Abstract
In recent years, virtual reality (VR) has emerged as a new safe and effective tool for neurorehabilitation of different childhood and adulthood conditions. VR-based therapies can induce cortical reorganization and promote the activation of different neuronal connections over a wide range of ages, leading to contrasted improvements in motor and functional skills. The use of VR for the visual rehabilitation in amblyopia has been investigated in the last years, with the potential of using serious games combining perceptual learning and dichoptic stimulation. This combination of technologies allows the clinician to measure, treat, and control changes in interocular suppression, which is one of the factors leading to cortical alterations in amblyopia. Several clinical researches on this issue have been conducted, showing the potential of promoting visual acuity, contrast sensitivity, and stereopsis improvement. Indeed, several systems have been evaluated for amblyopia treatment including the use of different commercially available types of head mounted displays (HMDs). These HMDs are mostly well tolerated by patients during short exposures and do not cause significant long-term side effects, although their use has been occasionally associated with some visual discomfort and other complications in certain types of subjects. More studies are needed to confirm these promising therapies in controlled randomized clinical trials, with special emphasis on the definition of the most adequate planning for obtaining an effective recovery of the visual and binocular function.
Highlights
Among the more recent products resulting from the evolution of digital technology, virtual reality (VR) has become increasingly entrenched in the field of clinical medicine, emerging as a new safe and effective tool in particular with regard to neurorehabilitation of different childhood and adulthood conditions [1,2,3,4,5]
VR technology can be used as a rehabilitation tool to exploit the sensory-motor adaptive capacity of the nervous system to compensate the deficits given in different pathologies, providing a technological method for intensive and repetitive training. is therapy approach allows researchers to manipulate the specificity and frequency of sensory feedback provided to the patient, resulting in adaptive learning algorithms and graduated rehabilitation activities that can be objectively and systematically modified to create individualized treatment paradigms
More and more studies are emerging to test VR-based therapies efficacy in rehabilitation of different disorders; the effectiveness of these studies has not yet reached the higher levels of evidence found in large scale randomised clinical trials (RCTs). us, more research is needed to establish the efficacy of sensory-motor rehabilitation through VR in various and larger clinical populations, and more importantly, to identify VR training parameters associated with an optimal transfer into real-world functional improvements
Summary
Among the more recent products resulting from the evolution of digital technology, virtual reality (VR) has become increasingly entrenched in the field of clinical medicine, emerging as a new safe and effective tool in particular with regard to neurorehabilitation of different childhood and adulthood conditions [1,2,3,4,5]. Professionals benefit from this technique, as they can have a high degree of control over the whole therapeutic experience of the patient. Journal of Ophthalmology multimodal stimuli with a high degree of validity and ecological control while recording changes in subject’s brain activity [6]. VR-based therapies have been shown to induce cortical reorganization and promote the activation of different neuronal connections over a wide range of ages [7,8,9,10], leading to contrasted improvements in some motor and functional skills, such as gait or balance [11, 12], while their potential contributions to the visual system remain virtually unexplored. Most authors who have considered the study of VR interventions in relation to vision have focused their efforts on describing the short- and long-term ocular side effects associated with its use and on recreating different performance tests to try to identify common eye disorders or related impairments [13,14,15,16], with only a few who have attempted to use this tool to improve visual abilities that are not being adequately addressed by existing treatment options [17,18,19,20]
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