Effective rehabilitation of reading by training in the technique of eccentric viewing: evaluation of a 4-year programme of service delivery

Palmer, Shelagh; Logan, David A.; Nabili, Shahriar; Dutton, Gordon N.

doi:10.1136/bjo.2008.152231

Cited by 32 publications

(34 citation statements)

References 14 publications

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“…Similar development of a preferred extra-foveal retinal location that was accompanied by reorganization of visual processing was reported to occur in patients with macular degeneration, and specifically only after foveal function was lost in both eyes 49 . In preparation for gene-augmentation trials of ACHM in humans, this issue should be carefully addressed, and visual rehabilitation programs to "teach" the use of the newly available visual data emanating from the now-active cone photoreceptors should be considered 42,50 . Patients may be assessed by novel techniques, such as A c c e p t e d m a n u s c r i p t 13 © 2015 The American Society of Gene & Cell Therapy.…”

Section: Discussionmentioning

confidence: 99%

Gene Augmentation Therapy Restores Retinal Function and Visual Behavior in a Sheep Model of CNGA3 Achromatopsia

et al. 2015

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Achromatopsia is a hereditary form of day blindness caused by cone photoreceptor dysfunction. Affected patients suffer from congenital color blindness, photosensitivity, and low visual acuity. Mutations in the CNGA3 gene are a major cause of achromatopsia, and a sheep model of this disease was recently characterized by our group. Here, we report that unilateral subretinal delivery of an adeno-associated virus serotype 5 (AAV5) vector carrying either the mouse or the human intact CNGA3 gene under the control of the red/green opsin promoter results in long-term recovery of visual function in CNGA3-mutant sheep. Treated animals demonstrated shorter maze passage times and a reduced number of collisions with obstacles compared with their pretreatment status, with values close to those of unaffected sheep. This effect was abolished when the treated eye was patched. Electroretinography (ERG) showed marked improvement in cone function. Retinal expression of the transfected human and mouse CNGA3 genes at the mRNA level was shown by polymerase chain reaction (PCR), and cone-specific expression of CNGA3 protein was demonstrated by immunohistochemisrty. The rescue effect has so far been maintained for over 3 years in the first-treated animals, with no obvious ocular or systemic side effects. The results support future application of subretinal AAV5-mediated gene-augmentation therapy in CNGA3 achromatopsia patients.

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Section: Discussionmentioning

confidence: 99%

Gene Augmentation Therapy Restores Retinal Function and Visual Behavior in a Sheep Model of CNGA3 Achromatopsia

et al. 2015

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“…Although these two components are seemingly indispensable for the foveal vision (that is the visual system continuously brings the target of interest into the fovea via eye movements to acquire detailed pattern information), integrating these two components has been largely ignored in previous peripheral vision training studies that focused on either perceptual training (Chung, Legge, & Cheung, 2004; Lee, Kwon, Legge, & Gefroh, 2010; Nguyen, Stockum, Hahn, & Trauzettel-klosinski, 2011; Seiple, Grant, & Szlyk, 2011; Yu, Cheung, Legge, & Chung, 2010; Yu, Legge, Park, Gage, & Chung, 2010), eccentric viewing (Frennesson, Jakobsson, & Nilsson, 1995; Nilsson et al, 2003; Nilsson, Frennesson, & Nilsson, 1998; Palmer, Logan, Nabili, & Dutton, 2010; Seiple et al, 2011), or oculomotor training (Nguyen et al, 2011; Seiple et al, 2011; Seiple, Szlyk, McMahon, Pulido, & Fishman, 2005; Tarita-Nistor et al, 2008; Vingolo, Cavarretta, Domanico, Parisi, & Malagola, 2007). …”

Section: Introductionmentioning

confidence: 99%

Integrating oculomotor and perceptual training to induce a pseudofovea: A model system for studying central vision loss

