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Medicine (Baltimore) ; 97(11): e9890, 2018 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-29538218

RESUMEN

RATIONALE: Visual therapy, which includes a restorative and compensatory approach, seems to be a viable treatment option for homonymous defects of the visual field in patients with postgeniculate injury of the visual pathway, due to occipital arteriovenous malformation (AVM). Until now, the Mexican population suffering from homonymous hemianopia did not have health services that provided any type of visual therapy for their condition. PATIENT CONCERNS: A 31-year-old patient, who underwent a surgical procedure for resection of the AVM, was referred with posterior low vision on the left side. DIAGNOSES: The patient was diagnosed with left homonymous hemianopia. INTERVENTIONS: Visual neurorehabilitation therapy (NRT), which integrated restorative and compensatory approaches, was administered for 3 hours each week. NRT included fixation, follow-up, search, peripheral vision, and reading. OUTCOMES: The NRT did not change visual field defects and, retinotopocally, the same campimetric defects remained. However, after training the tracking ocular movements improved to standard values on the ENG, further, the visual search became more organized. The reading reached a level without mistakes, with rhythm and goog intonation. The Beck test demostrated an improvement in depression symptoms. Regarding the daily life activities, the patient reported significant improvements. LESSONS: Visual NRT can significantly improve eye movements, as well as the quality of life and independence of the patient. This integral approach could be an effective therapeutic option for homonymous defects of the visual field.


Asunto(s)
Malformaciones Arteriovenosas/cirugía , Hemianopsia , Rehabilitación Neurológica/métodos , Lóbulo Occipital , Complicaciones Posoperatorias , Calidad de Vida , Movimientos Sacádicos , Procedimientos Quirúrgicos Vasculares/efectos adversos , Adulto , Femenino , Hemianopsia/diagnóstico , Hemianopsia/etiología , Hemianopsia/fisiopatología , Hemianopsia/psicología , Humanos , Lóbulo Occipital/irrigación sanguínea , Lóbulo Occipital/cirugía , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/fisiopatología , Complicaciones Posoperatorias/psicología , Resultado del Tratamiento , Procedimientos Quirúrgicos Vasculares/métodos , Pruebas del Campo Visual/métodos , Vías Visuales/lesiones
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