Abstract
Abstract: :
Purpose: To evaluate the reading performance of patients after macular translocation and torsional surgery (MT) and that of patients who underwent photodynamic therapy (PDT) for exudative age–related macular degeneration (AMD) or patients with non–exudative AMD (NE). Methods: A video–eye–tracker (SMI, Berlin) was used to evaluate the reading pattern. We compared the adaptation to the central scotoma and rotation of the retinal meridians (MT) versus that of simple eccentric fixation due to central scotoma (PDT/NE). Patients with an eye examination that remained stable for at least 3 months (to allow cerebral adaptation to eccentric fixation and head tilt) and a reading ability of the letter size 8M or less at 25 cm were included in this study. Presurgical visual acuity and the characteristics of the choroidal neovascularisation were not considered. Patients were matched according to age and magnification need (smallest text size fluently read). Eye–movements were monitored during oral reading of standardised texts of the patient's individually required text magnification and evaluated by matched pair analysis. Results: A total of 16 (9 female, 7 male, aged 75.9 +/– 6.2 years) patients were examined (9 MT, 6 PDT and 1 NE). Seven matched pairs of patients with a magnification need of 2;2.5;3;4;6; and 8 M were evaluated. In patients with MT a reading speed of 431 +/–173 characters/min was measured, in patients with PDT/NE the reading speed was 544 +/– 256 characters/min. The matched pair analysis did not reveal a significant difference between MT and PDT/NE groups, except for a higher number of forward saccades in MT: In MT and PDT/NE patients we compared the number (p=0.036) and amplitude of forward saccades (FS) and the number and amplitude of regressive saccades as well as the fixation duration. The number of vertical saccades and vertical fixational shifts were also evaluated. Conclusions: This study shows that MT patients have good compensation of the post–surgical rotation of the retinal meridians regarding the reading strategy. Except for a higher number of FS, we found no significant differences between MT and PDT/NE, although there was trend to a slightly lower reading speed, less characters read per saccade and more vertical saccades in MT patients. This, however, maybe due to the limited number of patients examined. A future controlled trial with pre– and post–surgical follow–up is required to appraise the functional rehabilitation.
Keywords: reading • eye movements • vitreoretinal surgery