Here, repetitive transorbital alternating current stimulation (rtACS) was applied in partially blind patients with the goal of activating their residual vision. Data Availability: Data are available from Institute for Biometry and Medical Informatics, Otto-von-Guericke University Magdeburg for researchers who meet the criteria for access to confidential data. 1. At FOLLOW-UP both groups reported subjective benefits in the NEI-VFQ scales visual field defect and related impairments (rtACS: p<0.01, sham: p = 0.02) and general health and mental distress (rtACS: p = 0.04; sham: p = 0.01), again with no significant difference between groups (p = 0.77). e0156134. The absolute change of HRP fixation accuracy and percentage of responses outside the valid response window in HRP were considered as reliability parameters. After 10 days rtACS, the mean threshold in static perimetry (median change 9.3%; CI[2.6;20.3], p = 0.003) significantly increased while after sham-stimulation no significant change in threshold in static perimetry was noted (median change 1.9%; CI [-4.8%, 8.8%]). Yes Primary and secondary endpoints were defined prospectively. Repeated transorbital alternating current stimulation (rtACS) doesn't require an operation or the implantation of electrodes in the eye. One serious adverse event with subsequent hospitalization occurred, but it was unrelated to rtACS. Vision Restoration Therapy (VRT) - NovaVision But if the brain is also affected by any additional loss of neurons, loss of functional connections in down-stream visual structures, or vascular autoregulation problems, then the complexity of the eye problem is far greater . https://doi.org/10.1371/journal.pone.0156134.g002. In prior rtACS-studies, the sham-condition was an auditory sound that mimicked current delivery [1415]. Tel. Eliana Harvey Kansas, United StatesScott Turner Birmingham, United KingdomXana LibnioCharlie FosterChester, United KingdomReinier De LangeAustraliaGary RosenNew Jersey, United StatesWalter PayneNorth Carolina, United StatesDan SpealOntario, CanadaArezou GhesmatiTexas, United States, You May Like: Glasses Prescription For 20/40 Vision. Kaia Health | 22,453 followers on LinkedIn. After BASELINE assessments patients were stimulated with either rtACS or sham-stimulation on 2 5 weekdays for 25 min at day1 to 50 min at day10 with eyes closed. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. B. , Naue, N . Post-intervention changes in the intact and residual visual field did not differ between groups. Randomization resulted in comparable average baseline situation and demographics in the rtACS- and sham-group. But stem cell transplantation was only tried in few patients and is not ready for wide scale clinical application . Analyzed the data: AL SK CG MB MD. Performance in these tests remained largely unchanged in both groups. The EEG-signal at occipital (O1, O2) areas of interest (AOIs) was referenced against the grand-average and preprocessed with ASA- software (ANT, Enschede, Netherlands) including a bandpass-filter (0.540Hz, filter-slope 24dB/oct. The Restore Vision Clinic is located in the heart of Berlin and is just a three-minute walk away from the four-star Holiday Inn hotel. Four 10mm Grass gold electrodes , 2 for each eye, were placed on the skin near the orbital cavity , and biphasic square-pulses were applied in bursts . 767-791, 2018, Read Also: Headache With Blurred Vision In One Eye. To assess functional interactions between brain regions coherence was analyzed indicating coupling between two signals as a function of frequency [19]. I'm not a doctor so take this with a grain of salt but I also recall being told that it is FDA approved. Rehabilitation centers in Germany are equipped in such a way as to recreate the "home" atmosphere as much as possible. I think this is more suited to AskScienceDiscussion than AskScience. Patients with certain types of retinal diseases including inherited dystrophies like retinitis pigmentosa and cone dystrophies have measurable benefits from this treatment as well. Results of a structured intervention-related questionnaire that also included a response category labeled not sure. According to self-organizing map (SOM)-charts relevant features for prediction are Neighborhood activity and Residual function. Crucially, children with cerebral palsy are often affected by unique visual/behavioural dysfunctions, e.g. Using these means and standard deviations in a sample size calculation for a two-sample t-test with nQuery Advisor 7.0 resulted in 41 patients per group for the first trial and 36 patients per group for the second trial. https://doi.org/10.1371/journal.pone.0156134.s003. When vision loss develops in ocular diseases affecting the retina and optic nerve, this has repercussions at the level of brain processing as well. For more information about PLOS Subject Areas, click As these cells breakdown and die, patients experience progressive vision loss, typically from the outside in, resulting in severe tunnel vision or complete blindness. Computer simulations of current flow in the intact brain suggest that a considerable amount of current enters the skull through the eye and