Microperimetry biofeedback training in a patient with bilateral myopic macular degeneration with central scotoma

Rajiv Raman, Deepali Damkondwar, Srividya Neriyanuri, Tarun Sharma, Rajiv Raman, Deepali Damkondwar, Srividya Neriyanuri, Tarun Sharma

Abstract

Microperimetry-1 (MP-1) evaluation and MP-1 biofeedback training were done in a case of bilateral myopic macular degeneration with a central scotoma. Fixation behavior, location and stability of preferred retinal locus, eye movement speed, and mean sensitivity were assessed. The mean retinal sensitivities before, after and at 1-year after training in the right eye were 2.9 dB, 2.9 dB and 3.7 dB and in the left eye were 3.5 dB, 3.7 dB and 1.8 dB. The fixation point in the 2° gravitation circle, improved from 40% to 50% in the right eye and from 43% to 67% in the left eye. The average eye speed before, after and at 1-year after training in right eye were 0.19°/s, 0.26°/s and 0.25°/s and in left eye were 0.36°/s, 0.25°/s and 0.27°/s. Thus, biofeedback training using MP-1 can improve the visual function in patients with macular diseases and central scotoma.

Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Microperimetry-1 image of color topography and stability of fixation at baseline, end of the biofeedback training and at 1-year follow-up.
Figure 2
Figure 2
Right eye: Fixation distribution: Graph of fixation points versus radius in degree. (a) Fixation behavior in center 2° area 40% before training with average eye speed of 0.19°/s. (b) Fixation behavior in center 2° area 50% after biofeedback training with average eye speed of 0.26°/s. (c) Fixation behavior in center 2° area 65% at 1-year of follow-up training with average eye speed of 0.25°/s
Figure 3
Figure 3
Left eye: Fixation distribution:Graph of fixation points versus radius in degree. (a) Fixation behavior in center 2° area 43% before training with average eye speed of 0.38°/s. (b) Fixation behavior in center 2° area 50% after biofeedback training with average eye speed of 0.25°/s. (c) Fixation behavior in center 2° area 75% at 1-year follow-up with average eye speed of 0.27°/s

References

    1. Rohrschneider K, Bültmann S, Springer C. Use of fundus perimetry (microperimetry) to quantify macular sensitivity. Prog Retin Eye Res. 2008;27:536–48.
    1. Sunness JS, Applegate CA, Haselwood D, Rubin GS. Fixation patterns and reading rates in eyes with central scotomas from advanced atrophic age-related macular degeneration and Stargardt disease. Ophthalmology. 1996;103:1458–66.
    1. Vingolo EM, Salvatore S, Cavarretta S. Low-vision rehabilitation by means of MP-1 biofeedback examination in patients with different macular diseases: A pilot study. Appl Psychophysiol Biofeedback. 2009;34:127–33.
    1. Fujii GY, De Juan E, Jr, Humayun MS, Sunness JS, Chang TS, Rossi JV. Characteristics of visual loss by scanning laser ophthalmoscope microperimetry in eyes with subfoveal choroidal neovascularization secondary to age-related macular degeneration. Am J Ophthalmol. 2003;136:1067–78.
    1. Prager F, Michels S, Simader C, Geitzenauer W, Schmidt-Erfurth U. Changes in retinal sensitivity in patients with neovascular age-related macular degeneration after systemic bevacizumab (avastin) therapy. Retina. 2008;28:682–8.
    1. Schuchard RA. Preferred retinal loci and macular scotoma characteristics in patients with age-related macular degeneration. Can J Ophthalmol. 2005;40:303–12.
    1. Nilsson UL, Frennesson C, Nilsson SE. Patients with AMD and a large absolute central scotoma can be trained successfully to use eccentric viewing, as demonstrated in a scanning laser ophthalmoscope. Vision Res. 2003;43:1777–87.
    1. Frennesson C, Jakobsson P, Nilsson UL. A computer and video display based system for training eccentric viewing in macular degeneration with an absolute central scotoma. Doc Ophthalmol. 1995;91:9–16.

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe