[关键词]
[摘要]
临床工作中，很多黄斑疾病如年龄相关性黄斑变性(ARMD)、Stargardt病在晚期因新生血管纤维瘢痕化或光感受器、视网膜色素上皮细胞受损形成中心暗点，从而出现视力下降、固视不稳定甚至旁中心注视，给患者的生活工作及心理带来很大困扰。长期以来，我们对该类患者的康复治疗手段有限，但近年来有不少文献指出，基于微视野计的生物反馈训练有望通过实现大脑皮层可塑性增强神经感觉适应能力，较大程度的利用残余视网膜功能来帮助那些伴中心暗点的低视力人群巩固或建立稳定的中心或旁中心注视，进而提高视力、阅读速度等视功能。为增进对该康复治疗手段的认识，本文将主要从微视野生物反馈训练(microperimetric biofeedback training，MBFT)机制及方案、优选视网膜位点的选择、在黄斑疾病中的临床应用及前景展开概述。
[Key word]
[Abstract]
In clinical practice, many macular diseases in advanced stages such as age-related macular degeneration(ARMD)and Stargardt disease are manifested reduced visual acuity, unstable and even paracentral fixation resulting from the central scotoma followed by the scarring of neovascular fibres or the impairment of photoreceptors and retinal pigment epithelium, which cause great distress to patients' life, work and psychology. For a long time, there have been limited rehabilitation treatments for such patients. However, recent articles have indicated that biofeedback training by using microperimetry is expected to enhance neurosensory adaptation by achieving cortical plasticity, and makes better use of residual retinal function to help those with low vision associated with central scotoma consolidate or establish stable central or paracentral fixation, thereby improving visual function including visual acuity and reading speed. In order to improve the understanding of this rehabilitation therapy, this article will overview the mechanism and protocol of microperimetric biofeedback training(MBFT), the selection of the preferred retinal locus, the clinical application in macular diseases and its prospects.
[中图分类号]
[基金项目]
白求恩朗沐中青年眼科科研基金(No.BJ-LM2018005J); 天津市教委科研计划项目(No.2017KJ216)
