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A. Deruaz, A.R. Whatham, M. Goldschmidt, C. Mermoud, A. Schnider, A.B. Safran; Improving Reading in Subjects With Long–standing Central Scotomas in 1–month Intensive Training . Invest. Ophthalmol. Vis. Sci. 2005;46(13):2330.
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Introduction: Recent studies in neuro–rehabilitation have shown the benefits of intensive training over a short period of time to stimulate cortical plasticity and to develop compensatory strategies (Kerkhoff, 2000, Taub et al, 2002). Our aim was to optimise reading in patients with macular disorders using such a procedure. As we previously observed, two capacities, discrimination of details and global viewing of words, are essential to efficient reading (Déruaz et al., 2002). They only occasionally spontaneously develop in affected individuals. We attempted to modify reading strategies to allow the patients to improve both capacities. Methods: Six affected individuals were involved. All patients had a macular condition which was present for more than a year, and had undergone regular low–vision rehabilitation procedure over three months. We conducted eight to ten one–hour training sessions within one month, using a scanning laser ophthalmoscope (SLO). Fixation was anchored using a cross. Words were presented to train the patients to use either a new retinal locus (TRL) or their already developed preferred retinal locus (PRL) in combination with a TRL according to their lack in either global viewing or detailed discrimination. Before and after the training, visual acuity (ETDRS chart), threshold character size for words and text reading were measured. Results:Five out of six patients improved their reading performances. In all of them, improvement, however, was partially maintained three months later and was still better than before the SLO training. Conclusions: Improvement in eccentric reading can be achieved with an intensive training procedure, even in patients with long–standing macular disease having undergone regular rehabilitation procedures. To maintain the improvement observed at the completion of the training procedure, and eventually even increase it, a follow–up might be needed with possible repeated SLO training sessions.
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