Innovative vision rehabilitation method for epiretinal membrane: Enhancing visual functions through Biofeedback Training

Purpose: To report a case with epiretinal membrane (ERM) treated with audio-luminous Biofeedback training (BT) which resulted in improvement of monocular and binocular visual functions. Observations: We report a case of ERM with distance Best Corrected Visual Acuity (BCVA) of 20/40 in the right dominant eye, and 20/20 in the left eye. The main symptom was binocular blurry vision, and the patient did not desire to pursue posterior vitrectomy due to its risks. Using a 10-2 microperimetry test with the MAIA Microperimeter, it was possible to identify an inferior paracentral relative scotoma in the right eye with splitting fixation. The right eye was trained with five 20-minute sessions with Biofeedback training towards a trained retinal locus (TRL) with better retinal sensitivity and 1.46° superior and temporal to the current preferred retinal locus (PRL). After training, the patient reported total improvement of symptoms, and BCVA was 20/25 in the right eye and 20/20 in the left eye. Conclusions and importance: Biofeedback training is a valuable treatment with no known adverse effects that can be performed as an alternative to patients with ERM with no surgical indication and debilitating symptoms, or as a post-surgery adjuvant treatment.