optic nerve (Fig 3A), affecting brain regions close to the eye socket. Patients were assigned to either the rtACS- or the sham-group by Randomization In Treatment Arms software (RITA, StatSol, Lbeck) with stratified block randomization considering the study center and the VF defect depth at BASELINE as potential prognostic factors. quality of life; tDCS, visuo-spatial and motion processing, complexity/crowding, and attention deficits . Wir sind mit ganzer professioneller Leidenschaft ttig, weil uns bewusst ist, wie unendlich wichtig gerade das Sehen fr ein erflltes, selbstbestimmtes und aktives Leben ist. Its close proximity to the clinic ensures both convenience and easy access during your treatment period. High vs. low defect depth was defined as stimulus detection rates below vs. above 30% inside the VF defect. Both of these sham conditions cannot completely rule out that patients correctly guessed to which group they belonged (because of lack of phosphene experience in shams), leaving open the possibility of an expectation bias. LORETA). However, a significant increase in reaction time in the alertness test was observed in the rtACS- but not in the sham-group (S1 Table). Apparently, if you have that gene you can get a vaccine to stop the degeneration. Attentional cueing improves vision restoration therapy in patients with visual field defects. (A) Current density maxima of about 0.0044 A/m2 can be observed on the upper part of the outer eye surface that is closest to the stimulating electrode. I was so impressed with my results from June 2017 that I returned this May 2018 and again am thrilled with my results. No, PLOS is a nonprofit 501(c)(3) corporation, #C2354500, based in San Francisco, California, US, Corrections, Expressions of Concern, and Retractions, https://doi.org/10.1371/journal.pone.0156134. VF mapping was conducted using a campimetric, high-resolution, super-threshold visual detection test (HRP) [17], a method that reveals areas of residual vision in the central VF with lower inter-test-variability than standard static perimetry due to target luminance above threshold. The Hodges-Lehmann effect estimator and 95%-confidence intervals (CI) are reported. The improvement of visual functioning together with spectral power and connectivity changes in the occipital EEG alpha band [12] are consistent with the hypothesis of a retinofugal entrainment by rtACS that improves visual perception through rhythmic firing of retinal ganglion cells. We conducted a multicenter, prospective, randomized, double-blind, sham-controlled trial in an ambulatory setting with daily application of rtACS (n = 45) or sham-stimulation (n = 37) for 50 min for a duration of 10 week days. As recently shown by patients with optic nerve damage who suffer from desynchronization of spatial and temporal processing deficits of their brain functional networks [12, 29] the therapeutic effects of rtACS may be mediated by re-synchronizing the brain networks, which were desynchronized by the vision loss. here. Fixation accuracy improved significantly at POST in both groups (median increase, rtACS: 1.1%, CI[0.1; 2.5], p = 0.017; sham: 1.3%, CI[0.0; 2.6], p = 0.023), with no significant difference between groups. Important issues are whether non-invasive current stimulation-induced visual system changes are due to neuroplastic alteration, if they can be potentiated by vision training [38], and if rtACS can also improve vision in patients with post-chiasmatic lesions [39]. In the first trial a mean percentage increase ( standard deviation) of 65.61 104.35 was observed in the rtACS-group (n = 19) and 16.93 31.22 in the sham-group (n = 14). Their clinic is in Berlin and has been operational for about 4 years (Not long I know, but long enough that they surely would have been shut down if they were a scam). Eight patients had two concomitant diagnoses of optic nerve atrophy. 6,529,759. At this stage, this has resulted in improved vision in my left eye. The ethics committees of the participating study centers in Magdeburg, Berlin, and Goettingen approved the study, and a statistical analysis plan was filed with the lead ethics committee. The study design was prospective and double blind; neither the patients nor the diagnostic examiners were aware to which treatment arm the patient belonged. Inclusion criteria included: (i) stable VF defect with residual vision as detected by super-threshold perimetry testing (HRP, cut-off 1.5% in at least one eye); (ii) lesion age >6 months; (iii) patient age >18 yrs; (iv) compliance with the experimenters instructions during diagnostic testing; and (v) sufficient fixation ability. The present randomized controlled, multi-center trial of non-invasive electrical brain stimulation documents the efficacy and safety of rtACS-treatment in patients with vision loss after optic neuropathies confirming earlier, exploratory, small-sample trials [1416]. Obviously, what the brain perceives is a function of how much retinal input it receives. Improved Vision IS Possible After Optic Nerve Damage In fact, performance change in HRP correlated negatively with changes in deviations from fixation during eye-tracked HRPs, i.e. This suggests that improvements of residual vision are the key factor of vision restoration. Wrote the paper: CG AA BAS SS SAB. The primary endpoint was percent change over BASELINE in the HRP detection rate. PLOS ONE promises fair, rigorous peer review, After BASELINE assessments patients were stimulated with either rtACS or sham-stimulation on 2 5 weekdays for 25 min at day1 to 50 min at day10 with eyes closed. (2016) Alternating Current Stimulation for Vision Restoration after Optic Nerve Damage: A Randomized Clinical Trial. 