Mejoría de la visión en una serie de pacientes con déficit visual de origen neurológico
Palabras clave:
Personas con Daño Visual, estimulación luminosa (estimulación visual), vías visuales, agudeza visual, rehabilitación, resultado del tratamiento, Visually impaired persons, photic stimulation, visual pathways, visual acuity, rehabilitation, treatment outcomResumen
RESUMEN
Antecedentes. Existe una gran frecuencia y prevalencia de lesiones, patologías y trastornos que afectan la función visual, generando frecuentemente, déficit y/o deterioro permanente y discapacidad visual. Entre las causas, las lesiones neurológicas visuales, trascienden la etiología oftalmológica y óptica clásica, y suponen un reto diagnostico, terapéutico y de rehabilitación. Objetivo. Mejorar (rehabilitar) la función visual en personas con déficit de la vía visual por medio de un protocolo original de restricción monocular del mejor ojo y programa intensivo, controlado y estructurado de estimulación visual del ojo con visión más afectada. Método. Investigación cuasi-experimental en 10 pacientes con deterioro visual neurológico secundario a enfermedad vascular, inflamatoria o traumática. Cada paciente posee una evaluación basal de su condición visual, una intervención (restricción visual más programa de estimulación visual), y una evaluación final. La evaluación basal y final tiene medición de agudeza visual (AV), imagen funcional (RMf visual) y perfil de funcionamiento visual. Investigación con aval del Comité de Ética de la Fundación Instituto Neurológico de Colombia. Resultados. Se encontró una mejoría global del 60% de los pacientes en AV cercana y lejana, con un valor p de significancia estadística. La comparación de medias de AV entre los pacientes antes y después de la intervención posee un valor p significativo: AV cercana valor P=0.0171 y AV lejana valor P=0.0099. Se obtuvieron cambios en el patrón de activación por RMf visual. Conclusiones. Hay indicios de mejoría (rehabilitación) de la función visual, mediante cambios en AV y RMf visual, indicando posiblemente un proceso de rehabilitación visual en fase crónica de déficit visual neurológico.
Palabras clave: Personas con Daño Visual, estimulación luminosa (estimulación visual), vías visuales, agudeza visual, rehabilitación, resultado del tratamiento.
VISION IMPROVEMENT IN A SERIES OF PATIENTS WITH NEUROLOGICAL VISUAL DEFICIT
Abstract
Background. There is a high frequency and prevalence of injuries, diseases and disorders that affect visual function, often generating deficit and / or permanent visual impairment and disability. Among the causes, visual nerve damage goes beyond classical etiology and pose diagnostic, therapeutic and rehabilitation challenges. Objective. To improve (rehabilitate) visual function in people with visual pathway deficit through an original protocol consisting in better eye monocular restriction and an intensive program, with controlled and structured visual stimulation of the affected eye with more vision. Method. Quasi- experimental research in 10 patients with neurological visual impairment secondary to vascular, traumatic or inflammatory disease. All patients have a baseline assessment of their visual condition, an intervention (visual restriction plus visual stimulation program), and a final evaluation. Baseline and final assessments include measurement of visual acuity (VA), functional imaging (visual fMRI) and profile of visual functioning. This research project was underwritten by the Ethics Committee of the Instituto Neurológico de Colombia. Results. Overall improvement in 60% of patients was found in close and far VA, with a p-value of statistical significance. Comparison of means of VA between patients before and after the intervention has a significant p value: VA P value = 0.0171 near and distant VA P value = 0.0099. Changes were obtained in the pattern of fMRI visual activation. Conclusions: There are signs of improvement (rehabilitation) of visual function through changes in VA and visual fMRI, possibly indicating a process of visual rehabilitation in the chronic phase of a visual neurological deficit.
Key words: Visually impaired persons, photic stimulation, visual pathways, visual acuity, rehabilitation, treatment outcome
Biografía del autor/a
Juan Camilo Suárez, Instituto Neurológico de Colombia
Mariana Atehortúa, Universidad CES Sabaneta
Mercedes Molina, Clínica Oftalmológica San Diego
Marta Muñoz, Clínica Oftalmológica San Diego
John Fredy Ochoa
José Iván Jiménez, Instituto Neurológico de Colombia
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