Skip to main content
Erschienen in: Documenta Ophthalmologica 3/2014

01.12.2014 | Original Research Article

Short-term effects of vision trainer rehabilitation in patients affected by anisometropic amblyopia: electrofunctional evaluation

verfasst von: Paolo Esposito Veneruso, Lucia Ziccardi, Giulia Magli, Benedetto Falsini, Adriano Magli

Erschienen in: Documenta Ophthalmologica | Ausgabe 3/2014

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The aim of the present study was to evaluate the short-term effects of the vision trainer rehabilitation technique on retinal and post-retinal function in young amblyopic patients outside the critical visual developmental period.

Methods

Twenty-one patients (mean age 12.2 ± 2.7 years, ranging from 9.1 to 18 years) affected by unilateral anisometropic amblyopia were studied, providing 21 amblyopic eyes (AE) and 21 sound eyes (SE). Thirty eyes from 15 age-similar normal subjects served as controls. All subjects underwent extensive ophthalmologic characterization to exclude any disease not related to amblyopia. All AE were subjected to rehabilitation sessions performed by the Retimax vision trainer (VT) program. The protocol consisted of 2 sessions per week, each lasting 10 min, for 10 consecutive weeks. Before and after the rehabilitation, electrophysiological [pattern electroretinogram (PERG) and visual evoked potential (VEP)] and psychophysical [best corrected visual acuity (BCVA) and microperimetry] data were collected from AE and SE.

Results

When comparing baseline data with those collected at the end of the study, PERG P50-N95 amplitude and BCVA values from AE had improved significantly by the end of the study (p < 0.05). Our electrophysiological findings also showed some abnormalities in SE when the data were compared to control eyes. We found a significant correlation (p < 0.05) between PERG amplitude and VEP implicit time in SE after visual rehabilitation.

