Table 4.
Summary of studies on digital therapeutics as vision rehabilitation in stroke patients
| Study | Study design | Sample size (n) | Intervention | Study description | Stage of stroke | Frequency of intervention | Follow-up | Outcome measures | Results |
|---|---|---|---|---|---|---|---|---|---|
| Sahraie et al. (2016) [72] | Clinical controlled study | IG: 16 | NEC Computer-based compensatory therapy | IG: NEC training | Chronic | 45 min/level, total of 12 levels | 2 wk intervention | TÜP | An improvement of around 31% in scanning speed in the cancellation task and 21% in the visual search task. |
| CG: 16 | CG: no training | 11 wk post-intervention | Pen and paper version of the cancellation tasks and visual search tasks | ||||||
| Aimola et al. (2014) [73] | RCT | IG:28 | Computer-based compensatory therapy | IG: reading and writing training | Chronic | 1 hr/day | 5 wk intervention | OculusTwinfield 2 perimeter | IG demonstrated a significant improvement in exploration and reading compared to CG. |
| CG:24 | CG: control training | Visual search tasks | |||||||
| TEA,SART1VFQ-251VIQ | |||||||||
| Sato et al. (2014) [74] | Pre-poststudy | 9 | VISIOcoach computer-based compensatory therapy | The visual performance measures compared in pre-training and post-training | Unspecified | Unspecified | 8 wk intervention | HVF30-2, ETDRSVA, Peiii-Robson Contrast Sensitivity chart, MP-1 microperimetry, video-recording of eye movements | Performance in reading tasks did not differ significantly after training. However, head and eye movements improved in all patients. |
| Kasten et al. (1995) [76] | Clinical controlled study | IG: 11 | Computer-based VRT | IG: computer-based VRT | Unspecified | 1 hr/day | 80-300 hr intervention | HRP | IG demonstrated a significant improvement in the detection of small light stimuli and an increased ability to discriminate colors in the blind field, whereas CG showed a decrease in the visual field. |
| CG:3 | CG: little or no therapy | TAP | |||||||
| Kasten et al. (1998) [77] | RCT | IG: 19 | Computer-based VRT | IG: computerized VRT | Chronic | 1 hr/day except Sundays | 6 mo intervention | HRP | VRT led to a significant improvement (29.4%) in the ability to detect visual stimuli in IG. 4.9°一5.8° visual-field expansion was observed. CG did not show comparable improvements. |
| CG: 19 | CG: placebo-no train-ing | TAP | |||||||
| Reinhard et al. (2005) [79] | Clinical controlled study | 17 | Computer-based VRT | The visual performance measures compared in pre-training and post-training | Chronic | 1 hr/day, 6 day/wk | 6 mo intervention | SLO | None of the patients showed a significant change in the visual field defect after training. |
| HRP | |||||||||
| TAP | |||||||||
| Schreiber et al. (2006) [80] | Clinical controlled study | 16 | Computer-based VRT | The visual performance measures compared in pre and post-training | Chronic | 1 hr/day, 6 day/wk | 6 mo intervention | SAP | VRT has little effect in rehabilitation of HVFD. |
| Huxlin et al. (2018) [70] | Clinical controlled trial | IG 17 | VPL | IG:VPL | Chronic | 300 trials/day, 5 day/wk | 3-14 mo intervention | HVF 24-2 and 10-2 | IG recovered 108 degrees [2] of vision on average, while CG improved over an area of 16 degrees [2]. |
| CG5 | CG: no training | Discrimination task performance | |||||||
| Das et al. (2014) [81] | Clinical controlled trial | Group 1:3 | VPL | Group 1: static orientation training | Chronic | 300 trials for 5 day/wk | - | HVF | Moving stimuli and double training may be superior training tools for inducing visual recovery in CB. |
| Graup 2:6 | Group 2: motion and static orientation discrimination training | ||||||||
| Huxlin et al. (2009) [82] | Clinical controlled study | 7 | VPL | The visual performance measures were compared in pre-training and post-training | Chronic | Unspecified | 9-18 mo intervention | HVF 24-2 and 10-2 | Perceptual relearning of complex visual motion processing is possible with damaged primary visual cortex when VPL is presented in the blind field. |
| Discrimination task performance |
IG, intervention group; CG, control group; NEC, NeuroEyeCoach; TÜP, Tübingen perimeter; RCT, randomized controlled trial; TEA, Test of Everyday Attention; SART, Sustained Attention to Response task; VFQ-25, Visual Functioning Questionnaire-25; VIQ, Visual Impairments Questionnaire; HVF, Humphrey Visual field; ETDRS VA, Early Treatment Diabetic Retinopathy Study Visual Acuity; MP-1, MicroPerimeter 1; VRT, visual restoration therapy; HRP, High-resolution perimetry; TAP, Tübinger automatic perimeter; SLO, scanning laser ophthalmoscope; SAP, static automated perimetry; HVFD, homonymous visual field defect; VPL, visual perceptual learning.