# Biofeedback rehabilitation in patients with binocular inhibition due to macular disease

**Authors:** Valeria Silvestri, Paola Piscopo, Simona Turco, Filippo Amore, Stanislao Rizzo, Mark S. Mandelcorn, Luminita Tarita-Nistor

PMC · DOI: 10.1007/s00417-025-06749-1 · Graefe's Archive for Clinical and Experimental Ophthalmology · 2025-01-25

## TL;DR

A new biofeedback method helps patients with macular disease improve binocular reading by stabilizing eye fixation and aligning retinal loci.

## Contribution

A novel biofeedback rehabilitation method that improves fixation stability and relieves binocular inhibition in macular disease patients.

## Key findings

- Fixation stability improved significantly in both eyes after training.
- Binocular reading speed increased from 57 ± 24wpm pre-training to 67 ± 24wpm post-training.
- 30% of patients experienced complete reversal of binocular reading inhibition.

## Abstract

To investigate whether patients with binocular reading inhibition due to central vision loss benefit from a new biofeedback (BF) rehabilitation method that aimed at improving fixation stability and at establishing a correspondence between the monocular preferred retinal loci (PRLs) on functioning retina in both eyes.

Thirty-three patients with bilateral macular disease and with binocular reading inhibition participated in 10 training sessions consisting of 10-min visual stimulation for each eye to stabilize fixation and relocate the PRL (if needed) using the BF module of the MP-1 microperimeter (Nidek Technologies Srl., Vigonza, PD, Italy). Binocular and monocular reading performance, contrast sensitivity, and visual acuity were evaluated pre and post training. Binocular summation/inhibition was evaluated with binocular ratio (BR).

Fixation stability improved significantly post training in both eyes. Maximum reading speed during binocular viewing increased from 57 ± 24wpm pre training to 67 ± 24wpm post training. BR increased for all parameters of reading, visual acuity, and contrast sensitivity. Training resulted in a complete reversal of binocular reading inhibition in 30% of patients.

For patients with binocular inhibition due to central vision loss, BF training to stabilize fixation and to bring the monocular PRLs into correspondence on functioning retina in both eyes is an efficient rehabilitation method to improve binocular performance.

Some patients with macular disease may suffer from binocular inhibition, when binocular performances are worse than the monocular performances with the better eye.Binocular inhibition represents an additional impairment to the already reduced visual acuity, contrast sensitivity, fixation stability and reading performance.

Some patients with macular disease may suffer from binocular inhibition, when binocular performances are worse than the monocular performances with the better eye.

Binocular inhibition represents an additional impairment to the already reduced visual acuity, contrast sensitivity, fixation stability and reading performance.

A new biofeedback training method was used to improve fixation stability in both eyes and to bring the monocular preferred retinal loci into retinal correspondence.This biofeedback rehabilitation procedure resulted in an increase in binocular reading speed and in a relief of binocular reading inhibition.

A new biofeedback training method was used to improve fixation stability in both eyes and to bring the monocular preferred retinal loci into retinal correspondence.

This biofeedback rehabilitation procedure resulted in an increase in binocular reading speed and in a relief of binocular reading inhibition.

## Full-text entities

- **Genes:** PRL (prolactin) [NCBI Gene 5617] {aka GHA1, pPRL}
- **Diseases:** macular disease (MESH:D008268), vision loss (MESH:D014786), inhibition (MESH:C565433)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

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## References

1 references — full list in the complete paper: https://tomesphere.com/paper/PMC12238173/full.md

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Source: https://tomesphere.com/paper/PMC12238173