Optimization of visual performance in patients with age-related macular degeneration using biofeedback training

Abstract

Purpose : The impairment of the central retina caused by age-related macular degeneration (AMD) results in low vision with a profound impact in quality of life. The present study aimed to investigate if visual functions, as well as the self-reported quality of vision, may improve as a result of the microperimetric biofeedback training applied to subjects with AMD.

Methods : Microperimetric sensitivity thresholds, spatial luminance contrast sensitivity, color discrimination, high contrast near visual acuity (VA), reading speed, and a questionnaire to access visual performance during daily activities were obtained from 12 subjects, aged from 60 to 78 years old, twice with approximately three months of interval. Six subjects diagnosed with AMD (three with wet and three with dry AMD; best corrected visual acuity ranging from 0.5 to 0.1) performed microperimetric (Macular Integrity Assessment, CenterVue, Padova, Italy) biofeedback training (12 sessions each lasting 10 minutes) between the two examinations. The other six subjects (five healthy subjects and one AMD subject) did not perform the training.

Results : We have found improvement in test results at the second examination compared to those of the first for subjects who performed the training. Near VA improved for some training subjects. The improvement in luminance contrast sensitivity at lower spatial frequencies (from 0.25 to 1.2 cpd) was significantly higher (p < 0.05) for the training subjects. In addition, self-reported quality of vision significantly improved (p < 0.05) for the training subjects.

Conclusions : The microperimetric biofeedback training optimized the visual performance of subjects with AMD. The significant improvement of the visual function may explain the better self-reported quality of vision. The biofeedback training might be considered for subjects with low vision due to macular degeneration to increase contrast sensitivity and optimize visual performance. Moreover, a more detailed assessment of visual abilities (measured and self-reported) may provide more information about functional changes generated by the biofeedback training to the visual system.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.