Effectiveness of anti-VEGF treatment in wet Age-related Macular Degeneration; an evaluation of silent reading performance with eye movement analysis

Purpose: To evaluate silent reading performance by means of eye fixation analysis before and after anti-VEGF treatment in wet AMD (wAMD) patients. Methods: : Twenty wAMD patients who underwent anti-VEGF treatment, in one eye, served as the AMD group. Twenty adults without ocular pathology, served as the control group. Central Retinal Thickness (CRT) and near visual acuity (VA) were assessed at baseline and after 3-4 months following their first visit. Reading performance was evaluated using short passages of 0.4 logMAR print size at 40 cm distance. Eye movements were recorded using a video eyetracker. Data analysis included computation of reading speed, fixation duration, number of fixations, and percentage of regressions. Results: : In the AMD group, silent reading speed in the treated eye correlated well with CRT reduction and improved significantly by an average of 15.9±28.5 wpm (p=0.041). This improvement was accompanied by an average reduction of 0.24±0.38 in fixations per word (p=0.023). The corresponding improvement in monocular VA was not statistically significant, as was the case with other eye fixation parameters. Conclusion: VA tests may underestimate the potential therapeutic effects following anti-VEGF treatment. Evaluating silent reading performance and eye fixation parameters may better characterize the effectiveness of therapeutic approaches in wAMD patients.