MP-1 Biofeedback: Luminous Pattern Stimulus Versus Acoustic Biofeedback in Age Related Macular degeneration (AMD)

Abstract

In this study we evaluated the efficacy of visual rehabilitation by means of two different types of biofeedback techniques in patients with age related macular degeneration (AMD). Thirty patients, bilaterally affected by AMD, were randomly divided in two groups: one group was treated with an acoustic biofeedback (AB group), the other was treated with luminous biofeedback of a black and white checkerboard flickering during the examination (LB group). All patients underwent a complete ophthalmological examination. Rehabilitation consisted of 12 training sessions of 10 min for each eye performed once a week for both groups. Both groups showed better visual performance after rehabilitation and luminous flickering biofeedback stimulus showed a statistically significant improvement in training the patients to modify their preferred retinal locus in comparison to acoustic biofeedback. This suggests that it might be possible in the damaged retina to override dead photoreceptor and outer retinal layers and involve residual surviving cells, as well as amplify and integrate retinal and brain cortex plasticity by using other spared channels towards associative pathways.

How effective is eccentric viewing training? A systematic literature review

“…This was associated with a significant decrease ( p < 0.05) in the number of errors recorded during the reading period (mean number of errors at baseline = 0.77 ± 0.98, and mean number of errors after training = 0.29 ± 0.29), with effect sizes of 0.46 for reading speed and 0.76 for the error rate. Similarly positive results were reported in a trial by Vingolo et al ,. which compared two types of biofeedback (acoustic and luminous) in training participants ( n = 15 per group, with bilateral neovascular AMD) to use a trained retinal locus.…”

“…However, the effect of training on distance VA has received some attention. An increase in distance VA was reported in two small before and after studies ( n = 5 for each study), one randomised trial, and one case study . A change in distance VA was found in another small controlled before and after study, but this failed to reach significance when Bonferroni correction was applied for multiple comparisons .…”

“…It is notable that only three of the studies included in the review stated that the outcome data were collected by a different individual to the one who administered the training . As there is a strong risk that participants will be inclined to respond more positively when outcomes are measured by the service provider, this may have exaggerated the effects of training, particularly with respect to self‐report items.…”

Patient-reported outcomes in randomised controlled trials on age-related macular degeneration

“…Whenever the name of PROM questionnaire or the specific name of a measure was unknown, we labelled them as ‘undetermined’, for example, questions to the participants regarding subjective changes in visual function such as whether patients were able to read faster or smaller sizes than previously 12. A total of 858 clinical and PROM and adverse outcomes were reported.…”

Low vision rehabilitation: current perspectives

“…42 When compared with acoustic biofeedback, this technique seems to provide better results in terms of best corrected visual acuity, reading speed, and fixation behavior. 43 Some hypotheses can be put forward to explain the mechanism by which this technique improves visual performance. Imaging studies indicate that the visual cortex in patients with age-related macular degeneration shows signs of cortical reorganization in areas of the cortex that topographically match the fovea.…”