Biofeedback Training for improving visual functions in children with nystagmus: a short-and-long term analysis

Theme: Paediatric ophthalmology and strabismus
What: Paediatric ophthalmology and strabismus
Part of: Paediatrics I: Pediatric Ophthalmology & Strabismus - Vision Screening to Retinoblastoma / Pédiatrie I: Ophtalmologie pédiatrique et strabisme - Dépistage du rétinoblastome
When: 6/1/2024, 04:15 PM - 05:45 PM
Where: Room | Salle 714 A

Abstract

Purpose: To increase visual functions and quality of life (QoL) in pediatric nystagmus cases with biofeedback training (BT).

Study design: We propose an interventional and non-randomized study to assess the effectiveness of Biofeedback training in the pediatric population of patients with infantile nystagmus. 

Methods: Children treated with audio-visual BT on the MAIA microperimeter were analyzed pre- and 1-week post-BT (short term). Outcomes were binocular best corrected visual acuity (BBCVA) for distance and near, fixation stability (FS), reading speed (RS), contrast sensitivity (CS), stereopsis, and Children’s Visual Function Questionnaire. BBCVA and FS were measured in the long term (> 3 months). One-way repeated ANOVA and paired t-tests were used for statistics.

Results: 23 cases (9.2 ± 2.3 years old) were followed for 1 week post-BT with a long term follow up of 14.8 ± 11.7 months. At the 1-week follow-up visit, there was a significant improvements in contrast sensitivity (from 0.16 ± 0.17 to 0.05 ± 0.08; p<0.001), reading speed (from 84.8 ± 42.7 to 108.9 ± 43.9; p<0.001), and QoL questionnaire scores (from 25.8 ± 2.8 to 27.4 ± 2.7; p=0.007). BBCVA logMAR VA improved from 0.38 ± 0.18 to 0.29 ± 0.19 and 0.27 ± 0.18 in the 1-week (p<0.001) and final follow-up (p<0.001) visits. Similarly, there was a significant improvement in near BCVA from baseline (0.13 ± 0.16) to the 1-week (0.05 ± 0.08; p=0.020) and final follow-up (0.02 ± 0.06; p=0.006) visits. Fixation stability improved from 14.3 ± 14.7 at baseline to 7.5 ± 8.9 (p=0.047) at 1-week and 5.4 ± 7.9 (p=0.006) at the final visit. 

Conclusion: Biofeedback training delivered significant improvement in BBCVA for distance and near, fixation stability, contrast sensitivity, reading speed, and subjective visual functioning in patients with nystagmus. In this series, BT improved fixation stability and visual acuity for at least  14.8 ± 11.7 months. As a safe and cost-efficient rehabilitation technique, this study brings evidence that BT could provide a novel and relevant visual rehabilitation for patients with nystagmus.

Presenter(s)

Presenting Author: Mariana Akemi Matsura Misawa

Additional Author(s):

Mohab Eldeeb, Department of Ophthalmology and Vision Sciences, University of Toronto

Michelle Markowitz, Toronto Western Hospital, Toronto, ON

Samuel N Markowitz, Low Vision Service, Department of Ophthalmology and Vision Sciences, University of Toronto

Monica Daibert-Nido, Low Vision Service, Department of Ophthalmology and Vision Sciences, University of Toronto

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