Conclusions

Short-term visual rehabilitation performed by the VT program ameliorated the electrofunctional and psychophysical parameters of vision in children outside the critical developmental period, thus indicating that VT might be a potential adjuvant therapy of traditional patching treatment.
Literatur
1.
Zurück zum Zitat Wiesel TN, Hubel DH (1963) Single-cell responses in striate cortex of kittens deprived of vision in one eye. J Neurophysiol 26:1003–1017PubMed Wiesel TN, Hubel DH (1963) Single-cell responses in striate cortex of kittens deprived of vision in one eye. J Neurophysiol 26:1003–1017PubMed
2.
Zurück zum Zitat Von Noorden GK (1985) Amblyopia a multidisciplinary approach. Proctor lecture. Invest Ophthalmol Vis Sci 26:1704–1716 Von Noorden GK (1985) Amblyopia a multidisciplinary approach. Proctor lecture. Invest Ophthalmol Vis Sci 26:1704–1716
3.
Zurück zum Zitat Miki A, Liu GT, Goldsmith ZG, Liu C-SJ, Haselgrove JC (2003) Decreased activation of the lateral geniculate nucleus in a patient with anisometropic amblyopia demonstrated by functional magnetic resonance imaging. Ophthalmologica 217:365–369PubMedCrossRef Miki A, Liu GT, Goldsmith ZG, Liu C-SJ, Haselgrove JC (2003) Decreased activation of the lateral geniculate nucleus in a patient with anisometropic amblyopia demonstrated by functional magnetic resonance imaging. Ophthalmologica 217:365–369PubMedCrossRef
4.
Zurück zum Zitat Samarawickrama C, Huynh SC, Mitchell P (2009) Retinal structure in amplyopia. Ophthalmology 116:2041PubMedCrossRef Samarawickrama C, Huynh SC, Mitchell P (2009) Retinal structure in amplyopia. Ophthalmology 116:2041PubMedCrossRef
5.
Zurück zum Zitat Al-Haddad CE, El Mollayess GM, Mahfoud ZR, Jaafar DF, Bashshur ZF (2013) Macular ultrastructural features in amblyopia using high-definition optical coherence tomography. Br J Ophthalmol 97:318–322PubMedCrossRef Al-Haddad CE, El Mollayess GM, Mahfoud ZR, Jaafar DF, Bashshur ZF (2013) Macular ultrastructural features in amblyopia using high-definition optical coherence tomography. Br J Ophthalmol 97:318–322PubMedCrossRef
6.
Zurück zum Zitat Dickmann A, Petroni S, Perrotta V et al (2012) Measurement of retinal nerve fiber layer thickness, macular thickness, and foveal volume in amblyopic eyes using spectral-domain optical coherence tomography. J AAPOS 16:86–88PubMedCrossRef Dickmann A, Petroni S, Perrotta V et al (2012) Measurement of retinal nerve fiber layer thickness, macular thickness, and foveal volume in amblyopic eyes using spectral-domain optical coherence tomography. J AAPOS 16:86–88PubMedCrossRef
7.
Zurück zum Zitat Celesia GG, Bodis-Wollner I, Chatrian GE, Harding GFA, Sokol S, Spekreijse H (1993) Recommended standards for electroretinograms and visual evoked potentials: report of an IFCN committee. Electroencephalogr Clin Neurophysiol 87:421–436PubMedCrossRef Celesia GG, Bodis-Wollner I, Chatrian GE, Harding GFA, Sokol S, Spekreijse H (1993) Recommended standards for electroretinograms and visual evoked potentials: report of an IFCN committee. Electroencephalogr Clin Neurophysiol 87:421–436PubMedCrossRef
8.
Zurück zum Zitat Marmor MF (1989) An international standard for electroretinography. Doc Ophthalmol 73:299–302PubMedCrossRef Marmor MF (1989) An international standard for electroretinography. Doc Ophthalmol 73:299–302PubMedCrossRef
9.
Zurück zum Zitat Parisi V, Manni G, Spadaro M et al (1999) Correlation between morphological and functional retinal impairment in multiple sclerosis patients. Invest Ophthalmol Vis Sci 40:2520–2527PubMed Parisi V, Manni G, Spadaro M et al (1999) Correlation between morphological and functional retinal impairment in multiple sclerosis patients. Invest Ophthalmol Vis Sci 40:2520–2527PubMed
10.
Zurück zum Zitat Maffei L, Fiorentini A (1981) Electroretinographic responses to alternating gratings before and after section of the optic nerve. Science 211:953–955CrossRef Maffei L, Fiorentini A (1981) Electroretinographic responses to alternating gratings before and after section of the optic nerve. Science 211:953–955CrossRef
11.
Zurück zum Zitat Maffei L, Fiorentini A (1982) Electroretinographic responses to alternating gratings in the cat. Exp Brain Res 48:327–334PubMedCrossRef Maffei L, Fiorentini A (1982) Electroretinographic responses to alternating gratings in the cat. Exp Brain Res 48:327–334PubMedCrossRef
12.
