Post audio-visual biofeedback training visual functions and quality of life in paediatric idiopathic infantile nystagmus: A pilot study

Abstract

Purpose: Biofeedback training (BT) was adapted to idiopathic infantile nystagmus syndrome (IINS) cases to enhance visual functions and quality of life (QoL). Methods: 10 patients (age 9 ± 3.2 years) treated with the audio-visual BT module of the MAIA microperimeter (Centervue, Padova, Italy) were assessed in two baseline visits and 1week post-BT (BT 80 min in total). The outcomes were distance and near binocular best corrected visual acuity (BBCVA), fixation stability, reading speed, contrast sensitivity, stereopsis and Children’s Visual Function Questionnaire. One-way repeated measured ANOVA and paired t-tests were used. Results: Distance BBCVA improved from 0.46 ± 0.21 and 0.43 ± 0.18 pre-BT to 0.33 ± 0.2 logMAR post-BT ( F (2,27) = 13.75, p = 0.0002). Post-BT was better than baseline ( p = 0.0001) and pre-BT ( p = 0.001). Near BBCVA improved from 0.23 ± 0.09 and 0.21 ± 0.14 pre-BT to 0.04 ± 0.08 post-BT (F (2,27) = 22.12, p = 0.000014), post-BT was better than baseline ( p = 0.0001) and pre-BT ( p = 0.0006). Stereopsis improved from 283 ± 338″ to 39 ± 32.2″ ( p = 0.04), contrast sensitivity from 0.26 ± 0.17 to 0.08 ± 0.12 log units ( p = 0.01), and reading speed improved from 74.7 ± 51.2 wpm to 104.7 ± 53.6 wpm ( p = 0.0006). Fixation stability improved from 33.6 ± 28.1 to 14.3 ± 10.1 sq. QoL increased from 23.8 ± 2.2 to 26.3 ± 2.3 units ( p = 0.001). Conclusion: BT benefited all visual functions and QoL in this pilot study, heralding a new possibility for Low Vision Rehabilitation in IINS.

Microperimetric Biofeedback Training for Children with Idiopathic Infantile Nystagmus Syndrome: a Short-and-Long Term Analysis

“…In this study we present BT as a new non-invasive therapy, with no side effects, showing a signi cant improvement in visual functions and quality of life in patients with idiopathic infantile nystagmus syndrome, con rming our last studies. 16,17 The bene ts from BT continued up to 5 years after BT. The last recent advance in the treatment of nystagmus was the use of topical brinzolamide in adults.…”

“…We used the MAIA microperimeter to train 10 children in a prospective pilot study that compared pre-and-post-BT visual functions 1 week after training. 16,17 The study showed an improvement in distance and near vision, contrast sensitivity, reading speed, parental questionnaire of quality of life, stereopsis, and a trend for improvement in xation stability. In this prospective pre-and-post case series we hypothesized that these improvements would be maintained for a longer period in an extended cohort.…”

Innovative vision rehabilitation method for hemianopsia: Comparing pre- and post audio-luminous biofeedback training for ocular motility improving visual functions and quality of life

“…The audiovisual sensory BT is a therapy used in low vision for more than 10 years, showing good results for near and distance vision in individuals with macular degeneration and other low vision conditions (13)(14)(15)(16)(17)(18)(19). A limitation of this study was the small number of participants.…”

“…By increasing the oculomotor control and relocating the visual fields through a change in the patient's locus of fixation, BT improves the visual acuity for distance, near vision, contrast sensitivity, retinal sensitivity, reading speed, and quality of life in many eye conditions. Mounting evidence has highlighted the benefits from BT in age-related macular degeneration, myopic degeneration, Stargardt's disease, glaucoma, and nystagmus (13)(14)(15)(16)(17)(18)(19). The studies show similar effectiveness using 4-10 sessions of BT, varying from 10 to 20 min each, although a minority of them followed the patients on a longterm basis (15).…”

Visual Function and Neuropsychological Profiling of Idiopathic Infantile Nystagmus

“…An early assessment, including visual functions (perceptual and oculomotor aspects) and visual–motor integration, is fundamental to detecting a subclinical vulnerability and providing dedicated training [ 49 , 75 ]. Daibert-Nido and colleagues, for example, proposed a specific type of oculomotor training in children with IIN using biofeedback technologies with a positive impact not only on visual functions, but also on reading speed and quality of life [ 76 ]. Further studies are needed to investigate possible intervention strategies in this population.…”