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Meesa Maeng, William H Seiple, Charlotte Jackson, Kaitlyn Randolph, Janet P Szlyk; Comparative Effectiveness of a Self-Guided Eye Movement Reading Training Program: Clinic vs. Home. Invest. Ophthalmol. Vis. Sci. 2018;59(9):629. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Studies have shown the effectiveness of oculomotor control training in improving reading speed and accuracy in patients with central scotomas due to retinal disease. Our recent work validated an interactive training platform designed to expand opportunities to practice oculomotor exercises independently. The current study evaluates reading outcomes using the interactive training platform in-clinic (IC) with real-time therapist feedback, compared to using the platform independently at-home (AH), without feedback.
Twenty five subjects were enrolled in the IC group (median 79 years, range 25-97) and 8 subjects were enrolled in the AH group (median 77.5 years, range 55-92). All subjects presented a central scotoma due to retinal disease. Both groups were trained to navigate a fully accessible, interactive training platform with touch-screen displays, speech recognition, and large icons. Using methods developed from our previous studies, the IC group completed eight training sessions, once per week, for one hour on the computer platform accompanied by a therapist. The AH group was required to train on the same platform at least one hour per week but encouraged to use the program as often as desired. Outcome measures were assessed at baseline, 4 and 8 weeks and included: MNREAD, visual acuity, contrast sensitivity, and microperimetry.
At baseline there were no significant age, acuity, or contrast sensitivity differences between the groups (p’s >.05). Mean reading speed at baseline was 55.7 ± 40.2 words per minute (WPM) for all participants and increased by an average of 24.68 WPM after 8 weeks (t= -3.065, p= 0.004). There was no significant difference in reading speed between the AH group (24.3 ± 17.7 WPM) and the IC group (22.58 ± 26.5 WPM)(t= -0.157, p= 0.87). Analysis of change in mean logMAR acuity for all subjects showed significant improvement in binocular acuity (p= 0.01) with increased fixation stability.
An at-home training platform is as effective at improving reading outcomes as training done in the clinic. Our findings offer alternative rehabilitation options for providers and their patients who may have difficulty attending in-clinic training due to limiting factors such as transportation restrictions or mobility. A self-administered oculomotor training program improves reading outcomes and can help eliminate barriers commonly faced by low vision patients.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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