Microperimetric Biofeedback Training Improved Visual Acuity after Successful Macular Hole Surgery

Abstract

Purpose. To evaluate the efficacy of setting a preferred retinal locus relocation target (PRT) and performing Macular Integrity Assessment (MAIA) biofeedback training in patients showing insufficient recovery of best corrected visual acuity (BCVA) despite successful closure of an idiopathic macular hole (MH). Methods. Retrospective interventional case series. Nine eyes of 9 consecutive patients with the decimal BCVA of less than 0.6 at more than 3 months after successful MH surgery were included. A PRT was chosen based on MAIA microperimetry and the patients underwent MAIA biofeedback training. BCVA, reading speed, fixation stability, and 63% bivariate contour ellipse area (BCEA) were evaluated before and after the training. Statistical analysis was carried out using paired Student's t-test. Results. PRT was chosen on the nasal side of the closed MH fovea in 8 patients. After the MAIA training, BCVA improved in all patients. The mean logMAR value of BCVA significantly improved from 0.33 to 0.12 (p = 0.007). Reading speed improved in all patients (p = 0.29), fixation stability improved in 5 patients (p = 0.70), and 63% BCEA improved in 7 patients (p = 0.21), although these improvements were not statistically significant. Conclusion. MAIA biofeedback training improved visual acuity in patients with insufficient recovery of BCVA after successful MH surgery.

Microperimetric Biofeedback Training After Successful Inverted Flap Technique for Large Macular Hole

“…The PRL was chosen within central 2 degrees, and a 10 min training was repeated at least three times within three months. After training, patients demonstrated a significant increase in visual acuity, whereas fixation stability did not change significantly [31].…”

“…The microperimetry uses the cerebral plasticity and neurosensory adaptation capabilities to improve the visual performance [27]. Previous studies with biofeedback technique using acoustic tone demonstrated the possibility to improve visual function, reading speed, fixation behavior and retinal sensitivity in several macular pathologies, as age-related macular degeneration (AMD), macular hole, rhegmatogenous retinal detachment, and macular dystrophy [27][28][29][30][31][32][33]. Moreover, a flickering visual stimulus is useful in the rehabilitation of patients with low vision at the late stage of AMD [34].…”

Biofeedback fixation training method for improving eccentric vision in patients with loss of foveal function secondary to different maculopathies

“…BFT is reported to be dependent on the location, with the highest retinal sensitivity in small central scotomata [22]. However, we explored the possibility of standardized BFT in cases with any central scotoma size.…”

Microperimetric biofeedback training fundamentals strategies and perspectives

“…These improvements regard visual acuity, retinal sensitivity, fixation stability, as well as reading speed. (10,41,57,59,60) Tarita-Nistor et al conducted a study on PRL relocation using microperimeter MP-1. The new PRL location was chosen in the upper part of the retina in all cases, approximately located at the same radial distance from the old PRL.…”