Department of Sense Organs: University "Sapienza" of Rome "Polo Pontino" Ophthalmology Unit "A. Fiorini" Hospital, Terracina, Italy.
Centro Studi Ipovisione, Milan, Italy.
Sci Rep. 2022 Oct 7;12(1):16877. doi: 10.1038/s41598-022-20191-x.
Glaucoma is one of the leading causes of non-reversible blindness worldwide, and almost 6 million people are estimated to be impaired visually in advanced stage of glaucoma. Recently, several studies on glaucoma has been focused towards new therapeutic approaches based on mechanisms independent from IOP control. Effects of new therapeutic agents, visual psychophysical training, or complementary medications targeting optic pathways today seem to be a relevant and effervescent field of research. The goal of the study is to evaluate in glaucoma patients if a rehabilitative strategy with a biofeedback training with microperimetry may be useful after surgery in recovery visual performance even when visual field defects are present in IOP is well controlled environment. Were enrolled 24 patients (28 eyes) with Primary Open Angle Glaucoma (POAG) (mean 63 range: 49-75 years) from our Glaucoma Center after filtering surgery. All patients after one months from surgical intervention underwent to a complete ophthalmologic examination: IOP measurement, gonioscopy, visual field and SD-OCT at baseline of RNFL thickness. In some cases, were included in the study both eyes because in POAG frequently clinical conditions are different in each eye, and secondarily new fixation target retinal location (TRL) was chosen based on single eye retinal sensitivity. Best corrected visual acuity was significantly increased after the training from 0.61 to 0.479 (p = 0.00058) with no change in refractive error. After the biofeedback patients presented increased value in Mean retinal sensitivity from 14.91 to 15.96 (p = 0.0078).Fixation stabilitywas improved either according to Fuji classification (increased from 75.1 to 81.3% p = 0.0073) or BCEA value, reduced from 8.7 to 6.0 square degrees (p = 0.013) we noted a marked increase in this parameter with better performances and satisfaction by the patient. RFNL thickness: no change was noted (p = 0.505) in this value as an indicator of disease's stability. Our data indicate that MP-3 Biofeedback may be a good strategy to reduce the impairment of the Glaucoma Patient.
青光眼是全球导致不可逆性失明的主要原因之一，据估计，全球有近 600 万人在青光眼晚期视力受损。最近，几项关于青光眼的研究侧重于基于与眼压控制无关的机制的新治疗方法。新型治疗药物、视觉心理物理训练或针对视神经通路的补充药物的疗效，如今似乎是一个相关且充满活力的研究领域。本研究的目的是评估在青光眼患者中，即使在眼压控制良好的环境下存在视野缺损，手术后使用微视野生物反馈训练进行康复治疗是否有助于恢复视力表现。我们从我们的青光眼中心招募了 24 名（28 只眼）原发性开角型青光眼（POAG）患者（平均年龄 63 岁，范围：49-75 岁）。所有患者在手术后一个月均接受了全面的眼科检查：眼压测量、房角镜检查、视野和 SD-OCT 检查，以评估基线时的视网膜神经纤维层厚度。在某些情况下，由于 POAG 通常在每只眼中的临床情况不同，因此在研究中同时纳入了双眼，其次根据单眼视网膜敏感度选择了新的固定目标视网膜位置（TRL）。经过训练后，最佳矫正视力从 0.61 显著提高到 0.479（p=0.00058），而屈光度没有变化。经过生物反馈治疗后，患者的平均视网膜敏感度从 14.91 提高到 15.96（p=0.0078）。根据 Fuji 分类（从 75.1%提高到 81.3%，p=0.0073）或 BCEA 值（从 8.7 度降低到 6.0 平方度，p=0.013），固定稳定性也得到了改善，我们注意到患者的表现和满意度都有了明显提高，这一参数也有了显著改善。视网膜神经纤维层厚度：该值无明显变化（p=0.505），表明疾病稳定。我们的数据表明，MP-3 生物反馈可能是减少青光眼患者视力损害的一种良好策略。
