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E. G. Gonzalez, L. Tarita-Nistor, L. Lillakas, S. N. Markowitz, M. J. Steinbach; Method for Training Eccentric Reading in Patients With AMD Using Biofeedback. Invest. Ophthalmol. Vis. Sci. 2009;50(13):4729.
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We developed a method for reading rehabilitation for patients with age-related macular degeneration (AMD) involving fixation stability training and preferred retinal locus (PRL) relocation to the upper retina.
Ten patients with AMD participated in a seven-session program consisting of: initial assessment, five one-hour weekly training sessions with daily homework, and final assessment. Assessment sessions included: 1) visual acuity; 2) reading acuity, critical print size, and maximum reading speed measured with the MNRead test; 3) fixation location, fixation stability, and microperimetry measured with the MP-1. The first assessment revealed a PRL located to the side of the scotoma for all patients. Using the biofeedback feature of the MP-1, the PRL was relocated to the upper part of the retina. The trained retinal locus (TRL) was chosen so that its distance from the former fovea was not greater than that of the old PRL and was equally sensitive or better. Fixation stability was trained using several fixation targets. For their daily homework patients were instructed to keep their eye in the position trained and given practice materials in a customized print size.
A new PRL in the superior part of the retina was acquired by all patients and they all exhibited significant improvements in reading acuity, critical print size and reading speed. Visual acuity improved slightly.
This training method is useful for: 1) relocating the PRL to a healthy part of the retina, 2) fixation stability improvement, and 3) reading performance improvement in patients with AMD.
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