Enhancing Visual Function with Fixation Stability and Eye Movement Training

Abstract

Purpose : Age-Related Macular Degeneration (AMD) is characterized by a loss of central retinal function and a shift in fixation to peripheral loci. Individually, eye movement training techniques and fixation stability training have been utilized in teaching patients to effectively use their remaining vision. This work has documented increased reading speeds, more stable fixation and changes in PRL locations with training. However to date, no studies have examined the potential gains of combining eye movement and fixation training. The purpose of our study is to directly measure fixation stability and scanning patterns of individuals affected by AMD before and after training with two established approaches.

Methods : Participants with a diagnosis of dry AMD or wet AMD, that has been stable for at least 3 months, are being recruited for this study. Participants are divided into 3 groups in a crossover design. The first group receives eye movement training followed by fixation training, whereas the second group receives the same training, but in the opposite order. A set of outcome measures is taken before training and following each training module. Training sessions were monitored using the FaceLAB5^TM eye tracking apparatus. The third group serves as a control, receiving no training, but is assessed with the outcome measures at the same intervals as the trained groups. Outcome measures including optical coherence tomography (OCT), microperimetry, and fixation stability, were assessed by the Optos OCT/SLO. Reading speed and comprehension were evaluated using the MNREAD acuity chart, and the participant’s ability to locate objects in a scene was recorded using the SMI eye tracking glasses.

Results : Thus far, the greatest improvement has been observed after the completion of both training modules (N=4). Participants improved in MNREAD acuity scores, ETDRS visual acuity scores and a decrease in object location time. They also had improvements in fixation stability; patients who had the poorest fixation at baseline demonstrated the greatest improvement. There were no significant changes in macular sensitivity as determined by microperimetry.

Conclusions : We were able to quantitatively show that patients with AMD could gain additional benefit when trained on two established programs. Additionally, we directly observed adaptations in eye movement patterns.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.