Retinal Fixation and Microperimetry

Crossland, Michael D.; Rubin, Gary S.

doi:10.1007/978-3-642-40300-2_2

Cited by 6 publications

(7 citation statements)

References 29 publications

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“…Results showed that, overall, near visual acuity and crowding significantly improved in the untrained eye. These results are consistent with what observed in the trained eye and further suggest that training might have improved fixation stability, which, as mentioned in the previous subsection, seems to be related to both acuity and crowding ( Calabrèse et al, 2011 ; Chen et al, 2019 ; Crossland & Rubin, 2014 ; Tarita-Nistor, Brent, Steinbach, & González, 2011 ; Tarita-Nistor, González, Markowitz, & Steinbach, 2008 ; Timberlake et al, 2005 ).…”

Section: Discussionsupporting

confidence: 91%

“…Additionally, there is evidence linking fixation stability and peripheral VA and reading, both in MD patients ( Calabrèse et al, 2011 ; Crossland & Rubin, 2014 ; Tarita-Nistor, Brent, Steinbach, & González, 2011 ; Tarita-Nistor, González, Markowitz, & Steinbach, 2008 ; Timberlake et al, 2005 ) and participants trained with simulated scotoma ( Chen et al, 2019 ), and with the hypothesis that reading difficulties may depend on unstable fixation ( Falkenberg et al, 2007 ) and the suggestion of potential rehabilitative benefits of interventions based on fixation stability training ( Falkenberg et al, 2007 ).…”

Section: Discussionmentioning

confidence: 99%

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Combining fixation and lateral masking training enhances perceptual learning effects in patients with macular degeneration

2020

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Macular degeneration (MD), a retinal disease affecting central vision, represents the leading cause of visual impairment in the Western world, and MD patients face severe limitations in daily activities like reading and face recognition. A common compensation strategy adopted by these patients involves the use of a region in the spared peripheral retina as a new fixation spot and oculomotor reference (preferred retinal locus, or PRL). Still, peripheral vision is characterized by poorer visual acuity, fixation stability, and larger crowding zones that further hinder processes like object recognition, visual search, and reading. Perceptual learning (PL) has been successfully used to improve visual acuity in mild visual conditions (e.g., presbyopia, amblyopia and myopia), but results in MD are less clear, often showing limited generalization of learning, unlike what is observed in a healthy population. A possible reason is the suboptimal fixation in the PRL that might prevent patients from processing the briefly presented training stimuli. Following this hypothesis, we trained five MD patients and four age-and eccentricity-matched controls with a protocol that combined contrast detection and a task previously used to train fixation stability. Results showed transfer of learning to crowding reduction, reading speed, and visual acuity in both MD patients and controls. These results suggest that in the case of central vision loss, PL training might benefit from the integration of oculomotor components to optimize the effect of training and promote transfer of learning to other visual functions.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Combining fixation and lateral masking training enhances perceptual learning effects in patients with macular degeneration

2020

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“…The maintained right visual field may avoid interrupting the reading process and improve the reading efficiency of patients with CVL. 20,29,30,32,33 Michael and Ojeda 34 reported a visual field difference in selective attention, and the right hemifield was superior to the left one. However, Fletcher et al 35 identified the PRL location relative to macular scotomas in a large low-vision patient population (1339 eyes) and found that the visual system showed a strong tendency to not place a PRL anatomically above a scotoma (field defect below fixation) and a weak tendency to not place the PRL anatomically to the right of a scotoma (field defect to the left of fixation).…”

Section: Discussionmentioning

confidence: 97%

“…These results seemed reasonable from a functional standpoint and agreed with previous studies. 20,[27][28][29][30][31] Field defects below fixation may interfere with many visual tasks that require information from the inferior visual field, such as walking, reading, and writing. The tendency for the visual system to locate visual field defects to the right of fixation was expected.…”

