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G. Matthews, J. K. Schmier, Z. N. Zakov, D. W. Covert; Impact of Visual Impairment on Service and Support Use by Individuals With Diabetic Retinopathy. Invest. Ophthalmol. Vis. Sci. 2007;48(13):175.
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To assess the patient-reported use of caregiving, assistive devices and services among individuals with diabetic retinopathy and evaluate the impact of visual impairment level on this use.
Two ophthalmologists and their staff invited patients with diabetic retinopathy to complete a survey on their use of visual aids, devices and caregiving. The clinical staff provided data on best corrected visual acuity (BCVA). The study was approved by a central IRB and respondents provided consent before completing the survey. Responses were analyzed by BCVA categories based on the better eye: normal (20/15 to 20/20), near normal (20/25 to 20/30), moderate low vision (20/40 to 20/60), severe/profound low vision (20/70 or worse). De-identified data were analyzed in SAS.
Interim analysis was conducted with 491 patients. Mean age was 64 and 44% were male. Most respondents (72%) were diagnosed at least three years earlier. Respondents with normal vision comprised 17% of the population, and near normal, moderate low and severe/profound groups comprised 39%, 32%, and 11%, respectively. Few patients reported using services such as transportation or job training. In general, the use of devices such as magnifying glasses, computer software and large print materials, increased as BCVA decreased. Use of paid and unpaid help was significantly associated with BCVA; while only 8% of those with normal vision reported caregiving, 71% of those with severe/profound low vision reported caregiving (p<0.05). Using standard costs for devices and services and a national average for caregiver time, annual costs for increased from $444 for respondents with normal vision to $45,136 to those with profound/severe low vision.
There are substantial differences in service and device use with decreased BCVA in patients with diabetic retinopathy.
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