Effectiveness of Mp-3 Microperimetric Biofeedback Fixation Training For Low Vision Rehabilitation in Patients Treated With Corticosteroid Ivt in Retinal Vein Occlusions

Overview

Journal Clin Optom (Auckl)

Publisher Dove Medical Press

Date 2024 May 27

PMID 38798785

Authors

Mariaelena Malvasi

Sabrina Compagno

Alessandro Segnalini

Vito Maurizio Malvasi

Fernanda Pacella

Paolo Turchetti

Elena Pacella

Affiliations

Soon will be listed here.

Abstract

Background: The success of fixation training using microperimetric biofeedback (MP-3 MBFT) in the realm of visual rehabilitation for patients with central vision loss caused by macular pathologies is well established. This study aimed to assess the effectiveness and safety of visual rehabilitation with microperimetric biofeedback in consolidating the benefits obtained, with the goal of reducing the need for repeated intravitreal injections (IVT). Specifically, the focus is on the eyes of patients with central vision loss treated with slow-release corticosteroid IVT following retinal venous thrombosis (RVO), aiming to enhance and maintain postoperative efficacy.

Methods: This retrospective review involved the examination of 44 eyes affected by macular edema due to RVO associated with central vision loss. Patients were divided into two groups, with only one undergoing ten sessions of 10-minute visual rehabilitation with a microperimeter (MP-3 MBFT) after IVT over a period of 20 weeks.

Results: All the treated patients demonstrated good tolerance to the procedure, with no reported complications. A comparison of best-corrected visual acuity (BCVA), retinal sensitivity recorded with a microperimeter, and pre-IVT fixation stability revealed statistically significant improvements at the end of the first month after IVT. However, the treatment group continued to exhibit superior and more enduring results at four months post-IV.

Conclusion: The synergistic use of MP-3 MBFT rehabilitation after IVT with slow-release corticosteroids has proven particularly effective in improving BCVA and long-term fixation stability. This led to a significant reduction in the number of required IVTs, with no related adverse events. The authors argue that biofeedback utilization represents a noninvasive therapeutic option devoid of contraindications and easy to implement and that it positively contributes to the overall patient experience regarding quality of life in advanced stages of macular diseases.

Citing Articles

Effectiveness of Mp-3 Microperimetric Biofeedback Fixation Training for Low Vision Rehabilitation in Patients Treated with Corticosteroid IVT in Retinal Vein Occlusions [Letter].

Triwiyanto T, Luthfiyah S Clin Optom (Auckl). 2024; 16:221-222.

PMID: 39224489 PMC: 11368140. DOI: 10.2147/OPTO.S490077.

References

Wu Z, Jung C, Ayton L, Luu C, Guymer R . Test-Retest Repeatability of Microperimetry at the Border of Deep Scotomas. Invest Ophthalmol Vis Sci. 2015; 56(4):2606-11. DOI: 10.1167/iovs.14-15977. View

Morales M, Saker S, Wilde C, Rubinstein M, Limoli P, Amoaku W . Biofeedback fixation training method for improving eccentric vision in patients with loss of foveal function secondary to different maculopathies. Int Ophthalmol. 2019; 40(2):305-312. DOI: 10.1007/s10792-019-01180-y. View

Thompson D, Iannaccone A, Ali R, Arshavsky V, Audo I, Bainbridge J . Advancing Clinical Trials for Inherited Retinal Diseases: Recommendations from the Second Monaciano Symposium. Transl Vis Sci Technol. 2020; 9(7):2. PMC: 7414644. DOI: 10.1167/tvst.9.7.2. View

Feher J, Kovacs I, Pacella E, Radak Z . [Correlation of the microbiota and intestinal mucosa in the pathophysiology and treatment of irritable bowel, irritable eye, and irritable mind syndrome]. Orv Hetil. 2014; 155(37):1454-60. DOI: 10.1556/OH.2014.29987. View

Sborgia G, Niro A, Tritto T, Albano V, Sborgia L, Sborgia A . Microperimetric Biofeedback Training after Successful Inverted Flap Technique for Large Macular Hole. J Clin Med. 2020; 9(2). PMC: 7074367. DOI: 10.3390/jcm9020556. View

Glacet-Bernard A, Coscas G, Zourdani A, Soubrane G, Souied E . Steroids and macular edema from retinal vein occlusion. Eur J Ophthalmol. 2012; 21 Suppl 6:S37-44. DOI: 10.5301/EJO.2010.6053. View