Zurück zum Zitat Morrone C, Fiorentini A, Bisti S, Porciatti V, Burr DC (1994) Pattern-reversal electroretinogram in response to chromatic stimuli: II. Monkey. Vis Neurosci 11:873–884PubMedCrossRef Morrone C, Fiorentini A, Bisti S, Porciatti V, Burr DC (1994) Pattern-reversal electroretinogram in response to chromatic stimuli: II. Monkey. Vis Neurosci 11:873–884PubMedCrossRef
13.
Zurück zum Zitat Porciatti V, Schiavi C, Benedetti P, Baldi A, Campos EC (1998) Cytidine-5 minute-diphosphocholine improves visual acuity, contrast sensitivity and visually-evoked potentials of amblyopic subjects. Curr Eye Res 17:141–148PubMedCrossRef Porciatti V, Schiavi C, Benedetti P, Baldi A, Campos EC (1998) Cytidine-5 minute-diphosphocholine improves visual acuity, contrast sensitivity and visually-evoked potentials of amblyopic subjects. Curr Eye Res 17:141–148PubMedCrossRef
14.
Zurück zum Zitat Campos EC, Prampolini ML, Gulli R (1984) Contrast sensitivity differences between strabismic and anisometropic amblyopia: objective correlate by means of visual evoked responses. Doc Ophthalmol 58:45–50PubMedCrossRef Campos EC, Prampolini ML, Gulli R (1984) Contrast sensitivity differences between strabismic and anisometropic amblyopia: objective correlate by means of visual evoked responses. Doc Ophthalmol 58:45–50PubMedCrossRef
16.
Zurück zum Zitat Parisi V, Scarale ME, Balducci N, Fresina M, Campos EC (2010) Electrophysiological detection of delayed postretinal neural conduction in human amblyopia. Invest Ophthalmol Vis Sci 51:5041–5048PubMedCrossRef Parisi V, Scarale ME, Balducci N, Fresina M, Campos EC (2010) Electrophysiological detection of delayed postretinal neural conduction in human amblyopia. Invest Ophthalmol Vis Sci 51:5041–5048PubMedCrossRef
17.
Zurück zum Zitat Tugcu B, Araz-Ersan B, Kilic M, Erdogan ET, Yigit U, Karamursel S (2013) The morpho-functional evaluation of retina in amblyopia. Curr Eye Res 38:802–809PubMedCrossRef Tugcu B, Araz-Ersan B, Kilic M, Erdogan ET, Yigit U, Karamursel S (2013) The morpho-functional evaluation of retina in amblyopia. Curr Eye Res 38:802–809PubMedCrossRef
18.
Zurück zum Zitat Medghalchi AR, Dalili S (2011) A randomized trial of atropine vs patching for treatment of moderate amblyopia. Iran Red Crescent Med J 13:578–581PubMedCentralPubMed Medghalchi AR, Dalili S (2011) A randomized trial of atropine vs patching for treatment of moderate amblyopia. Iran Red Crescent Med J 13:578–581PubMedCentralPubMed
19.
Zurück zum Zitat Scheiman MM, Hertle RW, Kraker RT, Pediatric Eye Disease Investigator Group et al (2008) Patching vs atropine to treat amblyopia in children aged 7 to 12 years: a randomized trial. Arch Ophthalmol 126:1634–1642PubMedCrossRef Scheiman MM, Hertle RW, Kraker RT, Pediatric Eye Disease Investigator Group et al (2008) Patching vs atropine to treat amblyopia in children aged 7 to 12 years: a randomized trial. Arch Ophthalmol 126:1634–1642PubMedCrossRef
20.
Zurück zum Zitat Pediatric Eye Disease Investigator Group, Repka MX, Kraker RT, Becket RW et al (2008) A randomized trial of atropine vs. patching for treatment of moderate amblyopia: follow-up at age 10 years. Arch Ophthalmol 126:1039–1044PubMedCrossRef Pediatric Eye Disease Investigator Group, Repka MX, Kraker RT, Becket RW et al (2008) A randomized trial of atropine vs. patching for treatment of moderate amblyopia: follow-up at age 10 years. Arch Ophthalmol 126:1039–1044PubMedCrossRef
21.
Zurück zum Zitat Pediatric Eye Disease Investigator Group Writing Committee, Rutstein RP, Quinn GE, Lazar EL et al (2010) Randomized trial comparing Bangerter filters and patching for the treatment of moderate amblyopia in children. Ophthalmology 117:998–1004PubMedCrossRef Pediatric Eye Disease Investigator Group Writing Committee, Rutstein RP, Quinn GE, Lazar EL et al (2010) Randomized trial comparing Bangerter filters and patching for the treatment of moderate amblyopia in children. Ophthalmology 117:998–1004PubMedCrossRef
22.
Zurück zum Zitat Lennerstrand G, Samuelsson B (1983) Amblyopia in 4-year-old children treated with grating stimulation and full-time occlusion; a comparative study. Br J Ophthalmol 67:181–190PubMedCentralPubMedCrossRef Lennerstrand G, Samuelsson B (1983) Amblyopia in 4-year-old children treated with grating stimulation and full-time occlusion; a comparative study. Br J Ophthalmol 67:181–190PubMedCentralPubMedCrossRef
23.
Zurück zum Zitat Tytla ME, Labow-Daily LS (1981) Evaluation of the CAM treatment for amblyopia: a controlled study. Invest Ophthalmol Vis Sci 20:400–406PubMed Tytla ME, Labow-Daily LS (1981) Evaluation of the CAM treatment for amblyopia: a controlled study. Invest Ophthalmol Vis Sci 20:400–406PubMed
