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Biofeedback Training after Successful Inverted Internal Limiting Membrane (ILM)-Flap Technique for High Myopic Macular Hole

Background: Microperimetric biofeedback training improved visual acuity and fixation stability in patients who previously underwent macular surgery. We aimed to compare the functional results of biofeedback training with the standard of care in patients who underwent successful inverted Internal Lim...

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Autores principales: Sborgia, Alessandra, Niro, Alfredo, Pastore, Valentina, Albano, Valeria, Boscia, Giacomo, Piepoli, Marina, Di Pardo, Camilla, Accurso Tagano, Lorenzo, Zerbinati, Marta, Landini, Luca, Pignataro, Maria Grazia, Petruzzella, Giovanni, Donghia, Rossella, Alqahtani, Abdullah S., Coassin, Marco, Dell’Omo, Roberto, Boscia, Francesco, Alessio, Giovanni, Sborgia, Giancarlo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10455115/
https://www.ncbi.nlm.nih.gov/pubmed/37629230
http://dx.doi.org/10.3390/jcm12165188
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author Sborgia, Alessandra
Niro, Alfredo
Pastore, Valentina
Albano, Valeria
Boscia, Giacomo
Piepoli, Marina
Di Pardo, Camilla
Accurso Tagano, Lorenzo
Zerbinati, Marta
Landini, Luca
Pignataro, Maria Grazia
Petruzzella, Giovanni
Donghia, Rossella
Alqahtani, Abdullah S.
Coassin, Marco
Dell’Omo, Roberto
Boscia, Francesco
Alessio, Giovanni
Sborgia, Giancarlo
author_facet Sborgia, Alessandra
Niro, Alfredo
Pastore, Valentina
Albano, Valeria
Boscia, Giacomo
Piepoli, Marina
Di Pardo, Camilla
Accurso Tagano, Lorenzo
Zerbinati, Marta
Landini, Luca
Pignataro, Maria Grazia
Petruzzella, Giovanni
Donghia, Rossella
Alqahtani, Abdullah S.
Coassin, Marco
Dell’Omo, Roberto
Boscia, Francesco
Alessio, Giovanni
Sborgia, Giancarlo
author_sort Sborgia, Alessandra
collection PubMed
description Background: Microperimetric biofeedback training improved visual acuity and fixation stability in patients who previously underwent macular surgery. We aimed to compare the functional results of biofeedback training with the standard of care in patients who underwent successful inverted Internal Limiting Membrane (ILM)-flap technique for high myopic macular holes (hMMH). Methods: This was a retrospective, comparative, cohort study. Patients with hMMH after surgical hole closure underwent microperimetric biofeedback using structured light stimulus plus acoustic tone (n = 12; Biofeedback) or standard of care with scheduled visits (n = 11; Control). Best-corrected visual acuity, retinal sensitivity at central 12° (RS) and 4° (CRS) with a mean deviation at central 12° (MD), and fixation stability as bivariate contour ellipse area (BCEA 68%, 95%, and 99%) were assessed at baseline and month 1, 3, 6, and 12. The Mann–Whitney test was used to test the difference between the groups. Results: Baseline functional parameters were not significantly different among the groups. BCVA significantly improved in each group (Biofeedback, p = 0.002; Control, p ≤ 0.02) at all follow-up visits. CRS significantly improved at 6 (p = 0.03) and 12 (p = 0.01) months in the Biofeedback group and at month 12 (p = 0.01) in the Control group. RS (p = 0.001) and MD (p = 0.005) improved at the last follow-up only in the trained group. After training, BCEA 68% and 95% significantly improved (6 and 12 months, p < 0.05). The Biofeedback group had better results in RS (p ≤ 0.02), CRS (p ≤ 0.02), and BCEA 68%, 95%, and 99% (p ≤ 0.01) compared to the Control at all follow-ups. BCVA and MD were better in the Biofeedback group at month 3 (p = 0.01), and month 3 (p = 0.01) and 12 (p = 0.003), respectively. Conclusions: Microperimetric biofeedback can increase retinal sensitivity and stabilize fixation better than the standard care over months after a successful inverted ILM-flap for hMMH.
