Asynchronous Dichoptic Visual Perceptual Training for Patients with Primary Open-Angle Glaucoma: A Pilot Study

Abstract Purpose We aimed to observe changes in the visual function of patients with primary open-angle glaucoma (POAG) after undergoing binocular asynchronous visual training. Methods Seven patients with POAG with binocular visual field defects underwent binocular asynchronous dichoptic virtual reality (VR)-based visual perceptual training for 20 days (45 min/session/day, 5 sessions/week, for 4 weeks). Perimetry, contrast sensitivity (CS), and vision-related quality of life assessments were performed for all patients. Results Six months after completing training, nine of 14 eyes showed better performance in the perimetry (the mean deviation [MD] of perimetry was improved as compared to baseline), including six severe eyes and three mild POAG eyes. Moreover, the MD values of four of the nine eyes showed significant improvement (more than 1-dB increase as compared to baseline), including three severe eyes and one mild POAG eye. However, the MD values did not differ significantly between baseline and post-training. Contrast sensitivity tests, performed at three spatial frequencies (3, 6, and 18 cycles/degree) were significantly enhanced after asynchronous dichoptic training ( p = 0.021, 0.026, and 0.020, respectively). Conclusion Patients with POAG, particularly those with severe POAG, performed significantly better in perimetry after training. All patients showed significantly improved performance on the CS tests. Improvements in visual function were sustained for at least 6 months. These results suggest that visual rehabilitation in patients with POAG can be achieved through asynchronous VR-based dichoptic visual perceptual training. A larger randomized clinical trial is required to confirm these effects. Trial registration: The trial registration number is #ChiCTR2100054625.