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C. Balacco, D. Giorgi, E. Pacella, P. Turchetti, F. Pacella, T. Mascaro, E.M. Vingolo, C.L. Vulcano; Biofeedback and Visual Rehabilitation in Patients With Macular Degeneration . Invest. Ophthalmol. Vis. Sci. 2006;47(13):798.
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Biofeedback is directed at improving the visual capacity of patients with ocular pathologies of different nature. In this study we evaluated the efficacy of biofeedback in the visual rehabilitation of the low vision patient.
153 eyes of 90 patients, (age range between 45–75 years) were studied. These were divided in senile macular degeneration in 114 eyes (mean age 72.6 years) and myopic macular degeneration in 39 eyes (mean age 58 years). The control group was composed of 48 eyes of 34 patients with senile macular degeneration (33 eyes) and myopic macular degeneration (15 eyes). Infrared photostimulation (non polarized light) and flicker foveal stimulation was carried out in a dark room. Visual alignment was performed with an accessory light. The intensity of the infrared light was chosen by the operator based on the residual visual acuity of the patient. In each application the frequency chosen was slightly inferior to the frequency at which the patient could see the light as non intermittent (Critical frequency of fusion, CFF). The treatment was carried out twice weekly for a total of 16 sessions. Each session was for 9 minutes per eye with a pause every 3 minutes. The parameters considered in our study was visual acuity (VA) with Standard Snellen Charts before treatment, after 8 sessions and at the end of treatment. At the final control we adoperated a luminous chart with a different arrangement of the letters.The control group underwent placebo treatment twice weekly for a total of 16 sessions. The duration and pauses in treatment were identical to those of the study group.
The average visual acuity of patients with macular degeneration was 0.22 before treatment, 0.3 after 8 applications and 0.34 at the end of 16 sessions of treatment. Statistical analysis revealed significative improvement of visual acuity in the study group with respect to the control group (t < 0.002). The visual acuity was stable at 6 months from treatment and values. These were maintained at 12 and 18 months from treatment, even though retreatment sessions were required in some cases.
Treatment with biofeedback of patients with low vision due to macular degeneration resulted in significative improvement of visual function (t<0.02).
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