24.
Zurück zum Zitat Willshaw HE, Malmheden A, Clarke J, Williams A, Dean L (1980) Experience with the CAM vision stimulator: preliminary report. Br J Ophthalmol 64:339–341PubMedCentralPubMedCrossRef Willshaw HE, Malmheden A, Clarke J, Williams A, Dean L (1980) Experience with the CAM vision stimulator: preliminary report. Br J Ophthalmol 64:339–341PubMedCentralPubMedCrossRef
25.
Zurück zum Zitat Campbell FW, Hess RF, Watson PG, Banks R (1978) Preliminary results of a physiologically based treatment of amblyopia. Br J Ophthalmol 62:748–755PubMedCentralPubMedCrossRef Campbell FW, Hess RF, Watson PG, Banks R (1978) Preliminary results of a physiologically based treatment of amblyopia. Br J Ophthalmol 62:748–755PubMedCentralPubMedCrossRef
26.
Zurück zum Zitat Eastgate RM, Griffiths GD, Waddingham PE et al (2006) Modified virtual reality technology for treatment of amblyopia. Eye (Lond) 20:370–374CrossRef Eastgate RM, Griffiths GD, Waddingham PE et al (2006) Modified virtual reality technology for treatment of amblyopia. Eye (Lond) 20:370–374CrossRef
27.
Zurück zum Zitat Cleary M, Moody AD, Buchanan A, Stewart H, Dutton GN (2009) Assessment of a computer-based treatment for older amblyopes: the Glasgow Pilot Study. Eye (Lond) 23:124–131CrossRef Cleary M, Moody AD, Buchanan A, Stewart H, Dutton GN (2009) Assessment of a computer-based treatment for older amblyopes: the Glasgow Pilot Study. Eye (Lond) 23:124–131CrossRef
28.
Zurück zum Zitat Contestabile MT, Recupero SM, Palladino D et al (2002) A new method of biofeedback in the management of low vision. Eye (Lond) 16:472–480CrossRef Contestabile MT, Recupero SM, Palladino D et al (2002) A new method of biofeedback in the management of low vision. Eye (Lond) 16:472–480CrossRef
29.
Zurück zum Zitat Giorgi D, Contestabile MT, Pacella E, Gabrieli CB (2005) An instrument for biofeedback applied to vision. Appl Psychophysiol Biofeedback 30:389–395PubMedCrossRef Giorgi D, Contestabile MT, Pacella E, Gabrieli CB (2005) An instrument for biofeedback applied to vision. Appl Psychophysiol Biofeedback 30:389–395PubMedCrossRef
30.
Zurück zum Zitat Flom MC, Kirschen DG, Bedell HE (1980) Control of unsteady, eccentric fixation in amblyopic eyes by auditory feedback of eye position. Invest Ophthalmol Vis Sci 19:1371–1381PubMed Flom MC, Kirschen DG, Bedell HE (1980) Control of unsteady, eccentric fixation in amblyopic eyes by auditory feedback of eye position. Invest Ophthalmol Vis Sci 19:1371–1381PubMed
31.
32.
Zurück zum Zitat Levi DM (2005) Perceptual learning in adults with amblyopia: a reevaluation of critical periods in human vision. Dev Psychobiol 46:222–232PubMedCrossRef Levi DM (2005) Perceptual learning in adults with amblyopia: a reevaluation of critical periods in human vision. Dev Psychobiol 46:222–232PubMedCrossRef
33.
Zurück zum Zitat Polat U, Ma-Naim T, Spierer A (2009) Treatment of children with amblyopia by perceptual learning. Vis Res 49:2599–2603PubMedCrossRef Polat U, Ma-Naim T, Spierer A (2009) Treatment of children with amblyopia by perceptual learning. Vis Res 49:2599–2603PubMedCrossRef
34.
Zurück zum Zitat Scheiman MM, Hertle RW, Beck RW, Edwards AR et al (2005) Randomized trial of treatment of amblyopia in children aged 7 to 17 years. Arch Ophthalmol 123:437–447PubMedCrossRef Scheiman MM, Hertle RW, Beck RW, Edwards AR et al (2005) Randomized trial of treatment of amblyopia in children aged 7 to 17 years. Arch Ophthalmol 123:437–447PubMedCrossRef
35.
Zurück zum Zitat Lewis TL, Maurer D (2005) Multiple sensitive periods in human visual development: evidence from visually deprived children. Dev Psychobiol 46:163–183PubMedCrossRef Lewis TL, Maurer D (2005) Multiple sensitive periods in human visual development: evidence from visually deprived children. Dev Psychobiol 46:163–183PubMedCrossRef
36.
Zurück zum Zitat Yalcin E, Balci O (2014) Efficacy of perceptual vision therapy in enhancing visual acuity and contrast sensitivity function in adult hypermetropic anisometropic amblyopia. Clin Ophthalmol 8:49–53PubMedCentralPubMed Yalcin E, Balci O (2014) Efficacy of perceptual vision therapy in enhancing visual acuity and contrast sensitivity function in adult hypermetropic anisometropic amblyopia. Clin Ophthalmol 8:49–53PubMedCentralPubMed
37.
