重视后视路损伤的治疗与视功能的康复

摘要

累及后视路的脑卒中、脑肿瘤及脑外伤所导致同向偏盲性视野缺损在临床上很常见.尽管部分患者在损伤早期视野有部分改善,但是仍严重影响患者日常生活工作能力.国外系列研究显示以“残余视觉理论”和“脑塑形”为基础的视觉重建治疗可以通过扩大患者视野改善视功能.尽管目前国际上对视觉重建治疗效果和机制还存在较大争论,但由于视路损害所致视功能损伤的普遍危害性,以及目前缺乏其他有效的治疗手段,在国内开展多学科合作、大样本的临床病例对照研究,客观评价各种治疗康复手段的效果,对于提高后视路损伤患者的日常生活和工作能力有重要意义.%Homonymous visual field defect which is usually caused by stroke,brain tumor and trauma,is common.In spite of partial spontaneous recovery,homonymous hemianopia still causes serious disability.Visual restoration therapy (VRT) based on the residual visual capability and brain plasticity theory was reported effectively enlarged visual field caused by impairment of visual pathway.Controversy still exits on the efficacy of these procedures.However,due to the high prevalence and poor outcome of visual pathway impairment,it is important to initiate multiple disciplinary co-operative study on VRT and other procedures for visual function rehabilitation to improve life quality of patients with retro-chiasmal visual pathway impairment.