Abstract
Abstract: :
Purpose:Visual training with visual evoked assisted biofeedback was previously used to improve performances in several visual disturbances, our goal was to evaluate if visual training would be useful also in AMD. Methods:We treated 15 patients affected by AMD (age range 8-55) with visual pathfinder (LACE inc.), as previously reported. Before and after treatment, a complete ophtalmologic examination, BCVA measurement and VEP were carried out according ISCEV stabdard with 4C/° checkboard pattern all patients underwent in a weekly session of 30 minutes each for 10 sessions after that, all examinations were repeated. Results:BCVA at the end of the study improved significantly starting from 0.12 + or - 0.07 to 0.26 + or - (p=0.035) while VEP amplitudes of P100 wave increased from 1.10 + or - micronvolts to 1.97 + or - 0.15 micronvolts (p=0.012). Conclusions: Visual training improves significantly visual acuity and pattern VEP, resulting in better performances and higher quality of vision, this effect could be due either to neural plasticity of the retina or to facilitating effect caused by the repeated high frequency stimulations. In this view training via alternative pathways could be possible to obtain better performances for higher amount of not regurarly involved but yet stimulated pathways. Visual recovery may allow re-introduction in acceptable life of the patient. These effects could be expleined by neural plasticity of visual system as demonstrated after brain lesions in rats. Our experience with visual training in macula degeneration patient suggest that even if is not possible in humans at the present time to regenerate retina photoreceptor, it could be possible restore in patients a better quality of sight and a positive psycologic situation; thus even if not determines a significative change in espectance of the patient may cause a better usefulness of his performances. All treated patients showed a good response after the treatment and asked us for new sessions after a period of time.
Keywords: age-related macular degeneration • aging: visual performance • low vision