes con cefalea tensional. En el primer grupo se encontraron tres pacientes (8.5 por ciento) con alteraciones campimétricas, uno de ellos portador de migraña con aura y dos con aura prolongada. Las alteraciones campimétricas observadas fueron bicuadrantanopsia inferior derecha, hemianopsia binasal y reducción concéntrica. En el grupo control no se encontraron alteraciones campimétricas (p-0.24). Los tres pacientes con alteraciones campimétricas mostraron zonas de isquemia en la región occipital en la tomografía axial computarizada. Los resultados muestran que la frecuencia de presentación de alteraciones campimétricas entre los grupos no tuvo significancia estadística. Sin embargo, cabe hacer notar que aproximadamente uno de cada diez pacientes con migraña pueden presentar alteraciones campimétricas. Las alteraciones campimétricas se correlacionaron con zonas de isquemia en la región occipital. En los pacientes con migraña es recomendable realizar la evaluación del campo visual, particularmente en aquellos pacientes que han experimentado fenómenos visuales.