Abstract
Purpose :
Age-related macular degeneration (AMD) is the leading cause of severe loss of visual acuity among people over 60 years of age. The aim of this study was to evaluate the effect of fixation training on the visual function of patients with AMD.
Methods :
Twenty-five patients (50 eyes) aged between 67 and 90 years participated in the study. Each patient underwent a complete ophthalmic examination of both eyes with microperimetry examination with MAIA II microperimeter. Patient's quality of life was assessed using the standardized "National Eye Institute Visual Function Questionnaire - 25" (NEI-VFQ-25). Bilateral geographic atrophy (13 patients, 26 eyes) or bilateral scarring (12 patients, 24 eyes) patient subgroups were isolated, both of which resulted in the presence of a bilateral absolute central scotoma of at least 2 degrees in diameter. All 25 patients underwent a cycle of 10 weekly fixation training sessions using a microperimeter, after which a full functional assessment was performed on both the 25 trained eyes and 25 companion (untrained) eyes.
Results :
The fixation trainings led to an improvement in BCVA and BNVA in all patients studied. BCVA at the post-training timepoint was significantly better (-0.14 logMAR) and an improvement in BCVA in companion, untrained eyes (-0.16 logMAR) compared to the pre-training. In trained eyes, there was an improvement in BNVA from 2.25 to 1.86. BNVA of companion eyes also improved from 2.96 to 2.76. Eyes with atrophy had more pronounced effect compared to eyes with scarring in both BCVA and BNVA. In the 63%BCEA and 95%BCEA parameters, a significant decrease was shown for all groups, with the largest effect after the first and after the last three training sessions. It was noted that undergoing peripheral vision training resulted in an improvement in fixation stability with a moderate effect in both the trained and companion eyes. It was shown that the effect of the completion of 10 training sessions on the retinal sensitivity parameter ranged from very small to small. The total NEI-VFQ-25 score for all patients increased from 40.91 to 54.96.
Conclusions :
Fixation training is an effective method of vision rehabilitation in AMD patients, leading to an improvement in both BCVA and BNVA, and to an improvement in selected fixation parameters of both eyes, leading to improved quality of life.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.