September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Effectiveness and cost-effectiveness of portable electronic vision enhancement systems (p-EVES) compared to optical magnifiers for near vision activities in visual impairment
Author Affiliations & Notes
  • Chris Dickinson
    Faculty of Life Sciences, University of Manchester, Manchester, United Kingdom
  • Rachel Bambrick
    Manchester Royal Eye Hospital, Manchester Academic Health Sciences Centre, Manchester, United Kingdom
  • Andrew Brand
    North Wales Organisation for Randomised Trials in Health, Bangor University, Bangor, United Kingdom
  • Nathan Bray
    Centre for Health Economics & Medicines Evaluation, Bangor University, Bangor , United Kingdom
  • Michelle Dutton
    Macular Society, Andover, United Kingdom
  • Robert Harper
    Manchester Royal Eye Hospital, Manchester Academic Health Sciences Centre, Manchester, United Kingdom
  • Barbara Ryan
    School of Optometry & Vision Sciences, Cardiff Univesity, Cardiff, United Kingdom
  • John J Taylor
    Faculty of Life Sciences, University of Manchester, Manchester, United Kingdom
  • Rhiannon Tudor Edwards
    Centre for Health Economics & Medicines Evaluation, Bangor University, Bangor , United Kingdom
  • Heather Waterman
    School of Healthcare Sciences, Cardiff Univesity, Cardiff, United Kingdom
  • Footnotes
    Commercial Relationships   Chris Dickinson, None; Rachel Bambrick, None; Andrew Brand, None; Nathan Bray, None; Michelle Dutton, None; Robert Harper, None; Barbara Ryan, None; John Taylor, None; Rhiannon Tudor Edwards, None; Heather Waterman, None
  • Footnotes
    Support  This publication presents independent research funded by the National Institute of Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number PB-PG-0211-24105). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.
Investigative Ophthalmology & Visual Science September 2016, Vol.57, No Pagination Specified. doi:
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      Chris Dickinson, Rachel Bambrick, Andrew Brand, Nathan Bray, Michelle Dutton, Robert Harper, Barbara Ryan, John J Taylor, Rhiannon Tudor Edwards, Heather Waterman; Effectiveness and cost-effectiveness of portable electronic vision enhancement systems (p-EVES) compared to optical magnifiers for near vision activities in visual impairment. Invest. Ophthalmol. Vis. Sci. 201657(12):.

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      © 2017 Association for Research in Vision and Ophthalmology.

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Abstract

Purpose : Low vision aids (LVAs), such as optical magnifiers, can improve performance of everyday tasks for individuals with visual impairment. With the introduction of p-EVES (portable handheld electronic LVAs), the question arises whether these offer real benefits to users, compared to simple LVAs. This prospective two-arm cross-over randomised controlled trial aimed to determine the clinical effectiveness, acceptability, and incremental cost-effectiveness of p-EVES compared to optical LVAs.

Methods : Experienced optical aid users (n=100) were recruited from Manchester Royal Eye Hospital, UK. Reading, performance of near vision activities, and device usage, were evaluated at baseline; and at 2 and 4 months, at the end of each study arm (A: existing optical aids plus p-EVES; B: optical aids only). Incremental cost-effectiveness ratios (ICERs) and cost-utility analyses were based on health- and vision-related QoL questionnaires using bootstrapping techniques. Economic evaluation was undertaken from a societal perspective, and included carer time costs.

Results : Overall, maximum reading speed for high contrast sentences was the same for optical aids and p-EVES, although the critical and threshold print sizes accessed with p-EVES were both significantly smaller (p<0.001). Optical aids were used for more tasks (p<0.001), and more frequently (p<0.001). However 70% preferred p-EVES for leisure reading, and p-EVES gave longer duration of reading (p<0.001). During the study arm with p-EVES, participants carried out more tasks independently (p<0.001), and reported less difficulty with near vision activities (p<0.001). An ICER of £735.77 (95% confidence interval = £481.03 - £1525.18) was found for a 6.73% improvement in ‘near vision’ visual function. Cost per QALY was estimated between £56,991.43 (lower 95% CI = £19,801.27) and £66,490.00 (lower 95% CI = £23,054.59). Sensitivity analysis reduced ICERs by up to 75%, with QALYs falling below £30,000.

Conclusions : The p-EVES tested did not replace optical aids, but were more effective for certain tasks. p-EVES are likely to be a cost-effective way to improve visual function at near, but this does not translate into improved quality of life, wellbeing and capability. However, sensitivity analysis indicated that cost-effectiveness may be achievable with a lower cost intervention.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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