Section: Discussionmentioning

confidence: 99%

“…[15][16][17] This natural PRL is commonly located on the fringe of lesions or too distant from the fovea in patients; furthermore, multiple PRLs sometimes develop, affecting fixation stability and inducing a poor vision outcome. 18,19 The location of a PRL is generally uncertain in different cases, 20 and the mechanism of PRL development is still being explored. [21][22][23][24][25][26] Can the visual function of all patients with CVL be improved by eccentric fixation training?…”

Section: Introductionmentioning

confidence: 99%

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Characteristics of Preferred Retinal Locus in Eyes with Central Vision Loss Secondary to Different Macular Lesions

Chen²,

Lin³

et al. 2021

Seminars in Ophthalmology

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Objective: Preferred retinal locus (PRL) training has been applied to low-vision rehabilitation for patients with central vision loss (CVL). This study aimed to explore the characteristics of a natural PRL in eyes with different macular lesions. The data may be useful in customizing training programs.Methods: A total of 72 eyes with CVL were included and assigned into two groups. In group A, 29 eyes diagnosed with macular holes featured relatively sharp borders and small areas of lesions. In group B, 44 eyes showed lesions characterized by irregular borders and large areas. The PRL location relative to a scotoma in the retina, fixation stability, and the average threshold surrounding the PRL were determined and compared between the two groups.Results: In group A, the PRL was located above in 48.28%, below in 27.59%, left in 62.07%, right in 31.03%, and inside in 3.45% of the eyes. In group B, the PRL was located above in 39.53%, below in 4.65%, left in 44.19%, right in 6.98%, and inside in 27.91% of eyes. The amount of retinal displacement occurring within 1° from an initial reference point (P< .05) and the 95% bivariate contour ellipse area (P< .05) in group A were respectively higher and lower than those in group B. However, the average thresholds around the PRLs in the two groups showed no significant difference (P > .05).Conclusions: A PRL to the left of or above a scotoma tends to develop to avoid the right and inferior field defect, regardless of the scale and boundary of lesions. Although light sensitivity around a PRL shows no relation to lesion features, fixation stability is worse in irregular and large lesions.

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Additional measures of macular function beyond visual acuity

Ríos,

Lövestam-Adrian,

Plainis

et al. 2023

Graefes Arch Clin Exp Ophthalmol

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Purpose Visual function is a complex process in which external visual stimuli are interpreted. Patients with retinal diseases and prolonged follow-up times may experience changes in their visual function that are not detected by the standard visual acuity measure, as they are a result of other alterations in visual function. With the advancement of different methods to evaluate visual function, additional measurements have become available, and further standardization suggests that some methods may be promising for use in clinical trials or routine clinical practice. The objectives of this article are to review these additional measurements and to provide guidance on their application. Methods The Vision Academy’s membership of international retinal disease experts reviewed the literature and developed consensus recommendations for the application of additional measures of visual function in routine clinical practice or clinical trials. Results Measures such as low-luminance visual acuity, contrast sensitivity, retinal fixation and microperimetry, and reading performance are measures which can complement visual acuity measurements to provide an assessment of overall visual function, including impact on patients’ quality of life. Measures such as dark adaptation, color vision testing, binocular vision testing, visual recognition testing, and shape discrimination require further optimization and validation before they can be implemented in everyday clinical practice. Conclusion Additional measurements of visual function may help identify patients who could benefit from earlier diagnosis, detection of disease progression, and therapeutic intervention. New and additional functional clinical trial endpoints are required to fully understand the early stages of macular disease, its progression, and the response to treatment.

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Retinal Fixation and Microperimetry

Cited by 6 publications

References 29 publications

Combining fixation and lateral masking training enhances perceptual learning effects in patients with macular degeneration

Combining fixation and lateral masking training enhances perceptual learning effects in patients with macular degeneration

Characteristics of Preferred Retinal Locus in Eyes with Central Vision Loss Secondary to Different Macular Lesions

Additional measures of macular function beyond visual acuity

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