Training of patients with age-related macular disease (AMD) using a scanner laser ophthalmoscope (SLO)

• Published in: Ophthalmic & physiological optics Vol. 17; no. 6; p. 542
• Main Authors: Culham, L. E., Fitzke, F.W., Marshall, J.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishers 01.11.1997
• ISSN: 0275-5408; 1475-1313
• DOI: 10.1046/j.1475-1313.1997.97873413.x

Purpose: AMD is the leading cause of blindness in developed countries. Rehabilitation is predominant in management since medical intervention is appropriate only in limited circumstances. Prescription of low vision devices is standard but additional low visual training using eccentric viewing techniques has been advocated. The SLO allows visualisation on a TV monitor of both the fundus image and presented visual stimuli and hence is ideally suited to undertake training. The aim was to test the concept that SLO training influenced patients' reading ability. Methods: Eleven patients were assessed by scotoma and acuity mapping, identification of the preferred retinal location (PRL) and evaluation of fixation stability and letter recognition. A novel SLO training programme totalling 6 hours over a period of 6 weeks emphasised optimal viewing strategies. Results: Of the ten patients who had a strong PRL an alternative retinal area that provided better performance could not be identified. With training, no significant change was observed in reading speed. However, improvements were recorded in visual acuity for distance (t = 2.765) and near (p < 0.0016), and in fixation stability (p > 0.0316) and letter recognition (p < 0.0009). Conclusions: SLO training improved patients' performance. This was not due to changing the retinal area used, but possibly was related to psychological benefits associated with training and the acquisition and perfection of new visual strategies.