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L. daCruz, G. Uppal, M. Freely, G. Rubin; Assessment of Reading Behaviour With an Infrared Eyetracker Following 360 Degree Macular Translocation for Age Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2007;48(13):2168.
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Difficulty in reading secondary to exudative age-related macular degeneration (AMD) is a significant cause of reduced quality of life for patients with this disease. Macular translocation (MT360) has been used to recover reading in AMD and in this study we aim to document the potential of MT360 in the restoration of normal vision and reading behaviour. We observe the 6 best outcome cases from a series of 23 patients treated with MT360. We investigate the influence of MT360, an invasive and involved procedure (new foveal location, muscle surgery, torsion), on reading behaviour (number, direction, and velocity of saccades) and fixation characteristics (preferred retinal loci (PRL) and stability of fixation). Outcome measures from the MT360 cohort were compared to age matched normals and patients with untreated dry + wet AMD
6 patients (aged 61-74) underwent the following assessment:ETDRS Acuity / Reading Acuity and Speed, Critical Print Size / Contrast Sensitivity / Eyetracker Assessment of Saccadic Behaviour / Fixation Stability
The MT360 cohort showed a significant improvement in all aspects of visual function following surgery. Cohort results for visual parameters followed the pattern Nomal>MT360>Dry>Wet. Of note, reading speed, fixation quality, and number of PRL of the MT360 cohort were found not to be different from the normal controls. Eyetracker analysis however revealed an increased number of horizontal saccades with reduced velocity and increased latency post MT360 relative to the comparative groups.
This study supports the premise that restoration of the choriocapilliaris-RPE-photoreceptor axis with MT360 significantly restores visual function beyond that of untreated AMD. The level of recovery closely approximates normal function and matches it in reading speed and quality of fixation. Despite this eyetracker analysis indicates the effect of this complex surgery, in particular the extraocular muscle surgery, has a negative impact on saccadic behaviour for reading.
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