June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Biofeedback training in patients with central vision loss and binocular inhibition
Author Affiliations & Notes
  • Filippo Amore
    National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of the Visually Impaired, Roma, Italy
    Department of Ophthalmology, Universita' Cattolica del Sacro Cuore, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy., National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of the Visually Impaired, Roma, Italy
  • Valeria Silvestri
    National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of the Visually Impaired, Roma, Italy
    Department of Ophthalmology, Universita' Cattolica del Sacro Cuore, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy., National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of the Visually Impaired, Roma, Italy
  • Paola Piscopo
    National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of the Visually Impaired, Roma, Italy
    Department of Ophthalmology, Universita' Cattolica del Sacro Cuore, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy., National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of the Visually Impaired, Roma, Italy
  • Simona Turco
    National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of the Visually Impaired, Roma, Italy
    Department of Ophthalmology, Universita' Cattolica del Sacro Cuore, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy., National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of the Visually Impaired, Roma, Italy
  • Luminita Tarita-Nistor
    Krembil Research Institute, Toronto, Ontario, Canada
  • Footnotes
    Commercial Relationships   Filippo Amore None; Valeria Silvestri None; Paola Piscopo None; Simona Turco None; Luminita Tarita-Nistor None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 2769. doi:
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      Filippo Amore, Valeria Silvestri, Paola Piscopo, Simona Turco, Luminita Tarita-Nistor; Biofeedback training in patients with central vision loss and binocular inhibition. Invest. Ophthalmol. Vis. Sci. 2023;64(8):2769.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Many individuals with maculopathy experience binocular inhibition. Binocular inhibition occurs when binocular performances are worse than those registered with only the best eye. To date no effective rehabilitation intervention have been designed for these patients. The aim of this study was to examine the effects of the biofeedback training on improving oculomotor control and binocular viewing

Methods : Forty eyes (28 armd, 8 Stargardt disease, 2 cone-rod dystrophy and 2 myopic maculopathy) of 20 patients were included in this prospective interventional study. Binocular inhibition was determined by binocular ratio (BR) for maximum reading speed. A BR smaller than 0.95 indicated inhibition. The rehabilitation consisted of 10 biofeedback training sessions performed twice per week with the MP1 microperimeter. Binocular and monocular visual acuity, contrast sensitivity, reading parameters at MNRead charts and fixation location and stability of the preferred retinal loci (PRLs) were recorded before and after biofeedback

Results : Binocular acuity and reading acuity did not change after rehabilitation program (p>0,05). Binocular contrast sensitivity, character print size and maximum reading speed improved significantly after training (p=0.02, p=0.05, p=0.02, respectively). Fixation stability quantified with the 68.2% bivariate contour ellipse area (BCEA) improved significantly from 3.6°2 (± 2.5) to 1.6°2 (± 5.7) (p=0.001) in the better eye and from 5.7°2 (±1.1) to 3.04°2 (±1.7) (p=0.002) in the worse eye after training. Before biofeedback training, 8 patients had PRLs in non-corresponding location while after rehabilitation only 1 subject did not move the PRLs in corresponding location. The new location was at 5.4 degrees from the former fovea in the better eye and at 6.6 degrees in the worse eye after training. Binocular ratio for reading speed improved significantly (p=0.001) from 0.76 (±0.14) to 0.91 (±0.07), with 35% of patients completely resolving the inhibition after training

Conclusions : Our study suggest that biofeedback training could have a positive impact in patients who exhibit binocular inhibition considering the improvement in binocular performances after rehabilitation. Our findings expand the visual rehabilitation options for these patients and provide additional information for understanding fixational oculomotor control of subjects with central vision loss due to macular diseases

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

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