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K. Thayaparan, H. Roche, M. D. Crossland, S. Chung, G. S. Rubin; A Pilot Study of Perceptual Training to Improve Reading Performance in Patients With Age-Related Macular Degeneration (AMD). Invest. Ophthalmol. Vis. Sci. 2010;51(13):123.
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Patients with central field loss from AMD have smaller visual span profiles, with corresponding slower reading speeds, than controls. Training with a trigram letter recognition task (TLRT) has been shown to increase visual span profiles and reading speed in controls. The purpose of this study was to assess whether TLRT training will increase visual span and reading speed of patients with AMD.
At baseline visual acuity, reading acuity, critical print size, maximum reading rate for sentences (MNRead) and paragraphs (IReST) were measured. Patients’ scotomas were also delineated using the Nidek MP-1. Visual span was determined using TLRT. Each patient participated in 4 to 6 sessions of TLRT training totalling 1320 trials at approximately weekly intervals and at the final visit all baseline measurements were repeated.
11 patients participated in the training, age ranging from 57 years to 89 years (mean = 78 years). Baseline visual acuity ranged from 1.14 logMAR to 0.34 logMAR, with large print reading speed (IReST) ranging from 23 wpm to 160 wpm with visual spans from 17.37 to 44.85 bits of information transferred. At baseline, visual span correlated with reading speed of large print (r = 0.63; p =0.04), but not for small print (r = 0.27; p =0.41). Acuity was not correlated with reading speed for text of either size (p > 0.3). After training, visual span increased by an average of 3.68 bits, but the difference was not statistically significant (p=0.19). Reading speed increased for large print by 15% (p=0.09) and by 37% (p=0.07) for small print. The change in visual span was not associated with the change in reading speed for either large (p=0.26) or small print (p=0.44).
Baseline results confirm that in patients with AMD, visual span is correlated with reading speed of large print, but not small print. While, visual span training using a TLRT task may not increase visual span, it does appear to increase small print reading speed for this group of patients.
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