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P. G. Limoli, E. Vingolo, L. D'Amato, E. Giacomotti, R. Solari, R. Di Corato, R. Di Corato, F. Cacciatore; Integrated Neural Photostimulation versus Customized Neural Photostimulation. Invest. Ophthalmol. Vis. Sci. 2008;49(13):3149. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Neural Photostimulation (NP) can increase VEPs, Visual acuity, reading speed and fixation steadiness.The purpose of this study is comparing fixation steadiness inside PRL and the resulting increase of visual performances in low vision patients who underwent Customized NP, versus those who underwent Integrated NP.
We analyzed a sample of 21 low vision patients (34 eyes) who had already undergone visual rehabilitation and NPS and who where clinically stabilized.All the patients underwent a periodical treatment of five sessions cycles every six months.In the first cycle, we used Integrated NP (association of Visual Pathfinder, IBIS, Sound Biofeedback by MP1). In the last cycle, we used Customized NP (association of Visual Pathfinder and Sound Biofeedback).We find PRL with microperimeter MP1 Nidek.At the beginning and at the end of each cycle we analyze fixation inside 2° central , with steadiness score, BCVA by far, by near and with low vision aids, VEPs and reading speed.
In this sample Integrated NPS had increased BCVA from 0.31 to 0.48, residual visual acuity by near from 24.9 to 15.7 pts, near visual acuity with low vision aids from 9.8 to 7.5 pts, fixation steadiness inside 2° central increased from 46.3% to 56.6%, decentralization improved from 2.8° to 2.0°, VEPs increased from 2.6 to 3.8 micronVolts, reading speed increased from 80,5 to 90,5 word per minute.Six months after, the same sample, with Customized NP, BCVA increased from 0.4 to 0.53, residual visual acuity by near increased from 18 to 15 pts, visual acuity with low vision aids increased from 7.0 to 6.3 pts, fixation steadiness in 2° central increased from 40.3% to 70.4%, decentralization improved from 3.5° to 2.6°, VEPs increased from 1.6 to 3.4 mVolts, reading speed improved from 83,1 to 94,6 words per minute.
We underline that photostimulation through the stabilization of the PRL inside 2° central, determines an increase of foveal detection thus obtaining an increase of visual acuity, VEPs, and reading performances. This increase can be modulated and improved according to the chosen rehabilitative method.Customized NP directly stimulates the PRL. In this way we can achieve better rehabilitative results.Particulary it seems to be better in increasing VEPs and visual acuity by far , by near and with visual aids. There are no significant differences in decentralization degrees.This therapy ought to be repeated because visual performances tend to relapse after some time, but it is always possible to restore visual acuity increase.
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