The Effect of Varied Microperimetric Biofeedback Training in Central Vision Loss: A Randomized Trial

Abstract

Significance This investigation reports for the first time the effects of different microperimetric biofeedback strategies in visually impaired subjects with central field loss. Purpose To evaluate the effects of two MP-3 micro-perimeter biofeedback strategies on the visual performance of subjects with central vision loss. Moreover, changes between the groups were compared to provide indications of practice with biofeedback stimulation in subjects with central vision loss. Methods Using simple randomization, 19 participants were trained according to two different biofeedback stimulation approaches using the MP-3 microperimeter. Patients were assigned to two different groups: subjects trained for 2 days a week (Group A) and 3 days a week (Group B). The patients in each group were randomized to perform a total of 10 or 15 sessions. Results Fixation stability increased from 4.5°2 (± 2.8) to 2.3°2 (± 2.2) and from 8.2°2 (± 6.9) to 1.4°2 (± 1) after 2 and 3 weekly biofeedback training sessions, respectively (P < .05). Biofeedback training induced a significant improvement of 40.7% and 29.4% in reading speed for groups A and B, respectively (P < .05). A comparison of two weekly biofeedback training sessions with three weekly biofeedback sessions demonstrated greater fixation stability in Group B (P < .05). Conclusions This study conclude that a biofeedback intervention is effective in enhancing oculomotor control in patients with central vision loss. In our study, a more intensive biofeedback strategy seemed to produce significantly better results in terms of functional vision parameters.

Effectiveness of Mp-3 Microperimetric Biofeedback Fixation Training For Low Vision Rehabilitation in Patients Treated With Corticosteroid Ivt in Retinal Vein Occlusions

“…MBFT microperimetry has proven effective in selecting the best fixation position and improving fixation stability, reading speed, acuity, and quality of life in patients with central vision loss caused by RVO. 29 , 44 …”

“…46,47 MBFT microperimetry has proven effective in selecting the best fixation position and improving fixation stability, reading speed, acuity, and quality of life in patients with central vision loss caused by RVO. 29,44 The combination of DEX IVT and MBFT led to early edema reduction and structural restoration of retinal cells, as well as stimulation of nerve synapses through biofeedback. This contributed to the functional restoration of retinal nerve cells, which are essential for visual recovery in patients with macular disease.…”

“…The automated MP-3 microperimeter program uses a 4–2 threshold strategy with a Goldmann III model, and the size of the fixation target during training is decided by the trainer, an experienced ophthalmologist. The retinal light threshold was measured using a Goldmann III with stimulus intensities between 0 and 34 dB and a stimulus duration of 200 ms. 44 …”

“…In this study, the rehabilitation programme consisted of three sessions of 10 minutes per eye performed twice a week for 20 consecutive weeks, whereas rehabilitation protocols with MBFT are variable and usually occur weekly over a period of 5 to 10 weeks, with each session lasting approximately 10 minutes. 15 , 44 …”

“…In this study, the rehabilitation programme consisted of three sessions of 10 minutes per eye performed twice a week for 20 consecutive weeks, whereas rehabilitation protocols with MBFT are variable and usually occur weekly over a period of 5 to 10 weeks, with each session lasting approximately 10 minutes. 15,44 The slow-release IVT of dexamethasone (Ozurdex ® ) (0.7 mg active ingredient) is a potent corticosteroid that suppresses inflammation by reducing edema, fibrin deposition, capillary permeability, and phagocytic migration in the inflammatory response. Currently, intravitreal implantation of DEX is the only drug approved by the FDA for the treatment of macular edema secondary to RVO, and this drug has a good safety profile.…”