Post audio-visual biofeedback training visual functions and quality of life in paediatric idiopathic infantile nystagmus: A pilot study

Purpose: Biofeedback training (BT) was adapted to idiopathic infantile nystagmus syndrome (IINS) cases to enhance visual functions and quality of life (QoL). Methods: 10 patients (age 9 +/- 3.2 years) treated with the audio-visual BT module of the MAIA microperimeter (Centervue, Padova, Italy) were assessed in two baseline visits and 1week post-BT (BT 80 min in total). The outcomes were distance and near binocular best corrected visual acuity (BBCVA), fixation stability, reading speed, contrast sensitivity, stereopsis and Children's Visual Function Questionnaire. One-way repeated measured ANOVA and paired t-tests were used. Results: Distance BBCVA improved from 0.46 +/- 0.21 and 0.43 +/- 0.18 pre-BT to 0.33 +/- 0.2 logMAR post-BT (F (2,27) = 13.75, p = 0.0002). Post-BT was better than baseline (p = 0.0001) and pre-BT (p = 0.001). Near BBCVA improved from 0.23 +/- 0.09 and 0.21 +/- 0.14 pre-BT to 0.04 +/- 0.08 post-BT (F (2,27) = 22.12, p = 0.000014), post-BT was better than baseline (p = 0.0001) and pre-BT (p = 0.0006). Stereopsis improved from 283 +/- 338 '' to 39 +/- 32.2 '' (p = 0.04), contrast sensitivity from 0.26 +/- 0.17 to 0.08 +/- 0.12 log units (p = 0.01), and reading speed improved from 74.7 +/- 51.2 wpm to 104.7 +/- 53.6 wpm (p = 0.0006). Fixation stability improved from 33.6 +/- 28.1 to 14.3 +/- 10.1 sq. QoL increased from 23.8 +/- 2.2 to 26.3 +/- 2.3 units (p = 0.001). Conclusion: BT benefited all visual functions and QoL in this pilot study, heralding a new possibility for Low Vision Rehabilitation in IINS.