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Valeria Silvestri, Marco Sulfaro, Paola Piscopo, Margherita Guidobaldi, Filippo Maria Amore; Design and in-office evaluation of a customizable Low Vision Tele-Rehabilitation Program. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3269.
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The aim of this study was to evaluate the efficacy of a customizable computer-based tele-rehabilitation program (CBTP), called EyeFitness (NIDEK Technologies, Padova, Italy), dedicated to low vision patients on an in-office setting before starting the tele-rehabilitation intervention.
An ad hoc created CBTP including 17 customizable exercises was developed. The exercises were designed to rehab different visual functions. Setting and stimulus parameters (number, position, size, contrast) can be modified for each exercise in order to create a visual training plan tailored to every eye defects. Seventeen patients affected by visual impairment due to different eye diseases were recruited with a best corrected visual acuity (BCVA) between 1 and 0,5 LogMAR in the better eye. Patients underwent to 20 consecutive visual training sessions of 45 minutes each, performed twice a week binocularly. Five patients did not receive any training and were used as controls. In both groups, BCVA, Contrast sensitivity (CS), Reading acuity (RA), Reading speed (RS), Bivariate contour ellipse area (BCEA), Retinal sensitivity (ReS) were compared before and after training. Moreover, accuracy and reaction time were evaluated.
Contrast sensitivity was found to be significantly improved both in the better eye (from 0,61±0,41 LogC to 0,92±0,40 LogC, p=0,03) and in the worse one (from 0,43±0,47 LogC to 0,81±0,43 LogC, p=0,04) for patients trained with CBTP. Statistically significant differences were also registered for BCEA values for 1-, 2-, 3- standard deviations ellipses in both eyes (p=0,05). Reading performance increased significantly from the average of 41,1±18,2 words per minute (wpm) to 53,7±18,9 wpm (p=0,05). Moreover, the comparison between pre and post visual stimulation for both accuracy (from 77,1±16,5 % to 95,5±1,5, p=0,0001) and reaction time (from 3,9±5,7sec to 0,94±0,03 sec, p=0,03) showed significant differences.
These data provide evidence by showing an improvement of visual functions in low vision patients underwent to CBTP. After the first session dedicated to software setting and exercises’ explanation, no issues (problems or difficulties) were reported neither by rehabilitation therapist nor by patients. Therefore, the benefits from stimulating residual vision suggest that this strategy could be adopted for future home training with certain advantages for patients and caregivers.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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