Short-Term Clinical Results of Preferred Retinal Locus Training

Objectives: This study evaluated acoustic biofeedback training using microperimetry in patients with foveal scars and an eligible retinal locus for better fixation. Materials and Methods: A total of 29 eligible patients were enrolled in the study. The acoustic biofeedback training module in the MAIA (Macular Integrity Assessment, CenterVue (R), Italy) microperimeter was used for training. To determine the treatment efficacy, the following variables were compared before and after testing: best corrected visual acuity (BCVA); MAIA microperimeter full threshold 4-2 test parameters of average threshold value, fixation parameters P1 and P2, and bivariate contour ellipse area (BCEA) for 63% and 95% of fixation points; contrast sensitivity (CSV 1000E Contrast Sensitivity Test); reading speed using the Minnesota Low-Vision Reading Test (MNREAD reading chart); and quality of life (NEI-VFQ-25). In addition, fixation stability parameters were recorded during each session. Results: The study group consisted of 29 patients with a mean age of 68.72 +/- 8.34 years. Median BCVA was initially 0.8 (0.2-1.6) logMAR and was 0.8 (0.1-1.6) logMAR after 8 weeks of preferred retinal locus training (p=0.003). The fixation stability parameter P1 improved from a mean of 21.28 +/- 3.08% to 32.69 +/- 3.69% (p=0.001) while mean P2 improved from 52.79 +/- 4.53% to 68.31 +/- 3.89% (p=0.001). Mean BCEA 63% decreased from 16.11 +/- 2.27 degrees 2 to 13.34 +/- 2.26 degrees 2 (p=0.127) and mean BCEA 95% decreased from 45.87 +/- 6.72 degrees 2 to 40.01 +/- 6.78 degrees 2 (p=0.247) after training. Binocular reading speed was 38.28 +/- 6.25 words per minute (wpm) before training and 45.34 +/- 7.35 wpm after training (p<0.001). Statistically significant improvement was observed in contrast sensitivity and quality of life questionnaire scores after training. Conclusion: Beginning with the fifth session, biofeedback training for a new trained retinal locus improved average sensitivity, fixation stability, reading speed, contrast sensitivity, and quality of life in patients with macular scarring.