1.52 of visual angle both horizontally and vertically, which is in the expected range [17]. Yes The date range for patient recruitment and follow-up was from December 2010 until February 2012. Blokowanie niektrych rodzajw plikw cookie moe wpyn na komfort korzystania z witryny i usug, ktre jestemy w stanie zaoferowa. Yes The CONSORT checklist (S1 File) and statistical analyses protocol (S2 File) are included as supporting information. Ask Our Physicians For Your Evaluation Isotropic conductivities were assigned to head tissues such as scalp, cerebrospinal fluid, gray and white matter (0.43, 1.79, 0.33, 0.142; [20]), air pockets (1e-6 S/m), skull (0.01 S/m [2122], and eye tissue (0.6, 1.05, 0.4 S/m for sclera, intraocular and nerve tissue [23]. Natrlich ist es fr die przise Befundung beim Patienten immer auch sehr wichtig, die gesamten Koordinaten fr den aktuellen Status der Augengesundheit zu bestimmen. The goal is to improve vision in diseases that are considered incurable. The beneficial functional consequence of rtACS for visual perception may possibly be explained by retinofugal entrainment and brain functional connectivity modulation [12, 16]. Needless to say, I have great respect for Dr. Fedorov and Dr. Chibisova and their passion to help the visually impaired. The differences between FOLLOW-UP and BASELINE are somewhat smaller than the differences between POST and BASELINE with a persistent significant effect in the primary measure detection accuracy in HRP in terms of both within- and between-group comparisons, indicating the stability of the gains (Fig 2A). The percent change over BASELINE was determined at 48 hrs (minimum interval) after the last stimulation day (i.e., the 10th stimulation session) (POST) and at 2 months FOLLOW-UP (FU) for each endpoint as 100*(POST resp. Is there anything I'm missing? Stem cells: What they are and what they do - Mayo Clinic After a spontaneous recovery period, visual field (VF) loss is considered irreversible which compromises vision-related quality of life (QoL) [24]. Just wondering if anyone has visited the vision restoration clinics in Germany and if so what your experiences were. For future studies in this area current flow simulations may help to target both safety considerations and improved stimulation paradigms. Stability of VF defects was ascertained by comparing VFs at BASELINE with those obtained during the screening visit 2 weeks earlier. The problem of vision restoration is not just a medical issue, but involves many other levels psychology of low vision, sociological integration and adaptation to day-to-day activity. HRP reaction time (absolute differences), visual acuity (logarithmic values) and questionnaire data were shown as absolute values. [Google . Performed the experiments: CG SS RM AM GGA MD. Data requests may be sent to imp@med.ovgu.de. No, Is the Subject Area "Visual acuity" applicable to this article? Informed written consent was obtained prior to randomization. Electrical stimulation enhances the overall activity of the visual system, and leads to functional restoration. Fedorov Therapy can't replace damaged cells or regenerate optic nerves; instead it increases the functionality of preserved cells on the retina and enhances the activity along optic nerves. In a small sample study, ACS was delivered in frequencies ranging from theta to high beta via electrodes placed near the eye to re-activate residual vision in optic neuropathy [14]. Only the percentage of males vs. females was unequally distributed but this was independent of study results. Our Therapy combines the science of ophthalmology and neurology to help restore lost eyesight from optic nerve damage. Fedorov Restore Vision Clinic Reviews - HealthyEyesTalk.com According to the prevailing view, tACS entrainment leads to a frequency-specific phase realignment of the endogenous oscillations with the applied alternating current with a subsequent frequency-specific power enhancement [3135]. Contributed reagents/materials/analysis tools: CG MB AM SS MD. Fedorov, A. Regardless of your decision to proceed with the treatment, our medical evaluation will be completely free-of-charge to you. Secondary endpoints of HRP were percentage change of the stimulus detection rate in the defective VF (excluding intact areas), the central 5-VF, and average reaction time in total HRP VF. Secondary analyses revealed improvements of near-threshold visual fields in the central 5 and increased thresholds in static perimetry after rtACS and improved reaction times, but visual acuity did not change compared to shams. Is the Subject Area "Vision" applicable to this article? Additionally, at