Neurovisual rehabilitation of patients with geographic atrophy secondary to age-related macular degeneration with AvDesk system

Purpose The aim of this study is to evaluate the efficacy of neurovisual rehabilitation using the AvDesk training system (Linari Medical, Pisa, Italy) in patients with geographic atrophy (GA) due to age-related macular degeneration (AMD) in their eye with better visual acuity. Methods This study employed a prospective, observational, single-centre case series design. All patients underwent neurovisual rehabilitation using an AvDesk device. The protocol included sessions twice a week for a duration of 3 consecutive weeks. Before and at the end of the protocol, all patients underwent a standardized ophthalmic examination. MAIA microperimeter was used to assess fixation parameters, using bivariate contour ellipse area (BCEA) at both 63% and 95% confidence intervals, and macular sensitivity (MS). Additionally, the NEI-VFQ 25 questionnaire was administered to evaluate the clinical response. Results 17 eyes from 17 patients were included in the study. The mean (SD) best-corrected visual acuity (BCVA) at baseline was 0.55 (0.28), improving to 0.39 (0.26) LogMAR (p = 0.0002), after completing the training. The mean (SD) MS did not change, ranging from 8.81 (6.08) d ss to 8.60 (5.99) d ss (p = 0.30). Following training, both BCEA 63% and 95% values exhibited a modest reduction, although these changes did not reach statistical significance (p > 0.05). Absolute scotomas remained stable (24.41 before treatment vs. 24.65 after treatment; p = 0.83). The NEI-VFQ 25 overall score improved from 55.05 to 62.18 post-treatment (p < 0.01). Conclusions The AvDesk training system is an effective tool for neurovisual rehabilitation in AMD patients with GA, yielding improvements in BCVA, fixation stability and quality of life.