Faculty Bibliography

Purpose: Previous research has demonstrated that oculomotor control training results in increased reading speed in patients with central scotomas due to retinal disease. Typically, reading-eye-movement training takes place in clinical settings and is executed by a therapist who provides guidance and immediate performance feedback. In-home vision rehabilitation has the potential to reduce travel, and expenses for patients and allow more frequent training. This study validated the effectiveness of an interactive, self-guided eye movement training program that could be independently used in the home. Methods: Eight subjects with central scotomas due to retinal disease participated in the 8-week study. The median age of subjects was 51 years (range, 25-94 years). Binocular visual acuity ranged from 20/80 to 20/400, and contrast sensitivity ranged from 0.56-1.88 log CS. Subjects performed eye movement training tasks once per week for one hour on a user-friendly computer platform, developed using methods from our previous research. The interface is fully accessible, consisting of large icons, touch-screen displays, speech recognition, and voice controls. The platform allows participants to self-administer training exercises by automatically selecting appropriate modules based on past training performance, executing the training exercise, and storing training data. The binocular training program advances from single- to three-letter word saccades and progressed from small saccades to larger eye movements. All subjects were trained to navigate the program and were required to demonstrate proficiency before beginning independent training. Outcome measures (MNREAD, visual acuity, contrast sensitivity, microperimetry thresholds) were assessed at baseline, 1 month, and post-training. Results: Mean reading speed at baseline was 69.3 wpm. Reading speed increased by an average of 44.2 wpm (63.7%) after 8 weeks of self-guided eye-movement training. Improvement in reading speed was independent of age, acuity, contrast sensitivity, and reading speed at baseline (p<.05). Conclusions: Consistent with our previous work, a computer platform designed for independent training of eye-movement control increased reading speed in subjects with central scotomas due to retinal disease. Our findings suggest that the platform could be effectively used for automated, in-home training

Structured abstract: Introduction: This study was conducted to evaluate the functional performance of the BrainPort V100 device, an FDA-cleared sensory-substitution system, in persons who are profoundly blind (that is, have some or no light perception). Methods: This was a prospective, single-arm, multicenter clinical investigation. Participants received 10 hours of device training and were required to use the device in their everyday environments for 1 year. Functional performance measures of object identification, orientation and mobility (O&amp;M), and word identification were assessed at baseline, in post-device training, and at the 3-, 6-, 9-, and 12-month time points. Results: Fifty-seven participants completed the study and used the device for 1 year. No device-related serious adverse events were reported, demonstrating that the risks associated with the BrainPort are minimal. Participants performed object recognition (91.2% success rate) and O&amp;M (57.9% success rate) tasks beyond chance level. Discussion: This study demonstrates that the BrainPort can be used safely and independently by persons who are blind. Participants with profound blindness can accomplish a set of tasks more successfully by using the BrainPort than without the device. Following initial training, performance on these tasks was maintained or improved over the course of 1 year. Implications for practitioners: The BrainPort is a noninvasive and nonsurgical device that heightens functional independence for persons who are blind. The device presents users with more information about their environment than conventional assistive devices, and can enhance independence in performing activities of daily living.

Background. Parkinson's disease (PD) progressively affects dopaminergic neurotransmission and may affect retinal dopaminergic functions and structures. Objective. This 2-year randomized, open-label, parallel-group, flexible-dose study, NCT00144300, evaluated ophthalmologic safety profiles of immediate-release (IR) pramipexole and ropinirole in patients with early idiopathic PD with