Rehabilitative strategies after filtering procedure in glaucoma

Area of Science:

• Ophthalmology
• Neuroscience
• Rehabilitation Medicine

Background:

• Glaucoma is a leading cause of irreversible blindness globally, affecting millions with advanced visual impairment.
• Current research explores therapeutic strategies beyond intraocular pressure (IOP) control, focusing on optic nerve pathways.
• Visual psychophysical training and complementary medications are emerging as relevant research areas.

Purpose of the Study:

• To evaluate the efficacy of a rehabilitative strategy using microperimetry biofeedback training in glaucoma patients after surgery.
• To determine if this approach can improve visual performance despite pre-existing visual field defects and controlled IOP.

Main Methods:

• Enrolled 24 patients (28 eyes) with Primary Open Angle Glaucoma (POAG) post-filtering surgery.
• Conducted ophthalmologic examinations including IOP, gonioscopy, visual field, and SD-OCT for RNFL thickness.
• Implemented a microperimetry biofeedback training program, with fixation target retinal location (TRL) adjusted per eye.

Main Results:

• Significant improvement in best-corrected visual acuity (0.61 to 0.479, p<0.001).
• Increased mean retinal sensitivity (14.91 to 15.96, p<0.01) and fixation stability (Fuji: 75.1% to 81.3%, p<0.01; BCEA: 8.7 to 6.0 sq. degrees, p<0.02).
• No significant change in Retinal Nerve Fiber Layer (RNFL) thickness, indicating disease stability.

Conclusions:

• Microperimetry (MP-3) biofeedback training is a beneficial strategy for glaucoma patients post-surgery.
• This rehabilitation approach can effectively reduce visual impairment and improve visual function in POAG patients.
• The training enhances visual acuity, sensitivity, and fixation stability without negatively impacting RNFL thickness.