To date, there’s still no widely accepted treatment for stroke-induced homonymous hemianopia. Motion discrimination therapy may be a possible therapy for reducing visual field deficits in these patients. A recent randomized study evaluated this approach but found no difference between patients and controls.
The clinical trial included 48 subjects between 21 and 75 years of age with stroke-induced homonymous hemianopia. All participants participated in 20- to 30-minute therapy sessions at home for six months. Before and after the therapy period, they underwent OCT, perimetry and quality of life testing.
“Although both training cohorts generated substantial areas of improvement over baseline within both the deficit and sighted hemifields, no group difference was observed,” the researchers noted. “Both training groups showed regions of worsened visual sensitivity in both hemifields, with sighted-field training resulting in more worsening than deficit-field training in the deficit hemifield.”
The researchers stated that their results do not agree with previously published studies. They suggested that this may be because they didn’t use a true placebo, i.e., the sighted hemifield was assumed to be visually intact and used as the control, while other studies report this field is far from normal with respect to processing speed and contrast sensitivity.
Cavanaugh MR, Blanchard LM, McDermott M, et al. Efficacy of visual retraining in the hemianopic field after stroke: results of a randomized clinical trial. Ophthalmology. November 22, 2020. [Epub ahead of print].