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A New Visual Stimulation Program for Improving Visual Acuity in Children with Visual Impairment: A Pilot Study.

Tsai LT, Hsu JL, Wu CT, Chen CC, Su YC - Front Hum Neurosci (2016)

Bottom Line: Significant gains in VA were found after the VS training [VA = 1.05 logMAR ± 0.80 to 0.61 logMAR ± 0.53, Z = -2.20, asymptotic significance (2-tailed) = 0.028].No significant changes were observed in the FVQ assessment [92.8 ± 12.6 to 100.8 ±SD = 15.4, Z = -1.46, asymptotic significance (2-tailed) = 0.144].VEP measurement showed improvement in P100 latency and amplitude or integration of the waveform in two participants.

View Article: PubMed Central - PubMed

Affiliation: School of Occupational Therapy, College of Medicine, National Taiwan UniversityTaipei, Taiwan; Occupational Therapy-Low Vision Rehabilitation, University of Alabama, BirminghamAL, USA.

ABSTRACT
The purpose of this study was to investigate the effectiveness of visual rehabilitation of a computer-based visual stimulation (VS) program combining checkerboard pattern reversal (passive stimulation) with oddball stimuli (attentional modulation) for improving the visual acuity (VA) of visually impaired (VI) children and children with amblyopia and additional developmental problems. Six children (three females, three males; mean age = 3.9 ± 2.3 years) with impaired VA caused by deficits along the anterior and/or posterior visual pathways were recruited. Participants received eight rounds of VS training (two rounds per week) of at least eight sessions per round. Each session consisted of stimulation with 200 or 300 pattern reversals. Assessments of VA (assessed with the Lea symbol VA test or Teller VA cards), visual evoked potential (VEP), and functional vision (assessed with the Chinese-version Functional Vision Questionnaire, FVQ) were carried out before and after the VS program. Significant gains in VA were found after the VS training [VA = 1.05 logMAR ± 0.80 to 0.61 logMAR ± 0.53, Z = -2.20, asymptotic significance (2-tailed) = 0.028]. No significant changes were observed in the FVQ assessment [92.8 ± 12.6 to 100.8 ±SD = 15.4, Z = -1.46, asymptotic significance (2-tailed) = 0.144]. VEP measurement showed improvement in P100 latency and amplitude or integration of the waveform in two participants. Our results indicate that a computer-based VS program with passive checkerboard stimulation, oddball stimulus design, and interesting auditory feedback could be considered as a potential intervention option to improve the VA of a wide age range of VI children and children with impaired VA combined with other neurological disorders.

No MeSH data available.


Related in: MedlinePlus

Results of pattern visual evoked potential (VEP) testing before and after the VS program in case A5 (A) and case A6 (B). Pre- and post-measurements of VEP were completed by case A5 and case A6. After training, the VEP amplitude was increased compared with pre-test, and this phenomenon was persistent in two cases. (A) Data from case A5: increased P100 amplitude (pre: 1.97 uV; post: 4.78 uV); (B) Data from case A6: post-training, shortened latency (pre: 144 ms; post: 118 ms), and increased amplitude of P100 (pre: 5.85 uV; post: 9.59 uV).
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Figure 2: Results of pattern visual evoked potential (VEP) testing before and after the VS program in case A5 (A) and case A6 (B). Pre- and post-measurements of VEP were completed by case A5 and case A6. After training, the VEP amplitude was increased compared with pre-test, and this phenomenon was persistent in two cases. (A) Data from case A5: increased P100 amplitude (pre: 1.97 uV; post: 4.78 uV); (B) Data from case A6: post-training, shortened latency (pre: 144 ms; post: 118 ms), and increased amplitude of P100 (pre: 5.85 uV; post: 9.59 uV).

Mentions: For the pattern reversal VEP (PRVEP), four of the participants finished the pre-test (cases A1 and A3 strongly refused the EEG cap), and cases A4, A5, and A6 finished the post-test (case A2 resisted patching for the VEP test). In addition to retinoschisis, case A4 also had abnormal nystagmus, which caused the pattern reversal response to be absent. In the end, only data from cases A5 and A6 were analyzed to present the change before and after the visual training (Figure 2A: A5, Figure 2B: A6). For case A5, there were slight changes in the P100 latency (pre-test: 97 ms; post-test: 108 ms), but apparent changes in amplitudes (pre-test: 1.97 uV; post-test: 4.78 uV) were noted after training. For case A6, the P100 latency was shorter (pre-test: 144 ms; post-test 118 ms), P100 amplitude was increased (pre-test: 5.85 uV; post-test: 9.59 uV), after visual training.


A New Visual Stimulation Program for Improving Visual Acuity in Children with Visual Impairment: A Pilot Study.

