Abstract
Purpose :
Biofeedback training (BT) has been used in low vision rehabilitation to stabilize fixation in patients with central vision loss for more than 10 years. In this study, we used BT to train fixational control in children with low vision due to nystagmus diagnosis. We hypothesised that many aspects of visual function will improve following BT intervention.
Methods :
Participants were 11 children (mean age 9.3 ± 3.4 years) with low vision due to idiopathic infantile nystagmus (8 cases) or other causes (3 cases). Their distance visual acuity ranged from 0.3 to 1.3 logMAR. The BT module of MAIA microperimeter (Centervue, Padova, Italy) was used in 4 consecutive 20-min weekly sessions in conjunction with home exercises. Distance visual acuity, near visual acuity, fixation stability quantified with the bivariate contour ellipse area (BCEA), reading speed, contrast sensitivity, stereopsis and Quality of Life Children’s Visual Function Questionnaire were assessed pre- and post-training. All outcome measures were obtained from N = 5 participants while three (distance, near visual acuity, and fixation stability) were obtained from all participants.
Results :
Following BT training, visual acuity for near and distance measures improved significantly. Distance visual acuity improved from 0.5 ± 0.26 logMAR to 0.4 ± 0.29 logMAR (p=0.004). Near visual acuity improved from 0.25 ± 0.11 logMAR to 0.14 ± 0.08 logMAR (p=0.009). Stereopsis for near improved significantly from 228 ± 78.4” to 74 ± 53.1” (p=0.02). BCEA values decreased from 30.4 ± 23.1 deg2 to 14.3 ± 0.7 deg2. Contrast sensitivity improved from 0.3 ± 0.09 to 0.16± 0.14 logMAR (p=0.07). Reading speed improved from 86.3 ± 29.6 wpm to 51.2 ± 11.4 wpm (p=0.07). Quality of life scores increased from 26.6 ± 3 to 45.3 ± 36.5 (p=0.3). No side effects were found.
Conclusions :
In our sample, biofeedback training for children with nystagmus resulted in significant increase in visual acuity for near, distance, and stereopsis. There was a trend for improvement of all visual function and quality of life scores. BT is a new promising therapy for pediatric nystagmus that can be incorporated in clinical practice with great benefits for the patients’ quality of life and visual functions.
This is a 2020 ARVO Annual Meeting abstract.