Zurück zum Zitat Nazemi F, Markowitz SN, Kraft S (2008) Treatment of anisometropic amblyopia in older children using macular stimulation with telescopic magnification. Can J Ophthalmol 43:100–104PubMedCrossRef Nazemi F, Markowitz SN, Kraft S (2008) Treatment of anisometropic amblyopia in older children using macular stimulation with telescopic magnification. Can J Ophthalmol 43:100–104PubMedCrossRef
38.
Zurück zum Zitat Parisi V, Manni G, Spadaro M et al (1999) Correlation between morphological and functional retinal impairment in multiple sclerosis patients. Invest Ophthalmol Vis Sci 40:2520–2527PubMed Parisi V, Manni G, Spadaro M et al (1999) Correlation between morphological and functional retinal impairment in multiple sclerosis patients. Invest Ophthalmol Vis Sci 40:2520–2527PubMed
39.
Zurück zum Zitat Parisi V, Gallinaro G, Ziccardi L, Coppola G (2008) Electrophysiological assessment of visual function in patients with non-arteritic ischaemic optic neuropathy. Eur J Neurol 15:839–845PubMedCrossRef Parisi V, Gallinaro G, Ziccardi L, Coppola G (2008) Electrophysiological assessment of visual function in patients with non-arteritic ischaemic optic neuropathy. Eur J Neurol 15:839–845PubMedCrossRef
40.
Zurück zum Zitat Ziccardi L, Sadun F, De Negri AM et al (2013) Retinal function and neural conduction along the visual pathways in affected and unaffected carriers with Leber’s hereditary optic neuropathy. Invest Ophthalmol Vis Sci 54:6893–6901PubMedCrossRef Ziccardi L, Sadun F, De Negri AM et al (2013) Retinal function and neural conduction along the visual pathways in affected and unaffected carriers with Leber’s hereditary optic neuropathy. Invest Ophthalmol Vis Sci 54:6893–6901PubMedCrossRef
41.
Zurück zum Zitat Fiorentini A, Maffei L, Pirchio M, Spinelli D, Porciatti V (1981) The ERG in response to alternating gratings in patients with diseases of the peripheral visual pathway. Invest Ophthalmol Vis Sci 21:490–493PubMed Fiorentini A, Maffei L, Pirchio M, Spinelli D, Porciatti V (1981) The ERG in response to alternating gratings in patients with diseases of the peripheral visual pathway. Invest Ophthalmol Vis Sci 21:490–493PubMed
42.
Zurück zum Zitat Hawlina M, Konec B (1992) New non-corneal HK-loop electrode for clinical electroretinography. Doc Ophthalmol 81:253–259PubMedCrossRef Hawlina M, Konec B (1992) New non-corneal HK-loop electrode for clinical electroretinography. Doc Ophthalmol 81:253–259PubMedCrossRef
43.
Zurück zum Zitat Porciatti V, Falsini B (1993) Inner retina contribution to the flicker electroretinogram: a comparison with the pattern electroretinogram. Clin Vis Sci 8:435–447 Porciatti V, Falsini B (1993) Inner retina contribution to the flicker electroretinogram: a comparison with the pattern electroretinogram. Clin Vis Sci 8:435–447
44.
Zurück zum Zitat Jasper HH (1958) The ten-twenty electrode system of the international federation of electroencephalography. Electroncephalogr Clin Neurophysiol 10:371–375 Jasper HH (1958) The ten-twenty electrode system of the international federation of electroencephalography. Electroncephalogr Clin Neurophysiol 10:371–375
45.
Zurück zum Zitat Fujii GY, de Juan E, Sunness J Jr, Humayun MS, Pieramici DJ, Chang TS (2002) Patient selection for macular translocation surgery using the scanning laser ophthalmoscope. Ophthalmology 109:1737–1744PubMedCrossRef Fujii GY, de Juan E, Sunness J Jr, Humayun MS, Pieramici DJ, Chang TS (2002) Patient selection for macular translocation surgery using the scanning laser ophthalmoscope. Ophthalmology 109:1737–1744PubMedCrossRef
46.
Zurück zum Zitat Sokol S, Nadler D (1979) Simultaneous electroretinograms and visually evoked potentials from adult amblyopes in response to a pattern stimulus. Invest Ophthalmol Vis Sci 18:848–855PubMed Sokol S, Nadler D (1979) Simultaneous electroretinograms and visually evoked potentials from adult amblyopes in response to a pattern stimulus. Invest Ophthalmol Vis Sci 18:848–855PubMed
47.
Zurück zum Zitat Arden GB, Wooding SL (1985) Pattern ERG in amblyopia. Invest Ophthalmol Vis Sci 26:88–96PubMed Arden GB, Wooding SL (1985) Pattern ERG in amblyopia. Invest Ophthalmol Vis Sci 26:88–96PubMed
Metadaten
Titel
Short-term effects of vision trainer rehabilitation in patients affected by anisometropic amblyopia: electrofunctional evaluation
verfasst von
Paolo Esposito Veneruso
Lucia Ziccardi
Giulia Magli
Benedetto Falsini
Adriano Magli
Publikationsdatum
01.12.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
Documenta Ophthalmologica / Ausgabe 3/2014
Print ISSN: 0012-4486
Elektronische ISSN: 1573-2622
DOI
https://doi.org/10.1007/s10633-014-9462-x

