Abstract

Background: There are limited treatment options to improve vision in patients with infantile nystagmus. We aimed to examine the use of repeated visual stimulation with Gabor patches to improve vision.

Methods: A prospective randomised (3:1) controlled single-blind study. Included were patients aged 9-55 years with infantile nystagmus, treated in one tertiary referral centre in central Israel. The treatment group underwent visual stimulation for 4 months, which consisted of treatment sessions of approximately 30 min, 3-4 times a week, using web-based dedicated software. Controls were followed without treatment.

Results: 26 patients were treated, and 10 served as controls. Mean age was 22.47±12 years. 12/26 (46%) of treated subjects achieved driving licence best corrected visual acuity (BCVA) (20/40) versus 1/10 (10%) of controls. Distance BCVA improved by 0.11±0.07 logMAR (one line) in treated patients compared with 0.013±0.06 logMAR in controls (p<0.001). Near BCVA improved by 0.20±0.18 logMAR (2 lines) in treated patients compared with 0.06±0.06 logMAR in controls (p=0.040). 88% (8/9) of study patients who had no stereopsis prior to treatment achieved stereopsis (mean 630') as opposed to 25% (1/4) of controls (p=0.10). Mean stereoacuity and contrast sensitivity improved by 802±730' and 292±391% in the study group as opposed to 246±376' and 152±67% in controls, respectively (p=0.031; p=0.157).

Conclusions: Visual perceptual learning using Gabor patches resulted in a significant improvement in near and distance visual acuity, as well as stereopsis. This modality may represent a promising non-invasive treatment option for improving visual function in patients with infantile nystagmus.