Post-stroke Visual Impairment: A Systematic Literature Review of Types and Recovery of Visual Conditions
Lauren R. Hepworth
Department of Health Services Research, University of Liverpool, Liverpool L69 3GB, United Kingdom
Fiona J. Rowe *
Department of Health Services Research, University of Liverpool, Liverpool L69 3GB, United Kingdom
Marion F. Walker
Department of Rehabilitation and Ageing, University of Nottingham, Nottingham NG7 2UH, United Kingdom
Janet Rockliffe
Speakability (North West Development Group), 1 Royal Street, London SE1 7LL, United Kingdom
Carmel Noonan
Department of Ophthalmology, Aintree University Hospital NHS Foundation Trust, L9 7AL, United Kingdom
Claire Howard
Department of Orthoptics, Salford Royal NHS Foundation Trust, Manchester M6 8HD, United Kingdom
Jim Currie
Different Strokes (London South East), 9 Canon Harnett Court, Wolverton Mill, MK12 5NF, United Kingdom
*Author to whom correspondence should be addressed.
Abstract
Aim: The aim of this literature review was to determine the reported incidence and prevalence of visual impairment due to stroke for all visual conditions including central vision loss, visual field loss, eye movement problems and visual perception problems. A further aim was to document the reported rate and extent of recovery of visual conditions post stroke.
Methods: A systematic review of the literature was conducted including all languages and translations obtained. The review covered adult participants (aged 18 years or over) diagnosed with a visual impairment as a direct cause of a stroke. Studies which included mixed populations were included if over 50% of the participants had a diagnosis of stroke. We searched scholarly online resources and hand searched journals and registers of published, unpublished and ongoing trials. Search terms included a variety of MESH terms and alternatives in relation to stroke and visual conditions. The quality of the evidence was assessed using key reporting guidelines, e.g. STROBE, CONSORT.
Results: Sixty-one studies (n=25,672) were included in the review. Overall prevalence of visual impairment early after stroke was estimated at 65%, ranging from 19% to 92%. Visual field loss reports ranged from 5.5% to 57%, ocular motility problems from 22% to 54%, visual inattention from 14% to 82% and reduced central vision reported in up to 70%. Recovery of visual field loss varied between 0% and 72%, with ocular motility between 7% and 92% and visual inattention between 29% and 78%.
Conclusion: The current literature provides a range of estimates for prevalence of visual impairment after stroke. Visual impairment post stroke is a common problem and has significant relevance to the assessment and care these patients receive. Prospective figures regarding incidence remain unknown.
Keywords: Incidence, prevalence, visual impairment, stroke, recovery, review