Clinical and laboratory evaluation of peripheral prism glasses for hemianopia.
Clinical and laboratory evaluation of peripheral prism glasses for hemianopia.
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DOI：
10.1097/opx.0b013e31819f9e4d
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发表时间：
2009-05
期刊：
影响因子：
--
通讯作者：
Peli E
中科院分区：
文献类型：
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作者：
Giorgi RG;Woods RL;Peli E
同名偏盲(每只眼同侧视力丧失)会损害导航和安全行走的能力。在一项长期配戴试验中，我们评估了周边棱镜作为一种治疗偏盲的低视力光学装置。23名完全性偏盲患者(右13例)，既没有视觉忽视，也没有认知障碍，参加了5次访问研究。为了扩大水平视野，患者的眼镜上和下都安装了压上™菲涅尔棱镜段(各40个棱镜屈光度)，横跨半盲(盲侧)晶状体的上和下部分。患者被要求在平均9周(范围：5到13周)的研究期间尽可能多地佩戴这些眼镜。测量临床成功(持续佩戴，表明总体受益)、视野扩大、感知方向和感知生活质量。临床成功：21名患者中有14名(67%)在研究结束时选择继续佩戴周边棱镜(2名患者因非视力原因未能完成研究)。在长期随访(8至51个月)时，12名患者中有5名(42%)报告仍在使用该装置。视野扩张：所有患者的上、下象限均有大约22度的视野扩张(双目视野计，Goldmann V4e)。感知方向：两名患者表现出对周边棱镜产生的视觉方向变化的一过性适应。生活质量：在研究结束时，报告了注意偏盲侧障碍的困难减少。据报道，外周棱镜为完成研究的患者中的三分之二提供了好处(通常是在避障方面)，对于视力康复设备来说，这是一个非常好的成功率。讨论了感知方向的长期中断和有限适应的可能原因。
Homonymous hemianopia (the loss of vision on the same side in each eye) impairs the ability to navigate and walk safely. We evaluated peripheral prism glasses as a low vision optical device for hemianopia in an extended wearing trial. Twenty-three patients with complete hemianopia (13 right) with neither visual neglect nor cognitive deficit enrolled in the 5-visit study. To expand the horizontal visual field, patients’ spectacles were fitted with both upper and lower Press-On™ Fresnel prism segments (each 40 prism diopters) across the upper and lower portions of the lens on the hemianopic (“blind”) side. Patients were asked to wear these spectacles as much as possible for the duration of the study, which averaged 9 (range: 5 to 13) weeks. Clinical success (continued wear, indicating perceived overall benefit), visual field expansion, perceived direction and perceived quality of life were measured. Clinical Success: 14 of 21 (67%) patients chose to continue to wear the peripheral prism glasses at the end of the study (2 patients did not complete the study for non-vision reasons). At long-term follow-up (8 to 51 months), 5 of 12 (42%) patients reported still wearing the device. Visual Field Expansion: Expansion of about 22 degrees in both the upper and lower quadrants was demonstrated for all patients (binocular perimetry, Goldmann V4e). Perceived Direction: Two patients demonstrated a transient adaptation to the change in visual direction produced by the peripheral prism glasses. Quality of Life: At study end, reduced difficulty noticing obstacles on the hemianopic side was reported. The peripheral prism glasses provided reported benefits (usually in obstacle avoidance) to 2/3 of the patients completing the study, a very good success rate for a vision rehabilitation device. Possible reasons for long-term discontinuation and limited adaptation of perceived direction are discussed.