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Patricia Udaondo, Ana Hervas Ontiveros, Salvador García-Delpech, David Salom, Rafael Martínez-Costa, Ángel Cisneros-Lanuza; Visual training with microperimetry for patients with unstable/excentric fixation after macular surgery. Invest. Ophthalmol. Vis. Sci. 2014;55(13):6109.
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The maia microperimeter identifies, in a fast and easy way, retinal threshold sensitivity and patient characteristics. In a previous study we conclude that microperimetry can provide useful information of retinal function and analyze the progression of the functional loss or improvement after macular surgical treatments and that functional (central visual acuity and visual field) and morphologic parameters (retinal thickness) are significantly related. In those patients with limited visual gained was usually associated to either an excentric or unstable fixation point. In this study our objective was to evaluate if with a vision training module patients could develop a new, more functional retinal locus or recolate the central one.
10 patients with unstable or excentric fixation point after macular surgery underwent a visual training with the microperimeter application twice a week for a month. A complete ophthalmic examination including best corrected visual acuity (BCVA), macular integrity measured with the device named MAIA (Topcon Medical Systems, Inc.) was used to determine visual sensitivity and fixation stability and the Optical Coherence Tomography 3D OCT-1000 (Topcon Medical Systems, Inc.) to study the anatomical profile and central macular thickness (CMT) in all cases before, a month and three months after surgery and the visual training.
All patients referred an improvement in visual acuity. No changes where observed in the anatomical profile but 7 of 10 patients improved the fixation point and the best corrected visual acuity that are clearly observed in the tests provided by the microperimeter and correlated with the OCT to easily compared the changes of the fixation on a posterior pole image and OCT scan.
Although further studies are necessary to determine the role and effectiveness of this visual training module we conclude that the preliminary results are good and the application should be consider to improve retinal sensitivity and visual acuity in patients after macular surgery. We also think that the study of macular integrity should be included in routine in patients with macular pathology to better understand the effect of treatments and time in the visual function and not only base the follow up in the macular anatomy.
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