Biofeedback visual rehabilitation in a patient with oculocutaneous albinism Trabucco P1, Carnevale C2, Gerace E2, Rigoni E2 1
Ospedale “S.M.Goretti”- Latina; 2Università degli studi di Roma “Sapienza”- Policlinico Umberto I, Roma
Purpose: To evaluate effects of biofeedback visual rehabilitation in a young patient with oculocutaneous albinism with the microperimeter MP- 1 Methods: a 14 year old girl with oculocutaneous albinism , visual acuity (BCVA) was 4/10 in the right eye and 5/10 in the left eye. She showed nystagmus and strabismus. Anterior segment examination showed a blue iris pigmentation with high transparency; fundus examination showed a retinal hypopigmentation. Microperimetry ( MP -1, software version 1.7.6; Nidek Technologies) was performed in pharmacological mydriasis. The target was a red cross of 2 degrees of fixation. We used a white background with a 4 apostlibs light, a type III stimulus with Goldman projection time of 200 ms and a customized grid of 68 stimuli around 10 degrees centered on the fovea. The threshold strategy used was 4-2-1. Fixation stability was assessed by calculating the bivariate contour ellipse area (BCEA) comprising 68% of the fixation points. The treatment was composed by 10 rehabilitation sessions on a weekly basis lasting 10 minutes for each eye. Results : Before treatment the mean retinal sensitivity was 19.3 dB in the right eye and 19.7 dB in the left eye, the BCEA in OD was 2.13 deg2 and 1.68 deg2 in OS. After 5 sessions, the mean retinal sensitivity was 19.8 dB and 19.7 in OD OS, the BCEA was 1:50 and 1:49 deg2 in OD deg2 in OS. After 10 sessions , the mean retinal sensitivity was 19.2 dB and 17.9 dB in OD OS, the BCEA in OD was 0.73 deg2 and 0.63 deg2 in OS. No significant statistical difference was noticed between average retinal sensitivity before, during (5 weeks), and after the rehabilitation sessions (respectively: p = 0.25, p = 0.46, p = 0.29 ). Instead it was noticed a statistically significant difference of the BCEA between 5 and 10 weeks after rehabilitation (p = 0.03). There were no changes in visual acuity . Conclusions : The results obtained in the studied patient show that the rehabilitation through biofeedback can improve the stability of the fixation, with obvious improvement in the quality of life of the patient. Nevertheless there were no improvements in visual acuity and retinal sensitivity. Moreover, therapy with biofeedback is extremely economical for the patient and does not have complications.