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Tony Succar, Saeideh Ghahghaei, Donald Calvin Fletcher, Laura Walker; Restoring Functional Stereopsis in AMD with Dichoptic Training. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5177.
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© ARVO (1962-2015); The Authors (2016-present)
Stereopsis, the ability to perceive 3-dimensional (3-D) depth, can be severely impaired in individuals with Age Related Macular Degeneration (AMD). While the consequences of central vision loss associated with AMD have been well documented, little attention has been paid to treating the impaired stereopsis which impacts both depth judgments and eye-hand coordination. Therefore, our research aims are to: (1) Implement a dichoptic training system for eye alignment and stereo-recovery, and (2) Evaluate the implementation of the training program to quantify its clinical effectiveness.
Participants diagnosed with macular degeneration with better visual acuity than 20/200 in each eye were recruited. Half were randomly allocated to an experimental training group using dichoptic glasses whereby stimuli were presented separately to each eye, and a control group trained binocularly using sham glasses (plano lenses). The training phase of the research entailed 5 sets of 2 hour video game training sessions. Prior to the training the following measures were recorded at baseline: 1) Stereoacuity 2) SLO fixation locus 3) SLO microperimetry 4) OCT 5) California Central Visual Field Test 6) Contrast Sensitivity and 7) Activity Inventory (AI) an adaptive visual function questionnaire used to measure the perceived changes in functional visual abilities. During training, stereoacuity and SLO fixation loci were recorded before each session. All measurements were repeated one month after the training.
Some participants spontaneously select a new viewing position that allows progressive stereo-recovery (Figure 1). It is not yet clear if there are also benefits to general visual functioning as measured by the Activity Index, however anecdotal reports of improved function were obtained. For example, “I find parking much easier between the lanes”, and “I now pick up my pen directly, rather than scooping it from the side”. The control group showed no improvements on the measures.
This study reports the first evidence showing improved functional stereopsis in AMD through dichoptic training. At present there is no cure for AMD, these findings may translate directly to the clinical benefit of AMD patients and provide a rehabilitation basis for enhancing functional stereovision.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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