Perceptual learning improves visual functions in patients with albinistic bilateral amblyopia: A pilot study

Vision recovery with perceptual learning and non-invasive brain stimulation: Experimental set-ups and recent results, a review of the literature

BACKGROUND

Vision is the sense which we rely on the most to interact with the environment and its integrity is fundamental for the quality of our life. However, around the globe, more than 1 billion people are affected by debilitating vision deficits. Therefore, finding a way to treat (or mitigate) them successfully is necessary.

OBJECTIVE

This narrative review aims to examine options for innovative treatment of visual disorders (retinitis pigmentosa, macular degeneration, optic neuropathy, refractory disorders, hemianopia, amblyopia), especially with Perceptual Learning (PL) and Electrical Stimulation (ES).

METHODS

ES and PL can enhance visual abilities in clinical populations, inducing plastic changes. We describe the experimental set-ups and discuss the results of studies using ES or PL or their combination in order to suggest, based on literature, which treatment is the best option for each clinical condition.

RESULTS

Positive results were obtained using ES and PL to enhance visual functions. For example, repetitive transorbital Alternating Current Stimulation (rtACS) appeared as the most effective treatment for pre-chiasmatic disorders such as optic neuropathy. A combination of transcranial Direct Current Stimulation (tDCS) and visual training seems helpful for people with hemianopia, while transcranial Random Noise Stimulation (tRNS) makes visual training more efficient in people with amblyopia and mild myopia.

CONCLUSIONS

This narrative review highlights the effect of different ES montages and PL in the treatment of visual disorders. Furthermore, new options for treatment are suggested. It is noteworthy to mention that, in some cases, unclear results emerged and others need to be more deeply investigated.

Mechanisms Underlying Directional Motion Processing and Form-Motion Integration Assessed with Visual Perceptual Learning

Dynamic Glass patterns (GPs) are visual stimuli commonly employed to study form–motion interactions. There is brain imaging evidence that non-directional motion induced by dynamic GPs and directional motion induced by random dot kinematograms (RDKs) depend on the activity of the human motion complex (hMT+). However, whether dynamic GPs and RDKs rely on the same processing mechanisms is still up for dispute. The current study uses a visual perceptual learning (VPL) paradigm to try to answer this question. Identical pre- and post-tests were given to two groups of participants, who had to discriminate random/noisy patterns from coherent form (dynamic GPs) and motion (RDKs). Subsequently, one group was trained on dynamic translational GPs, whereas the other group on RDKs. On the one hand, the generalization of learning to the non-trained stimulus would indicate that the same mechanisms are involved in the processing of both dynamic GPs and RDKs. On the other hand, learning specificity would indicate that the two stimuli are likely to be processed by separate mechanisms possibly in the same cortical network. The results showed that VPL is specific to the stimulus trained, suggesting that directional and non-directional motion may depend on different neural mechanisms.

Broad and Long-Lasting Vision Improvements in Youth With Infantile Nystagmus After Home Training With a Perceptual Learning App

Current treatments for infantile nystagmus (IN), focused on dampening the oscillating eye movements, yield little to no improvement in visual functioning. It makes sense, however, to treat the visual impairments associated with IN with tailored sensory training. Recently, we developed such a training, targeting visual crowding as an important bottleneck in visual functioning with an eye-movement engaging letter discrimination task. This training improved visual performance of children with IN, but most children had not reached plateau performance after 10 supervised training sessions (3,500 trials). Here, we evaluate the effects of prolonged perceptual learning (14,000 trials) in 7-18-year-old children with IN and test the feasibility of tablet-based, at-home intervention. Results demonstrate that prolonged home-based perceptual training results in stable, long lasting visual acuity improvements at distance and near, with remarkably good transfer to reading and even stereopsis. Improvements on self-reported functional vision scores underline the clinical relevance of perceptual learning with e-health apps for individuals with IN.