Eccentric Viewing Training for Age-Related Macular Disease

Ophthalmology Science · 9 authors, 1 centre

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TL;DR

All groups received standard low-vision rehabilitation.

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All groups received standard low-vision rehabilitation. The primary outcome was patient-reported visual task ability measured on the Activity Inventory at six months. No significant difference was found between groups on the primary outcome (F(3,174) = 1.48, P = 0.22) or on any secondary measures.

STUDY TYPE

RCT

SPECIALTY

ophthalmology

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100% · A

ORIGINAL PAPER

PMC10767206

Eccentric Viewing Training for Age-Related Macular Disease

Ophthalmology Science

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ABSTRACT

Abstract Purpose Eccentric viewing training for macular disease has been performed for > 40 years, but no large studies including control groups have assessed the benefits of this training. The EFFECT ( E ccentric F ixation F rom E nhanced C linical T raining) study is a large randomized controlled trial of 2 types of eccentric viewing training. Design Randomized controlled trial. Participants Two hundred adults with age-related macular disease. Methods Participants were randomized to either of the following: (1) a control group; (2) a group receiving supervised reading support; (3) a group receiving 3 sessions of training to optimize the use of their own preferred retinal locus; or (4) a group receiving 3 sessions of biofeedback training of a theoretically optimal trained retinal locus. All participants received standard low-vision rehabilitation. Main Outcome Measures The primary outcome was patient-reported visual task ability measured on the Activity Inventory instrument at goal level. Secondary outcomes included reading performance and fixation stability. Results There was no difference between groups on change in task ability ( F (3,174) = 1.48, P = 0.22) or on any of the secondary outcome measures. Visual acuity and contrast sensitivity fell in all groups, suggesting that disease progression outweighed any benefit of training. Conclusions Eccentric viewing training did not systematically improve task ability, reading performance, or fixation stability in this study. Our results do not support the routine use of eccentric viewing training for people with progressing age-related macular disease, although this training may help people with end-stage disease. Rehabilitation of an inherently progressive condition is challenging. Financial Disclosure(s) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article. Keywords: Low vision, Rehabilitation, Eccentric viewing, Reading, Age-related macular disease

CITATION EXPORT

Gary S Rubin, Michael D Crossland, Hannah MP Dunbar et al.. Eccentric Viewing Training for Age-Related Macular Disease. Ophthalmology Science. (2023). https://doi.org/10.1016/j.xops.2023.100422

AUTHORS

9 · 1 CENTRES

Gary S Rubin, Michael D Crossland, Hannah MP Dunbar, Graham M Brown, Bledi Petriti, Hannah Roche, Sarah V Sirrell, Kavitha Thayaparan Broom, Robin D Hamilton

1NIHR Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital, London, UK