This study will test the hypothesis whether visual field defect caused by chronic stroke could be improved by visual perceptual learning. The secondary hypothesis is that improvement of visual field defect would be accompanied by connectivity changes in visual networks. In addition, investigators will evaluate whether improvement of visual field defect could achieve improvement of subjective visual function.
Study design: A PROBE (Prospective, Randomized, Open-label, Blinded-endpoint) design Methods: 1. Visual perceptual learning (VPL) group 1. Visual perceptual learning (24 times for 2 months, 3 times per week) in visual field defect areas 2. At baseline and post-VPL evaluations (2 months after): Structural \& Functional MRIs, Visual field tests, Visual evoked potential, Visual cognitive tests, Subjective visual function questionnaires 2. Control group 1. At baseline and 2-months later: No VPL, Structural \& Functional MRIs, Visual field tests, Visual evoked potential, Visual cognitive tests, Subjective visual function questionnaires 2. Visual perceptual learning after 2-month follow-up evaluation (24 times for 2 months, 3 times per week) (The patients who were stratified by age (over 65 years old or not) and degree of visual field defect (quadrantanopia or complete hemianopia) will be randomly assigned into the learning and control group.) 3. Investigations 1. Improvement of visual field test scores between VPL group and control group 2. Analysis of brain network changes in MRI data 3. Correlation analysis of improvement of visual field defect and MRI data 4. Correlation analysis of improvement of visual field defect and visual evoked potential (VEP) data 5. Correlation analysis of improvement of visual field defect and neuropsychological data
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
36
24 times of training for visual perceptual learning
Asan Medical Center
Seoul, South Korea
Improvement of visual field scores in visual field defect areas
Improvement of mean deviation scores in defected areas by Humphrey 750i Field test
Time frame: At 2 months (plus or minus 7 days) after baseline evaluation
Performance of visual perceptual learning
Performance (scores) of visual perceptual learning
Time frame: At 2 months (plus or minus 7 days) after baseline evaulation
Connectivity changes in MRI
1. Functional connectivity changes in resting-state functional MRI 2. Structural connectivity changes in diffusion tensor imaging
Time frame: Between baseline and 2 months (plus or minus 7 days) after
Improvement of visual field score in whole visual field area
Improvement of mean deviation scores in whole visual field by Humphrey 750i Field test
Time frame: At 2 months (plus or minus 7days) after baseline evaluation
Change of subjective visual function
1. Change in Korean version of National Eye institute Visual Functioning Questionnaire-25 (NEI-VFQ-25) 2. Change of subjective visual field area
Time frame: At 2 months (plus or minus 7days) after baseline evaluation
Changes of visual evoked potential
Changes between baseline and 2 months after in half-field visual evoked potential (VEP) data
Time frame: Between baseline and 2 months (plus or minus 7 days) after
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