Perceptual learning in patients with Stargardt disease

Sasso, Paola; Silvestri, Valeria; Sulfaro, Marco; Scupola, Andrea; Fasciani, Romina; Amore, Filippo

doi:10.1016/j.jcjo.2019.03.012

Cited by 8 publications

(12 citation statements)

References 46 publications

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“…Vision rehabilitation is effective in improving function for individuals with visual impairment. Over the last two decades, many vision rehabilitation techniques have been designed and implemented for improving oculomotor control by stabilising fixation, reducing crowding effects and enlarging visual span by relocating the PRL to a more convenient position relative to the scotoma 25–27 . Many rehabilitation technicians use prisms to move the image peripherally, but the effectiveness of this technique remains under discussion 28,29 …”

Section: Introductionmentioning

confidence: 99%

Biofeedback stimulation in the visually impaired: a systematic review of literature

Silvestri

Turco

Guidobaldi

et al. 2021

Ophthalmic Physiologic Optic

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Background: It is estimated that approximately 1.3 billion people live with some form of distance or near visual impairment. Numerous studies have been carried out to evaluate the effects of biofeedback (BF) and establish if it could be a useful tool in vision rehabilitation for various eye diseases. Objective: This systematic review aimed: 1) to examine the current evidence of BF efficacy for the rehabilitation of the visually impaired and 2) to describe methodological variations used in previous BF studies to provide recommendations for vision rehabilitation interventions. Methods: A systematic review was conducted in the Medline, PubMed, Cochrane Library and Web of Science databases to collect documents published between January 2000 and May 2020. Of the 1,960 studies identified, 43 met the criteria for inclusion. The following information was collected from each study: sample size, control group, any eye disease, apparatus used, frequency and number of sessions of BF, main outcomes of training and whether a follow-up was conducted. The first group included studies published as scientific articles in peer-reviewed journals. The second group included abstracts of studies presented at peer-reviewed conferences. Publications were also grouped according to the eye disease treated. Results: 25 articles and 18 peer-reviewed conference abstracts (PRCAs) were included in this review. BF stimulation is a commonly used technique for the treatment of visual impairment caused by macular disease. Most BF studies evaluate the effect of training on the preferred retinal locus (PRL), particularly with regard to fixation location and stability. Across these studies, participants who received BF intervention improved fixation stability and reading speed. High variability in the number of sessions and the duration of BF training was found. Most studies did not use a control group. Conclusions: The findings of this review present evidence for biofeedback treatment in vision rehabilitation, with improved oculomotor abilities. Currently, it is not possible to formulate evidence-based recommendations for a standard training procedure due to the poor quality of existing randomised controlled trials. High-quality studies are needed to develop standard protocols for a range of eye diseases.

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Section: Introductionmentioning

confidence: 99%

Biofeedback stimulation in the visually impaired: a systematic review of literature

Silvestri

Turco

Guidobaldi

et al. 2021

Ophthalmic Physiologic Optic

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“…Because reading is a basic function needed for conducting activities of daily living, its improvement is the most sought after by patients entering low vision rehabilitation 5,6 . Efforts have been made to design rehabilitation techniques that aim to improve oculomotor control by stabilising fixation, alleviating crowding effects by using fonts with larger spacing between the letters, and enlarging visual span by relocating the preferred retinal locus (PRL) above or below the scotoma 7‐11 . It has been shown that these approaches can lead to improvements in patients' reading performance.…”