Tsai LT, Hsu JL, Wu CT, Chen CC, Su YC - Front Hum Neurosci (2016)

Results of pattern visual evoked potential (VEP) testing before and after the VS program in case A5 (A) and case A6 (B). Pre- and post-measurements of VEP were completed by case A5 and case A6. After training, the VEP amplitude was increased compared with pre-test, and this phenomenon was persistent in two cases. (A) Data from case A5: increased P100 amplitude (pre: 1.97 uV; post: 4.78 uV); (B) Data from case A6: post-training, shortened latency (pre: 144 ms; post: 118 ms), and increased amplitude of P100 (pre: 5.85 uV; post: 9.59 uV).
© Copyright Policy
Related In: Results  -  Collection

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Show All Figures
getmorefigures.php?uid=PMC4834310&req=5

Figure 2: Results of pattern visual evoked potential (VEP) testing before and after the VS program in case A5 (A) and case A6 (B). Pre- and post-measurements of VEP were completed by case A5 and case A6. After training, the VEP amplitude was increased compared with pre-test, and this phenomenon was persistent in two cases. (A) Data from case A5: increased P100 amplitude (pre: 1.97 uV; post: 4.78 uV); (B) Data from case A6: post-training, shortened latency (pre: 144 ms; post: 118 ms), and increased amplitude of P100 (pre: 5.85 uV; post: 9.59 uV).
Mentions: For the pattern reversal VEP (PRVEP), four of the participants finished the pre-test (cases A1 and A3 strongly refused the EEG cap), and cases A4, A5, and A6 finished the post-test (case A2 resisted patching for the VEP test). In addition to retinoschisis, case A4 also had abnormal nystagmus, which caused the pattern reversal response to be absent. In the end, only data from cases A5 and A6 were analyzed to present the change before and after the visual training (Figure 2A: A5, Figure 2B: A6). For case A5, there were slight changes in the P100 latency (pre-test: 97 ms; post-test: 108 ms), but apparent changes in amplitudes (pre-test: 1.97 uV; post-test: 4.78 uV) were noted after training. For case A6, the P100 latency was shorter (pre-test: 144 ms; post-test 118 ms), P100 amplitude was increased (pre-test: 5.85 uV; post-test: 9.59 uV), after visual training.

Bottom Line: Significant gains in VA were found after the VS training [VA = 1.05 logMAR ± 0.80 to 0.61 logMAR ± 0.53, Z = -2.20, asymptotic significance (2-tailed) = 0.028].No significant changes were observed in the FVQ assessment [92.8 ± 12.6 to 100.8 ±SD = 15.4, Z = -1.46, asymptotic significance (2-tailed) = 0.144].VEP measurement showed improvement in P100 latency and amplitude or integration of the waveform in two participants.

View Article: PubMed Central - PubMed

Affiliation: School of Occupational Therapy, College of Medicine, National Taiwan UniversityTaipei, Taiwan; Occupational Therapy-Low Vision Rehabilitation, University of Alabama, BirminghamAL, USA.

ABSTRACT
The purpose of this study was to investigate the effectiveness of visual rehabilitation of a computer-based visual stimulation (VS) program combining checkerboard pattern reversal (passive stimulation) with oddball stimuli (attentional modulation) for improving the visual acuity (VA) of visually impaired (VI) children and children with amblyopia and additional developmental problems. Six children (three females, three males; mean age = 3.9 ± 2.3 years) with impaired VA caused by deficits along the anterior and/or posterior visual pathways were recruited. Participants received eight rounds of VS training (two rounds per week) of at least eight sessions per round. Each session consisted of stimulation with 200 or 300 pattern reversals. Assessments of VA (assessed with the Lea symbol VA test or Teller VA cards), visual evoked potential (VEP), and functional vision (assessed with the Chinese-version Functional Vision Questionnaire, FVQ) were carried out before and after the VS program. Significant gains in VA were found after the VS training [VA = 1.05 logMAR ± 0.80 to 0.61 logMAR ± 0.53, Z = -2.20, asymptotic significance (2-tailed) = 0.028]. No significant changes were observed in the FVQ assessment [92.8 ± 12.6 to 100.8 ±SD = 15.4, Z = -1.46, asymptotic significance (2-tailed) = 0.144]. VEP measurement showed improvement in P100 latency and amplitude or integration of the waveform in two participants. Our results indicate that a computer-based VS program with passive checkerboard stimulation, oddball stimulus design, and interesting auditory feedback could be considered as a potential intervention option to improve the VA of a wide age range of VI children and children with impaired VA combined with other neurological disorders.

No MeSH data available.


Related in: MedlinePlus