BASELINE, POST and FOLLOW-UP, patients completed a neuropsychological test battery that included an alertness reaction time test, and a trail-making paper-pencil-test. Vision loss after optic neuropathy is considered irreversible. Sein Schmidt, Affiliation While additional studies are needed to further explore the mechanisms of action, our results warrant the use of rtACS treatment in a clinical setting to activate residual vision by brain network re-synchronization, which can partially restore vision in patients with stable vision loss caused by nervous system damage. Moesz ustawi przegldark tak, aby blokowaa lub ostrzegaa Ci o tych plikach cookie, ale niektre czci witryny mog wtedy nie dziaa. Our treatment is recommended for patients suffering from any optic nerve atrophy but especially damage originating as glaucomatous, ischemic, traumatic, inflammatory, post tumor, or hydrocephalus induced optic neuropathies. Non-invasive current stimulation in vision recovery: a review of the This subject dropped out of the study. Mental health in Germany: services and support | Expatica https://doi.org/10.1371/journal.pone.0156134.g003. VRT is a prescription therapy that is clinically supported through decades of research and 20 clinical studies, including a 302 patient study in which notable improvements were seen in over 70% of the patients. Together with reliability parameters of HRP, the eye-tracking results documented excellent retinotopic reliability of the primary outcome measure, validating that improved visual detection could not be explained by altered eye movements (such as saccades towards the blind field). The thalamus and visual cortex show only low current densities compared to other sites presumably because they are further away from the shortest path between electrodes. The trial was registered in January 2011 upon receiving approval from the leading ethics committee in December 2010. and included sample size calculation, statistical analysis plan, initialization of randomization and data source verification. Read Also: Global Vision Bible Church Live Stream. About 2 of 3 patients treated with rtACS reported being satisfied with the treatment even though only 1 of 3 patients was aware of vision improvements. Although it is possible to get fake reviews, it's difficult to make them reputable. Wireless Outdoor Cameras With Night Vision. Why not make your stay a city break?Although youll visit our clinic daily for Fedorov Restoration Therapy, youll have plenty of free time to explore the city. Resting state eyes-closed EEG immediately before and after one day of treatment was analyzed after the first rtACS session. (B) Local current density maxima can be found at frontal brain regions spatially located close to the stimulating anodal electrode. A study of 120 children with cerebral palsy found that 50% had strabismus and/or significant refractive error and 11% had visual field defects . Upon completion of the 10-day treatment, all initial diagnostic tests were repeated (POST). High vs. low defect depth was defined as stimulus detection rates below vs. above 30% inside the VF defect. Institute of Medical Psychology, Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany, Affiliation The use of bone images (skull CT) for computing the conductivity effects in relation to electrical analysis and stimulation of head tissues is described in US Pat. We learned that vision impairment is very serious condition, affecting many areas of everyday life. No, Is the Subject Area "Brain damage" applicable to this article? Reddit and its partners use cookies and similar technologies to provide you with a better experience. Restore Vision Clinic in Berlin was created to serve one purpose - to improve the eyesight of our pa Fedorov Restoration Therapy | Berlin ACS, Drugs that improved the visual fields of glaucoma patients had the following characteristics and limitations: the short-term changes were not related to IOP changes one could observe threshold shifts in relative scotomas , but very rarely though occasionally changes in the size of absolute scotomas, all the drugs that improved VF had in common that they improved blood flow in the eye , and improvements were more likely seen in FS+ but only infrequently in FS- cases . Authors: Sabel, Bernhard A.a * | Flammer, Josefb | Merabet, Lotfi B.c, Affiliations: Institute of Medical Psychology, Medical Faculty, Otto-von-Guericke University of Magdeburg, Magdeburg, Germany | Department of Ophthalmology, University of Basel, Basel, Switzerland | Department of Ophthalmology, The Laboratory for Visual Neuroplasticity, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, USA. Detection increases and decreases after intervention are shown in blue and red, respectively. rtACS treatment is a safe and effective means to partially restore vision after optic nerve damage probably by modulating brain plasticity. It may be argued that visual improvements after rtACS can be explained by perceptual learning due to repeated testing. Results are given as medians and 95%-CI. Henrich-Noack P, Fedorov A, Gall C. Vision restoration after brain and retina damage: the "residual vision