Interventions for visual field defects in patients with stroke

For visual field defects in stroke compensatory scanning training might be more beneficial than placebo or control at improving scanning ability and reading speed, but not at improving visual field outcomes, although the evidence is insufficient.

Summary

A Cochrane review included 6 studies. Four studies compared the effect of scanning (compensatory) training with a control or placebo intervention. Meta-analysis demonstrated that scanning training is more effective than control or placebo at improving reading ability (MD 3.24, 95% CI 0.84 to 5.59; 3 studies, n=129) and visual scanning (MD 18.84, 95% CI 12.01 to 25.66; 3 studies, n=129) but that scanning may not improve visual field outcomes (MD -0.70, 95% CI -2.28 to 0.88; 2 studies, n=110). There were insufficient data to enable generalised conclusions to be made about the effectiveness of scanning training relative to control or placebo for the primary outcome of activities of daily living (1 study, n=33). One study (n=19) compared the effect of a restitutive intervention with a control or placebo intervention and one study (n=39) compared the effect of a substitutive intervention with a control or placebo intervention, there were no significant differences between the groups.

Comment: The quality of evidence is downgraded by study quality (inadequate allocation concealment) and imprecise results (limited study size for each comparison) and indirectness (differences between the population of interest and those studied).

Ədəbiyyat

1. Pollock A, Hazelton C, Henderson CA et al. Interventions for disorders of eye movement in patients with stroke. Cochrane Database Syst Rev 2011;(10):CD008389.