Weitere Artikel der Ausgabe 3/2014

Documenta Ophthalmologica 3/2014 Zur Ausgabe

Neu im Fachgebiet Augenheilkunde

Ophthalmika in der Schwangerschaft

Die Verwendung von Ophthalmika in der Schwangerschaft und Stillzeit stellt immer eine Off-label-Anwendung dar. Ein Einsatz von Arzneimitteln muss daher besonders sorgfältig auf sein Risiko-Nutzen-Verhältnis bewertet werden. In der vorliegenden …

Operative Therapie und Keimnachweis bei endogener Endophthalmitis

Vitrektomie Originalie

Die endogene Endophthalmitis ist eine hämatogen fortgeleitete, bakterielle oder fungale Infektion, die über choroidale oder retinale Gefäße in den Augapfel eingeschwemmt wird [ 1 – 3 ]. Von dort infiltrieren die Keime in die Netzhaut, den …

Bakterielle endogene Endophthalmitis

Vitrektomie Leitthema

Eine endogene Endophthalmitis stellt einen ophthalmologischen Notfall dar, der umgehender Diagnostik und Therapie bedarf. Es sollte mit geeigneten Methoden, wie beispielsweise dem Freiburger Endophthalmitis-Set, ein Keimnachweis erfolgen. Bei der …

So erreichen Sie eine bestmögliche Wundheilung der Kornea

Die bestmögliche Wundheilung der Kornea, insbesondere ohne die Ausbildung von lichtstreuenden Narben, ist oberstes Gebot, um einer dauerhaften Schädigung der Hornhaut frühzeitig entgegenzuwirken und die Funktion des Auges zu erhalten.   

Update Augenheilkunde

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.