S E G Nilsson, C Frennesson, U L Nilsson
Linköping University, Department of Ophthalmology, Linköping, Sweden
Purpose: To evaluate the usefulness of the scanning laser ophthalmoscope (SLO) in establishing a new retinal locus for reading in patients with AMD and an absolute central scotoma.
Patients and methods: Patients with advanced AMD, an absolute central scotoma and a visual acuity <0.1 (<20/200) were enrolled. They were unable to read without devices. With devices but without training, reading speed was very low, generally <l5 words/min. Microperimetry of the scotoma was performed in the SLO and the patient's preferred retinal locus (PRL) was defined by using our software for generating letters, words and scrolled text on the retina. Most patients fixate to the left of the lesion (scotoma), which is unfavourable for reading. An ideal location of a new trained retinal locus (TRL) for reading above (or occasionally below) the lesion was determined as well as visual acuity and the need for magnification at this eccentricity. Initial training in the use of the TRL was carried through by means of scrolled text in the SLO. Training was then continued for 4-5 hours by reading printed text with the aid of high-power positive lenses (12-15X) and a short reading distance. Finally, reading speed was tested a second time.
Results: More than 80% of the patients were able to use eccentric fixation and the new TRL for reading with great stability and at an average speed of approximately 65 words/min. Several cases will be shown in a video presentation.
Conclusion: The SLO was found to be a most valuable tool in visual rehabilitation.
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