activation theory". Indeed, in the present study we cannot exclude that some of the effects on coherence are due to volume conduction effect. The difference between groups in the primary outcome measure was found to be maily caused by a reduction of the absolute scotoma region in the rtACS-group. How does Fedorov Restoration Therapy work? Department of Ophthalmology, University Medical Center, Georg-August University of Goettingen, Goettingen, Germany, Affiliation Several open questions should be addressed in future studies. Partial vision loss, with sometimes considerable residual vision is by far more prevalent than total vision loss. Standard deviation of the mean fixation position extended up to approx. Post-intervention changes in the intact and residual visual field did not differ between groups. VF improvement as measured by kinetic perimetry did not persist after 2 months in both groups. FOLLOW-UP comparisons were calculated separately for each treatment arm using Wilcoxon matched-pairs signed rank tests. No, Is the Subject Area "Visual impairments" applicable to this article? Further secondary endpoints were static and kinetic perimetry results (foveal and mean threshold of 30-VFs, mean eccentricity/VF size), best corrected near and far visual acuity (Landolt), and patient-reported outcome, i.e., an intervention-related questionnaire with a structured response format and a vision-related QoL questionnaire (NEI-VFQ-39) [18] to evaluate subjective improvements of visual field defect and related impairments (15 items) and general health and mental distress (four items) at POST and FOLLOW-UP. For allocation concealment, patients of the sham-group received minimal dose stimulation. Of 98 eligible patients, 45 were treated with rtACS and 37 with sham-stimulation. I can also see from Google Scholar that the papers have been cited multiple times. For assessing current flow properties of rtACS, a single computer simulation was performed to mimic stimulation using an electrode placed over the right eye and return electrode at the neck region of the subject. Ein weiterer Messwert, der vor allem bei Glaukom-Patienten wichtig sein kann, ist der . Group comparisons of the EEG-spectrum confirm that alpha- and beta but not theta power increases were significantly greater after 10 days rtACS (median change: 0.037) than after sham-stimulation (median change: 0.015), F(1,1529.605) = 6.894, p = 0.009. The percentage of reactions outside the valid response window (1501000ms) after stimulus presentation in HRP increased slightly after rtACS (0.3%, CI[0.0; 0.9], p = 0.016) and remained unchanged after sham (-0.03%, CI[-0.5; 0.2], 0.377) with a significant difference between groups (p = 0.033). Future studies might use high-density EEG, which would allow using source reconstruction algorithms (e.g. https://doi.org/10.1371/journal.pone.0156134.s001, https://doi.org/10.1371/journal.pone.0156134.s002. With this innovative method, it is possible to improve vision with the help of electrical stimulation. Retinitis pigmentosa (RP) is the name given to a group of inherited eye diseases that affect the retina (the light-sensitive part of the eye). The return electrode (stainless steel plate, 32x30 mm) was positioned on the right arm. Here, 10 daily rtACS sessions increased light detection performance and improved patient-reported vision-related QoL which was moderately correlated with VF gains [15]. While the rtACS- group exhibited significant improvements in BASELINE vs. POST comparisons of medians (Hodges-Lehmann-estimator 6.4%, CI[2.9;11.6], p<0.001 (Wilcoxon signed rank test, one-sided), the sham-group did not (1.1%, CI[-2.0;4.3]). This allows patients of all ages to feel comfortable. First, we defined 5 spectral bands: delta, 13 Hz; theta, 37 Hz; alpha (alpha I), 714 Hz; and beta, 1430 Hz. The difference between groups in the primary outcome measure was found to be maily caused by a reduction of the absolute (black) scotoma region in the rtACS-group. But I can't seem to find any proof that they not are reputable. Even in traditionally ocular diseases , a selective degeneration of cells in visual brain nuclei has been shown as indicated by atrophy of the LGN, optic radiation and visual cortex , and even non-visual brain structures that control emotions . Alternating Current Stimulation for Vision Restoration after Optic The Fedorov Restore Vision Clinic is located in the heart of this beautiful city, with first-class museums, art galleries, enticing shops, scrumptious restaurants, nightclubs, and many world-famous historical attractions like the Berlin Wall and Berlin Palace, ensuring you will not leave disappointed. Other neuropsychiatric disorders with visual system disturbance are psychosis/schizophrenia, autism, and dyslexia . Tell us a brief history of vision loss, your diagnosis and current vision complaints. (A) Patient flow for cases included in the primary outcome measure analysis. Protecting, replacing or regenerating cells to restore vision is currently a very active research field. and our What is stem cell therapy (regenerative medicine) and how does it work?
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