Visual rehabilitation in patients with myopic maculopathy: our experience

Can J Ophthalmol. 2013 Oct;48(5):438-42. doi: 10.1016/j.jcjo.2013.08.004.

Abstract

Objective: To evaluate the efficacy of the MP-1 microperimeter (Nidek Technologies Srl, Padova, Italy) and Visual Pathfinder (LACE Inc) in improving visual function of patients with myopic maculopathy.

Design: Prospective, nonrandomized, interventional case series.

Participants: Seventeen patients (34 eyes) between 36 and 58 years of age with myopic maculopathy and central retinal scotomas.

Methods: After a complete eye examination, all patients underwent 10 training sessions with MP-1 biofeedback (7 minutes) and Visual Pathfinder (3 minutes) for each eye once a week. Statistical analysis was performed with Student t test. The p values less than 0.05 were considered statistically significant.

Results: The mean best corrected visual acuity increased from 0.64 ± 0.22 to 0.38 ± 0.20 logMAR at the end of follow-up (p = 0.03); visual-evoked potential P100 amplitude increased from 3.54 ± 1.90 to 6.64 ± 2.91 μV at the end of follow-up (p = 0.04); average retinal sensitivity, calculated in the 12 degrees of the central retina, increased from 6.6 ± 2.6 to 14.6 ± 3.6 dB (p = 0.03). Fixation behaviour in the 2 degrees of the central retina increased from 45% ± 17% to 75% ± 23% (p = 0.04). The bivariate contour ellipse area (95%) increased from 10.34 ± 3.11 to 7.64 ± 2.71 square degrees (p = 0.04).

Conclusions: The combination of acoustic biofeedback training with MP-1 and Visual Pathfinder offers a reasonable improvement of visual function in patients with myopic maculopathy. This method might be considered as a rehabilitative strategy as a "therapeutic option" in these patients for whom most treatments usually do not work.

MeSH terms

  • Adult
  • Biofeedback, Psychology / methods*
  • Evoked Potentials, Visual / physiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myopia, Degenerative / complications
  • Myopia, Degenerative / physiopathology
  • Myopia, Degenerative / rehabilitation*
  • Prospective Studies
  • Reading
  • Retina / physiopathology
  • Retinal Diseases / etiology
  • Retinal Diseases / physiopathology
  • Retinal Diseases / rehabilitation*
  • Scotoma / etiology
  • Scotoma / physiopathology
  • Scotoma / rehabilitation*
  • Treatment Outcome
  • Visual Acuity / physiology*
  • Visual Field Tests / methods*