C Dauxerre¹, F Vital-Durand², C Corbé3, J Tesson3
¹EPHE, Neuropsychologie, Paris, France; ²Inserm/EPHE, Cerveau et Vision, Bron, France; 3HIA Percy, CPEMPN, Clamart, France
As most daily tasks, including reading, rely upon a dynamic strategy, we used kinetic campimetry to assess visually impaired people with macular disease. We investigated the contribution of the kinetic visual field data to the rehabilitation program in 54 adult subjects, (mean age 68), with stable macular disease. All of them asked for better reading efficiency.
In addition to visual acuity and contrast sensitivity tests we assessed functional visual abilities in order to determine the probable best localizations of eccentric fixation. We planned to study the data of monocular and binocular Goldmann campimetry before and after rehabilitation in terms of depth, localization and size of functional areas. The procedure respected subject's fatigue. During monocular exams, achromatic stimuli were presented with indices V4, III1, II1 and then any other index with which a threshold could be obtained. Binocular field was done with a III4 stimulus. Stimulus velocity was 2 to 3 degree/second from the periphery inward. The results were correlated with the PRLs determined by two experts using corneal reflex light.
Preliminary data analysis shows that the kinetic visual field permits the definition of optimal areas available at eccentric fixation in correlation with the task involved, and to choose the one permitting optimal visual function. These data are used to orient the rehabilitation program and guide the choices of oculomotor strategy, and monocular or binocular training. Finally, the study shows that, after rehabilitation, the PRLs become stable and unconscious, so that the patient no longer can fixate in the scotomatous region. As a consequence, the final test of the visual field could not be realized.
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