The effect of visual perception rehabilitation on functional vision in cases with hereditary retinal dystrophy

Hereditary Retinal Dystrophies (HRDs) are genetic diseases that cause progressive vision loss. They occupy a significant place among the causes of visual impairment, especially in childhood. Vision loss that begins in childhood increases with age, and individuals with increasing visual impairments become dependent on others. In adulthood, it also leads to social and workforce losses for families, society, and most importantly, imposes a burden on the affected individuals themselves. In recent years, the development of the concept of neuroplasticity and learning through experience has shown that rehabilitation can increase functional vision in hereditary retinal diseases. Learning through experience means that the brain uses continuous stimuli from the environment received through vision, the cortex, and other senses to perceive, think, move, remember, and develop planning strategies. Experiences lead to the formation and structural and functional changes of synapses. The goal of rehabilitation is to ensure that adaptation efforts and sensorimotor compensation skills occur at the most suitable and highest level for the patient's needs. Our study aims to serve as a starting point for the development of visual rehabilitation approaches that increase visual skills and functional vision, reduce disability levels, and increase participation in social production for individuals with HRD/Con Dystrophy (KD) causing low vision. There is very little international research on the impact of functional vision and quality of life on HRD patients and disability rates, and there is no study on this subject in our country. Reviewing low vision rehabilitation practices from an ophthalmologist's perspective and evaluating their effectiveness will contribute significantly to the creation of personalized rehabilitation programs and the scientific evaluation of results. The study population consists of 180 patients registered in the low vision rehabilitation and vision research center of Ankara University Eye Diseases Clinic. With a 5% error margin and 80% power, the sample size was calculated as 16 patients, and since KD is in a rare disease group, the patients' pre-rehabilitation values were used as a control group. As part of the project, patients to undergo rehabilitation (16 patients) were randomly selected from those included in the population. Electroretinography (ERG) was used to confirm that the selected patient group had KD. In addition to visual acuity, refractive value measurement, anterior segment, fundus, and eye movement examinations, contrast sensitivity, Microperimetry, MVPT_4 test (Visual perception skills test), and NVFQ-25 low vision quality of life scale, MNRead reading test were applied. In rehabilitation applications, manual methods and the most widely used digital device, the Bernell Vision Trainer (OTSP1SO and OTSP1), were used. All patients underwent ICF coding. Result: Visual rehabilitation applications have been effective in improving functional vision levels and developing visual skills, leading to an increase in quality of life. KeyWords: HereditaryConeDystrophy, Neuroplasticity,Visual rehabilitation,Perceptional learning,, Quality of Life,ICF