Assessing the 'MD_evReader' iPad app as a technological aid to enhance reading in macular disease.

背景年龄相关性黄斑变性(AMD)是英国登记失明的主要原因，也是导致50岁以上人群失明的最常见原因。AMD患者使用的一种适应性策略是利用AMD患者视网膜的外围区域偏心地观察刺激，这些区域可能在AMD中受损较少。这种所谓的“偏心观看”(EV)技术是黄斑学会正在实施的一项训练计划的一部分，并提供了一种适应MD后果的方法。电动汽车的一个局限性是，很难克服这种自然的、强烈的、倾向于进行眼动(称为扫视)的倾向，这种倾向通常是为了将目光和注意力转移到物体和文字上进行详细处理。眼球运动系统已经进化成专门将目光转移到物体上，试图保持一个古怪的凝视位置是费力的，也是不自然的。然而，稳定的偏心注视是EV技术的基本要求，需要一定程度的练习才能在阅读时保持注视。阅读动态(水平滚动)文本不需要眼球移动，并有望在使用EV技术时改善阅读性能和用户阅读体验。该项目有两个主要目标：第一个是评估阅读动态(滚动)文本的阅读性能和用户体验；第二个是将该应用程序纳入黄斑学会的“偏心观看”培训计划和“日常生活冠军”计划。该项目的第一部分将正式调查黄斑疾病志愿者在阅读MD_evReader提供的动态(滚动)文本时的阅读情况。兴趣的主要衡量标准是：阅读率(每分钟的字数)和理解力(文本被理解的程度)，并将这些与阅读正常的静态文本行进行比较。我们还将使用现代基于视频的眼球跟踪器来获得偏心观看性能的详细测量(成功保持偏心观看位置的时间百分比)。此外，还将通过问卷调查评估用户在使用和不使用该应用程序时的阅读体验。第二个目标是将该应用程序作为训练工具纳入黄斑学会的偏心观看(EV)培训计划。这款应用程序将被用来演示偏心观看技术，并允许人们练习这项技术。将在初步培训6个月后，使用用户体验的问卷测量和电动汽车技术维护情况的自我报告来评估APP作为培训辅助工具的有效性。这些措施也将从参加电动汽车培训课程而没有使用APP作为培训辅助工具的个人(对照)那里获得。控制组将包括在本项目开始日期之前接受过电动汽车培训的个人。这款应用程序还将作为日常生活冠军(DLC)计划的一部分进行演示，作为可用于提高阅读能力的技术辅助的一个例子。

ContextAge-related macular degeneration (AMD) is the leading cause of registered blindness in the UK and is the single most common cause of vision loss in people over the age of 50. One adaptive strategy, used by individuals with AMD, is to view stimuli eccentrically using the peripheral regions of their retina that may be less impaired in AMD. This so-called 'eccentric viewing' (EV) technique forms part of a training program being implemented by the Macular Society and offers one way of adapting to the consequences of MD. One limitation of EV is that it is difficult to overcome the natural, strong, tendency to make eye-movements (called saccades) that are normally made to shift gaze and attention onto objects and words for detailed processing. The eye movement system has evolved specifically to shift gaze onto objects and trying to hold an eccentric gaze location is effortful and unnatural. Stable eccentric fixation is, however, an essential requirement of the EV technique and requires some degree of practice in order to maintain fixation whilst reading. Reading dynamic (horizontally scrolling) text does not require eye movements and is expected to improve reading performance and user experience of reading when using the EV technique. The project has two main objectives: the first is to evaluate reading performance and user experience of reading dynamic (scrolling) text; the second is to incorporate the app into the Macular Society's 'Eccentric viewing' training programme and in the 'Daily Living Champions' scheme.The first part of the project will be a formal investigation of reading in volunteers with macular disease when reading dynamic (scrolling) text presented with the MD_evReader. The main measures of interest are: reading rate (words per minute) and comprehension (how well the text was understood) and these will be compared with reading normal static lines of text. We will also use a modern video-based eye tracker to obtain detailed measures of eccentric viewing performance (percentage of time spent successfully holding an eccentric viewing position). In addition the user experience of reading with and without the app will also be evaluated using a questionnaire.The second objective is to incorporate the app as a training aid in the Macular Society's eccentric viewing (EV) training programme. The app will be used a method for demonstrating the eccentric viewing technique and will also allow people to practice the technique. The effectiveness of the app as a training aid will be evaluated using questionnaire measures of user experience and self-reports of the maintenance of the EV technique 6 months after initial training. These measures will also be obtained from individuals (controls) who have taken part in EV training sessions without having used the app as a training aid. The control group will include individuals who have had EV training before the start date of this project. The app will also be demonstrated as part of the Daily Living Champion (DLC) scheme as an example of a technological aid that can be used to improve reading.