Abstract
Improvement of residual vision by visuo-spatial cueing in patients with homonymous visual field loss
Objectives: In areas of residual vision of patients with visual field defects, perceptual thresholds are elevated. Can visual performance of patients – like in healthy subjects – be improved by orienting attention at the visual field border with a spatial cue?
Methods: Experiment 1: Test of immediate, short-term effects of attention of a spatial cue in a visual field test. Experiment 2: Use of the same cue in a training program for the restoration of visual functions (experimental group) and comparison with the effects of visual field training without a cue (control group).
Results: Experiment 1: Compared to uncued conditions, stimulus detection was increased and reaction times were decreased after presentation of a cue. The size of the attention effect depended on the size of the area of residual vision. Experiment 2: The experimental group showed a more pronounced permanent increase of intact field size in the cued area than in unattended regions or than the control group. The cue changed the topographical pattern of visual field plasticity.
Conclusion: A systematic combination of light stimulation (bottom-up) at the visual field border with spatial attention (top-down) yields short-term as well as long-term improvement of visual function that is more pronounced than the effects of light stimulation alone. Cognitive processes established in research with healthy subjects can be implemented in neuropsychological rehabilitation to improve treatment outcome.
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