Andrade M, Muro E, Moran F . Simulation of plasticity in the adult visual cortex. Biol Cybern. 2001; 84(6):445-51. DOI: 10.1007/PL00007988. View

Kolar P . Risk factors for central and branch retinal vein occlusion: a meta-analysis of published clinical data. J Ophthalmol. 2014; 2014:724780. PMC: 4070325. DOI: 10.1155/2014/724780. View

Noma H, Mimura T, Yasuda K, Shimura M . Role of soluble vascular endothelial growth factor receptor signaling and other factors or cytokines in central retinal vein occlusion with macular edema. Invest Ophthalmol Vis Sci. 2015; 56(2):1122-8. DOI: 10.1167/iovs.14-15789. View

10.

Nair P, Aiello L, Gardner T, Jampol L, Ferris III F . Report From the NEI/FDA Diabetic Retinopathy Clinical Trial Design and Endpoints Workshop. Invest Ophthalmol Vis Sci. 2016; 57(13):5127-5142. PMC: 6016432. DOI: 10.1167/iovs.16-20356. View

11.

Rosengarth K, Keck I, Brandl-Ruhle S, Frolo J, Hufendiek K, Greenlee M . Functional and structural brain modifications induced by oculomotor training in patients with age-related macular degeneration. Front Psychol. 2013; 4:428. PMC: 3713239. DOI: 10.3389/fpsyg.2013.00428. View

12.

Pacella E, Pacella F, La Torre G, Impallara D, Malarska K, Brillante C . Testing the effectiveness of intravitreal ranibizumab during 12 months of follow-up in venous occlusion treatment. Clin Ter. 2013; 163(6):e413-22. View

13.

Song P, Xu Y, Zha M, Zhang Y, Rudan I . Global epidemiology of retinal vein occlusion: a systematic review and meta-analysis of prevalence, incidence, and risk factors. J Glob Health. 2019; 9(1):010427. PMC: 6513508. DOI: 10.7189/jogh.09.010427. View

14.

Rosenfeld P, Brown D, Heier J, Boyer D, Kaiser P, Chung C . Ranibizumab for neovascular age-related macular degeneration. N Engl J Med. 2006; 355(14):1419-31. DOI: 10.1056/NEJMoa054481. View

15.

Strauss R, Ho A, Munoz B, Cideciyan A, Sahel J, Sunness J . The Natural History of the Progression of Atrophy Secondary to Stargardt Disease (ProgStar) Studies: Design and Baseline Characteristics: ProgStar Report No. 1. Ophthalmology. 2016; 123(4):817-28. DOI: 10.1016/j.ophtha.2015.12.009. View

16.

Lesmes L, Jackson M, Bex P . Visual Function Endpoints to Enable Dry AMD Clinical Trials. Drug Discov Today Ther Strateg. 2020; 10(1):e43-e50. PMC: 7453884. DOI: 10.1016/j.ddstr.2012.11.002. View

17.

Gonzalez V, Boyer D, Schmidt-Erfurth U, Heier J, Gordon C, Benz M . Microperimetric assessment of retinal sensitivity in eyes with diabetic macular edema from a phase 2 study of intravitreal aflibercept. Retina. 2015; 35(4):687-94. DOI: 10.1097/IAE.0000000000000430. View

18.

Vingolo E, Salvatore S, Cavarretta S . Low-vision rehabilitation by means of MP-1 biofeedback examination in patients with different macular diseases: a pilot study. Appl Psychophysiol Biofeedback. 2009; 34(2):127-33. DOI: 10.1007/s10484-009-9083-4. View

19.

La Torre G, Pacella E, Saulle R, Giraldi G, Pacella F, Lenzi T . The synergistic effect of exposure to alcohol, tobacco smoke and other risk factors for age-related macular degeneration. Eur J Epidemiol. 2013; 28(5):445-6. DOI: 10.1007/s10654-013-9798-7. View

20.

Widihastha S, Iskandar E, Satari K, Irfani I, Virgana R, Amiruddin P . Vision rehabilitation using microperimetric biofeedback training in age-related macular degeneration. Int J Ophthalmol. 2023; 16(6):933-938. PMC: 10250943. DOI: 10.18240/ijo.2023.06.16. View