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spelling pubmed-104551152023-08-26 Biofeedback Training after Successful Inverted Internal Limiting Membrane (ILM)-Flap Technique for High Myopic Macular Hole Sborgia, Alessandra Niro, Alfredo Pastore, Valentina Albano, Valeria Boscia, Giacomo Piepoli, Marina Di Pardo, Camilla Accurso Tagano, Lorenzo Zerbinati, Marta Landini, Luca Pignataro, Maria Grazia Petruzzella, Giovanni Donghia, Rossella Alqahtani, Abdullah S. Coassin, Marco Dell’Omo, Roberto Boscia, Francesco Alessio, Giovanni Sborgia, Giancarlo J Clin Med Article Background: Microperimetric biofeedback training improved visual acuity and fixation stability in patients who previously underwent macular surgery. We aimed to compare the functional results of biofeedback training with the standard of care in patients who underwent successful inverted Internal Limiting Membrane (ILM)-flap technique for high myopic macular holes (hMMH). Methods: This was a retrospective, comparative, cohort study. Patients with hMMH after surgical hole closure underwent microperimetric biofeedback using structured light stimulus plus acoustic tone (n = 12; Biofeedback) or standard of care with scheduled visits (n = 11; Control). Best-corrected visual acuity, retinal sensitivity at central 12° (RS) and 4° (CRS) with a mean deviation at central 12° (MD), and fixation stability as bivariate contour ellipse area (BCEA 68%, 95%, and 99%) were assessed at baseline and month 1, 3, 6, and 12. The Mann–Whitney test was used to test the difference between the groups. Results: Baseline functional parameters were not significantly different among the groups. BCVA significantly improved in each group (Biofeedback, p = 0.002; Control, p ≤ 0.02) at all follow-up visits. CRS significantly improved at 6 (p = 0.03) and 12 (p = 0.01) months in the Biofeedback group and at month 12 (p = 0.01) in the Control group. RS (p = 0.001) and MD (p = 0.005) improved at the last follow-up only in the trained group. After training, BCEA 68% and 95% significantly improved (6 and 12 months, p < 0.05). The Biofeedback group had better results in RS (p ≤ 0.02), CRS (p ≤ 0.02), and BCEA 68%, 95%, and 99% (p ≤ 0.01) compared to the Control at all follow-ups. BCVA and MD were better in the Biofeedback group at month 3 (p = 0.01), and month 3 (p = 0.01) and 12 (p = 0.003), respectively. Conclusions: Microperimetric biofeedback can increase retinal sensitivity and stabilize fixation better than the standard care over months after a successful inverted ILM-flap for hMMH. MDPI 2023-08-09 /pmc/articles/PMC10455115/ /pubmed/37629230 http://dx.doi.org/10.3390/jcm12165188 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Sborgia, Alessandra
Niro, Alfredo
Pastore, Valentina
Albano, Valeria
Boscia, Giacomo
Piepoli, Marina
Di Pardo, Camilla
Accurso Tagano, Lorenzo
Zerbinati, Marta
Landini, Luca
Pignataro, Maria Grazia
Petruzzella, Giovanni
Donghia, Rossella
Alqahtani, Abdullah S.
Coassin, Marco
Dell’Omo, Roberto
Boscia, Francesco
Alessio, Giovanni
Sborgia, Giancarlo
Biofeedback Training after Successful Inverted Internal Limiting Membrane (ILM)-Flap Technique for High Myopic Macular Hole
title Biofeedback Training after Successful Inverted Internal Limiting Membrane (ILM)-Flap Technique for High Myopic Macular Hole
title_full Biofeedback Training after Successful Inverted Internal Limiting Membrane (ILM)-Flap Technique for High Myopic Macular Hole
title_fullStr Biofeedback Training after Successful Inverted Internal Limiting Membrane (ILM)-Flap Technique for High Myopic Macular Hole
title_full_unstemmed Biofeedback Training after Successful Inverted Internal Limiting Membrane (ILM)-Flap Technique for High Myopic Macular Hole
title_short Biofeedback Training after Successful Inverted Internal Limiting Membrane (ILM)-Flap Technique for High Myopic Macular Hole
title_sort biofeedback training after successful inverted internal limiting membrane (ilm)-flap technique for high myopic macular hole
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10455115/
https://www.ncbi.nlm.nih.gov/pubmed/37629230
http://dx.doi.org/10.3390/jcm12165188
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