Vision restoration therapy

1 Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
2 New York University School of Medicine, NY, USA
3 Emory University School of Medicine, Atlanta, GA, USA
4 Neurology and Neuro-Ophthalmology, Northeast Health System, USA
5 Cerebrovascular Division, University of Miami, FL, USA
6 Bascom Palmer Eye Institute, Miami, FL, USA

Correspondence to:
Jose G Romano
MD, Cerebrovascular Division, University of Miami, FL, USA; jromano@med.miami.edu

Accepted for publication 1 March 2005

Keywords: vision restoration therapy

A recent paper1 and accompanying editorials2,3 in the BJO have raised the question of whether vision restoration therapy is effective in the rehabilitation of visual field defects. As members of the scientific medical advisory board of NovaVision, we believe these editorials require comment and refer the interested reader to an opposing editorial in a recent issue of the BJO by Sabel and colleagues4 and to an article in press in Restorative Neurology and Neuroscience.5 Although we acknowledge that statements by members of an advisory board are always complicated by potential conflicts of interest, we hope that our colleagues will recognise our commitment to scientific debate.

We believe the current evidence does not support Horton’s contention that "no therapeutic intervention...can correct effectively the underlying visual field deficit" after post-chiasmatic injury. On the contrary, a comprehensive and critical review of the literature reveals that there is a sound scientific basis for recommending vision restoration therapy for some patients with hemianopia. Studies of the practical effectiveness and scientific basis of vision restoration therapy are now ongoing, and patients are being treated at nine US centres. We urge physicians and scientists to review the current literature and the results of future studies as they become available. Although there are clearly important questions regarding this intervention that need to be elucidated, it is evident that the main goal, that of visual rehabilitation, is attained for some of those treated with vision restoration therapy. In our opinion, the preponderance of the data supports the notion that this intervention is valuable and results in visual improvement for certain patients with visual field defects.

References

Reinhard J , Schreiber A, Schiefer U, et al. Does visual restitution training change absolute homonymous visual field defect? A fundus-controlled study. Br J Ophthalmol 2005;89:30–5.

Horton JC. Disappointing results from Nova Vision’s visual restoration therapy. Br J Ophthalmol 2005;89:1–2.

Plant GT. A workout for hemianopia. Br J Ophthalmol 2005;89:2.

Sabel BA, S Kenkel S, Kasten E. Vision restoration therapy. Br J Ophthalmol 2005;89:522–4.

Sabel BA, Kenkel S, Kasten E. Vision restoration therapy (VRT) efficacy as assessed by comparative perimetric analysis and subjective questionnaires. Restor Neurol Neurosci 2004;22:399–420.