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Katrin Kaltenegger, Elke Altpeter, Angelika Cordey, Claudia Gehrlich, Gerhard Eschweiler, Susanne Trauzettel-Klosinski; Reading training in dry AMD improves reading ability and prevents secondary depression. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5168.
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© ARVO (1962-2015); The Authors (2016-present)
Central vision loss due to age-related macular degeneration (AMD) often leads to reading problems, reduced quality of life (QoL) and secondary depression. In a previous study we showed that support with magnifying aids improved emotional and cognitive status and QoL. In this randomized, controlled study we investigate, whether additional reading training (after being adapted to appropriate visual aids) can further improve these parameters.
Standardized questionnaires were used to assess emotional status by Montgomery–Åsberg Depression Rating Scale (MADRS), cognitive status by Dementia Detection Test (DemTecT) and QoL by Impact of Vision Impairment Profile (IVI). Measurements were performed before training (t1), directly after (t2) and after six weeks without training (t3). Reading examination included assessment of reading speed by International Reading Speed Texts (IReST), fixation locus and fixation stability index (FSI) by scanning laser ophthalmoscope (SLO) at t1, t2, t3. Visual acuity and magnification need were assessed with standardized procedures (ETDRS, Zeiss charts). Out of 184 recruited patients, 54 fulfilled the inclusion criteria, 41 were finally included (mean age 72 years ± 8 SD). Inclusion criteria: AMD, absolute central scotoma, magnification need 1-10 times, visual acuity 0.2-1.0 LogMAR. Exclusion criteria: Simultaneous anti-VEGF-treatment, any other eye disease, markedly reduced emotional or cognitive status.Patients were randomly assigned to two training groups. 1. Intervention group (IG): Reading training with single word presentation (RSVP) (n=25, including 15 with crossover design); 2. Control-group (CG) crossword training (n=16); Both groups trained 15 minutes/day, 5 days/week for 6 weeks.
In IG, reading speed significantly increased at t2 (7 words/min; p = 0.004), at t3 (10 words/min; p = 0.0005) compared to t1. FSI did not change. Number of patients with mild depressive symptoms decreased (from 34% (t2) to 18% (t3)). There was no change in cognitive agility (DemTect). IVI showed improvement in reading-related tasks. CG did not show any changes.
The results indicate that patients with AMD, who have already been using magnifying visual aids, benefit from additional reading training. They are also able to use their acquired skills in daily life reading. Moreover, the results show that reading training can help to reduce depressive symptoms.
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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