Liu¹,

Kwon²

2016

Journal of Vision

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People with a central scotoma often adopt an eccentric retinal location (Preferred Retinal Locus, PRL) for fixation. Here, we proposed a novel training paradigm as a model system to study the nature of the PRL formation and its impacts on visual function. The training paradigm was designed to effectively induce a PRL at any intended retinal location by integrating oculomotor control and pattern recognition. Using a gaze-contingent display, a simulated central scotoma was induced in eight normally sighted subjects. A subject's entire peripheral visual field was blurred, except for a small circular aperture with location randomly assigned to each subject (to the left, right, above, or below the scotoma). Under this viewing condition, subjects performed a demanding oculomotor and visual recognition task. Various visual functions were tested before and after training at both PRL and nonPRL locations. After 6–10 hr of the training, all subjects formed their PRL within the clear window. Both oculomotor control and visual recognition performance significantly improved. Moreover, there was considerable improvement at PRL location in high-level function, such as trigram letter-recognition, reading, and spatial attention, but not in low-level function, such as acuity and contrast sensitivity. Our results demonstrated that within a relatively short time, a PRL could be induced at any intended retinal location in normally-sighted subjects with a simulated scotoma. Our training paradigm might not only hold promise as a model system to study the dynamic nature of the PRL formation, but also serve as a rehabilitation regimen for individuals with central vision loss.

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“…The majority of learners reported practicing, and the median time spent seemed appropriate at 15 minutes per day and just over 1 hour per week. Time spent was, however, extremely variable, which suggests that this was not perhaps as structured a regimen as it seems to be in other programs (e.g., keeping diaries 27 ). The time between sessions with the trainer was relatively long compared to other programs, at 3 weeks, and this is in fact slightly less than the expectation of a 1-month interval suggested by Mac Soc.…”

Section: Discussionmentioning

confidence: 95%

“…Similar training methods applied in Sweden 26 were initially offered to only 60/351 patients with AMD who attended for visual rehabilitation (the majority just needed simple magnifiers). In addition to those who need only simple magnification, there is also a group whose physical and mental well-being is poor, and they are most unlikely to be in a position to benefit; Nilsson and Nilsson 26 and Palmer et al 27 both excluded individuals in this category.…”

Section: Discussionmentioning

confidence: 99%

Evaluating the Effectiveness of an Established Community-Based Eccentric Viewing Rehabilitation Training Model—the EValuation Study

Dickinson

Subramanian

Harper

2016

Invest. Ophthalmol. Vis. Sci.

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Citation: Dickinson C, Subramanian A, Harper RA. Evaluating the effectiveness of an established communitybased eccentric viewing rehabilitation training model-the EValuation study. Invest Ophthalmol Vis Sci. 2016;57:3640-3649. DOI:10.1167/ iovs.15-18458 PURPOSE. This study evaluated the community-based eccentric viewing (EV) training offered across the United Kingdom by the Macular Society. Volunteer trainers deliver free one-to-one training, usually in learners' homes. They also share information about lighting, magnification, social support, and low-vision technology.METHODS. The audio-recorded reading performance of learners was compared before and after training. Telephone questionnaires were used to assess life satisfaction, amount of reading performed, and health-and vision-related quality of life. Learners were also interviewed to obtain their subjective opinions. RESULTS.A total of 121 learners completed all stages of the study. There was no significant change in maximum reading speed. A statistically significant (P < 0.001) but small improvement in both critical print size and threshold print size was found, but frequency and duration of reading did not increase. There was a borderline significant (P ¼ 0.022) increase in ''life satisfaction'' for the learners, but a highly significant (P < 0.001) decrease in their ''positive affect.'' There was no change in health-or vision-related quality of life, or in the difficulty experienced in performing everyday tasks. However, according to learner interviews, 72% felt they had achieved a positive outcome from the training, and 75% felt they had received helpful advice in addition to the EV training.CONCLUSIONS. The lack of improvement of reading speed and modest improvement in threshold print size should be interpreted in the context of the unique features of this EV program, since many learners who would seem to have limited scope for improvement still undertake the training.

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Effective rehabilitation of reading by training in the technique of eccentric viewing: evaluation of a 4-year programme of service delivery

Cited by 32 publications

References 14 publications

Gene Augmentation Therapy Restores Retinal Function and Visual Behavior in a Sheep Model of CNGA3 Achromatopsia

Gene Augmentation Therapy Restores Retinal Function and Visual Behavior in a Sheep Model of CNGA3 Achromatopsia

Integrating oculomotor and perceptual training to induce a pseudofovea: A model system for studying central vision loss

Evaluating the Effectiveness of an Established Community-Based Eccentric Viewing Rehabilitation Training Model—the EValuation Study

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