A Visual Telerehabilitation Program in Virtual Reality for Age-Related Macular Degeneration: Randomized Feasibility...

Area of Science:

• Ophthalmology
• Rehabilitation Medicine
• Virtual Reality Technology

Background:

• Age-related macular degeneration (AMD) causes progressive central vision loss in older adults.
• Low-vision rehabilitation, often clinic-based biofeedback training (BFT), can improve functional vision.
• Home-based virtual reality (VR) offers potential for sustained visual stimulation but requires feasibility and safety evaluation in AMD patients.

Purpose of the Study:

• To assess the feasibility and safety of integrating home-based VR 3D single-object tracking (3D-SOT-VR) with conventional BFT.
• To evaluate this combined approach in older adults with dry AMD through a randomized controlled trial.
• To generate hypotheses for future large-scale effectiveness studies.

Main Methods:

• A parallel, randomized, single-blind, controlled formative trial was conducted.
• Participants with dry AMD received either BFT alone or BFT plus home-based 3D-SOT-VR for 4 weeks.
• Feasibility outcomes included recruitment, adherence, and VR-induced symptoms; functional outcomes included visual acuity and reading speed.

Main Results:

• Recruitment fell short of the target due to external factors (COVID-19).
• Intervention completion was high (100% BFT, 75% BFT-VR), with acceptable adherence and no significant VR-related adverse events.
• While group visual outcomes were not significant, individual reading speed improved in the BFT-VR group, correlating with VR task performance.

Conclusions:

• Clinic-based BFT combined with home-based, remotely monitored VR visual stimulation is safe for older adults with dry AMD.
• Significant contextual barriers related to recruitment, retention, and data management were identified.
• Further research is needed to address these feasibility issues before effectiveness can be tested.