We also excluded patients with cognitive impairment, earing loss, or any other reason that hindered the proper execution of MP-1 biofeedback. Exclusion criteria were eyes undergoing reoperation of primary failure or redetachment, the presence of any other macular pathology such as macular hole, age-related macular degeneration, or macular oedema, patients with advanced glaucoma, and diabetic retinopathy. We included only patients who accepted to perform visual rehabilitation treatment after an appropriate discussion about limitations, benefits, and risks of the procedure. The diagnosis of retinal detachment was based on a complete eye examination including best-corrected visual acuity (BCVA) test using a standard Snellen chart, slit-lamp biomicroscopy, intraocular pressure test, and binocular indirect ophthalmoscopy. They suffered from RD treated with scleral buckle surgery or pars plana vitrectomy with silicon oil tamponade. Goretti” Hospital between 2008 and early 2013. įifty-two eyes of 52 patients (23 female and 29 male) were enrolled at the Department of Ophthalmology, “S.M. This phenomenon has been referred to as adaptive eccentric fixation or oculomotor rereferencing. It has been also found that some patients exhibit a rereferencing of the oculomotor system to the PRL, which leads them to say that they are looking straight ahead when they are fixating with the PRL (i.e., when the eye is not in the primary position). Moreover, a sizeable proportion of patients use more than one PRL for a given task. The term “preferred retinal locus” (PRL) describes a retinal area that acts as a pseudofovea for visual tasks when a central macular scotoma affects visual performance. The MP-1 microperimeter biofeedback examination allows the ophthalmologist to train the patient to fixate the target with a new preferred retinal locus (PRL), which can be defined as a discrete retinal area that contains more than 20% of the fixation points. Visual rehabilitation is a therapeutic approach that has been applied to different ocular diseases characterized by visual deterioration and loss of stable central fixation. Previous studies have shown that the MP-1 results are reproducible and comparable to standard automated perimetry. Therefore, the functional defect can be localized anatomically onto the macular abnormality. An infrared camera establishes and tracks the patient's fixation, and the resulting visual field is registered onto the corresponding fundus photograph. The MP-1 microperimeter measures several points in the patient's central field and effectively maps out microscotomas. In this study we have evaluated the use of biofeedback rehabilitation with the MP-1 microperimeter (NIDEK Technologies Srl, Padova, Italy) as a possible strategy to speed up recovery time in operated eyes.įundus-related microperimetry (MP) is a functional measure of macular sensitivity. Postoperative clinical findings associated with incomplete recovery include cystoid macular edema, epiretinal membranes, retinal folds, retinal pigment epithelium (RPE) migration, and persistent subretinal fluid (SRF). Preoperative factors influencing macula recovery include preoperative visual acuity, duration, and height of detachment, and the presence of vitreomacular traction. Successful reattachment of the macula after RD is often associated with incomplete visual recovery. Visual recovery after surgery for macula-off retinal detachment (RD) is often discouraging because performances are very limited even if retinal reattachment is achieved. Our data demonstrate that in biofeedback group there was a significant recovery in visual performances that still remains evident after 3 months from the baseline. Visual recovery after RD surgery is still unclear, and it does not depend on entity of the RD. At the end of biofeedback treatment (WK 6) BCVA of group A was significantly better ( P < 0.001) than group B and BCVA was still better in group A than group B at WK 12 ( P = 0.028) and at WK 18 ( P = 0.041). At baseline, there was no significant difference in BCVA between groups ( P = 0.4230). Controls were scheduled at baseline and 6, 12, and 18 weeks. Biofeedback strategy was started 15 days after the suspension of cycloplegic eye drops in buckling procedure or after silicone oil removal in the vitrectomized eyes. After surgery, patients were divided into two groups: group A, including patients submitted to biofeedback with MP-1 strategy group B, patients who received common care strategy. To evaluate possible speeding up recovery time after retinal detachment (RD) surgery using biofeedback strategy.
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