Section: Introductionmentioning

confidence: 99%

Reading with central vision loss: binocular summation and inhibition

Silvestri

Sasso

Amore

et al. 2020

Ophthalmic Physiologic Optic

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Purpose: There are conflicting reports as to whether there is a binocular advantage or disadvantage when reading with central vision loss. This study examined binocular reading summation in patients with macular degeneration. Methods: Seventy-one patients with bilateral central vision loss due to macular degeneration [mean age: 63 (S.D. = 21) years] participated. Reading performances during binocular and monocular viewing with the better eye (i.e., the eye with the best monocular visual acuity) were evaluated using different versions of the Italian MNREAD reading chart (www.precision-vision.com). Fixation stability and preferred retinal loci (PRLs) were recorded monocularly for each eye. The overall sample was split into inhibition, equality, and summation groups based on the binocular ratio (i.e., binocular/monocular) of the maximum reading speed. Results: 41% of patients experienced binocular inhibition, 42% summation, and 17% equality. Binocular reading speed of the inhibition group was approximately 30 words per minute slower than those of the equality and summation groups, although the inhibition group had the best visual acuity. These patients generally had monocular PRLs in non-corresponding locations temporal or nasal to the scotoma, had the largest interocular acuity difference and lacked residual stereopsis. The three groups did not differ in fixational control, contrast sensitivity or critical print size. Conclusions: Equal proportions of patients with central vision loss show binocular reading summation and inhibition. Patients with binocular reading inhibition have poorer reading performance and different clinical characteristics than those with binocular reading summation and equality.

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“…By contrast, effects of VPL in individuals with ocular impairment seem to be smaller and less stable. For example, in patients with a retinal defect (Stargardt disease) ten sessions of VPL yielded an initial improvement of reading speed and VA, but these improvements were no longer visible 6 months later ( Sasso et al, 2019 ). However, there is evidence of long-lasting PL effect in age-related macular degeneration, which is similar to Stargardt’s disease ( Maniglia et al, 2016 ).…”

Section: Discussionmentioning

confidence: 99%

“…Interestingly, visual perceptual learning (VPL) – performance enhancement on a visual task as a result of visual experience ( Sasaki et al, 2010 ) – proves an effective, non-invasive, personalized treatment strategy to improve visual functions ( Deveau and Seitz, 2014 ). It is helpful in different patient populations such as subjects with amblyopia ( Levi et al, 1997 ; Polat et al, 2004 ), macular degeneration [( Plank et al, 2014 ), also Stargardt disease ( Sasso et al, 2019 )], presbyopia ( Polat et al, 2012 ), myopia ( Tan and Fong, 2008 ; Camilleri et al, 2014a , b ; Casco et al, 2014 ), and other forms of visual impairment ( Huurneman et al, 2013 , 2016a , b , c ; Nyquist et al, 2016 ; Battaglini et al, 2021 ). Several recent studies indicate that VPL transfers to improvements in daily life visual functioning ( Tan and Fong, 2008 ; Deveau and Seitz, 2014 ; Plank et al, 2014 ), underscoring the prospects of VPL as a valuable treatment option.…”

Section: Introductionmentioning

confidence: 99%

Broad and Long-Lasting Vision Improvements in Youth With Infantile Nystagmus After Home Training With a Perceptual Learning App

Huurneman¹,

Goossens

2021

Front. Neurosci.

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Current treatments for infantile nystagmus (IN), focused on dampening the oscillating eye movements, yield little to no improvement in visual functioning. It makes sense, however, to treat the visual impairments associated with IN with tailored sensory training. Recently, we developed such a training, targeting visual crowding as an important bottleneck in visual functioning with an eye-movement engaging letter discrimination task. This training improved visual performance of children with IN, but most children had not reached plateau performance after 10 supervised training sessions (3,500 trials). Here, we evaluate the effects of prolonged perceptual learning (14,000 trials) in 7-18-year-old children with IN and test the feasibility of tablet-based, at-home intervention. Results demonstrate that prolonged home-based perceptual training results in stable, long lasting visual acuity improvements at distance and near, with remarkably good transfer to reading and even stereopsis. Improvements on self-reported functional vision scores underline the clinical relevance of perceptual learning with e-health apps for individuals with IN.

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Perceptual learning in patients with Stargardt disease

Cited by 8 publications

References 46 publications

Biofeedback stimulation in the visually impaired: a systematic review of literature

Biofeedback stimulation in the visually impaired: a systematic review of literature

Reading with central vision loss: binocular summation and inhibition

Broad and Long-Lasting Vision Improvements in Youth With Infantile Nystagmus After Home Training With a Perceptual Learning App

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