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Joan Stelmack, X Charlene Tang, Yongliang Wei, Scott Sayers, Robert W Massof; Veterans Affairs Low Vision Intervention Trial II: 4-Month and One-Year Results. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5187.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To compare the effectiveness of low vision rehabilitation (LVR) and basic LV in a single masked RCT conducted at 9 VA clinical sites.
Methods: 323 subjects with macular diseases and best-corrected visual acuity of 20/50 to 20/200 were randomized to LVR treatment or a basic LV control group. All participants received a LV exam and were eligible for the same LV devices at no charge. In LVR, a therapist dispensed devices and provided mean 1.9 ± 0.3 therapy sessions (194.5 ± 114.0 minutes ) with assigned homework to teach use of remaining vision and prescribed devices. In basic LV, devices were dispensed by the optometrist without therapy (mean 44.9 ± 10.0 minutes). The primary outcome measure compared the changes in visual reading ability estimated from patients’ difficulty ratings of reading items on the VA LV VFQ-48 questionnaire between the treatment and control groups from pre-intervention baseline to 4-months later. Secondary outcomes are changes in visual ability, visual ability domain scores calculated from subsets of items (mobility, visual information processing, and visual motor skills) from pre-intervention baseline to 4 months later. Follow-up was conducted at one-year after the control group received usual VA low vision therapy.
Results: At 4-months, all subscales and overall scores in both groups improved after the intervention, p< .05. However, the treatment group had more significant improvement compared to the control group in all domains except for mobility: reading 1.3 vs. 0.9 logits, visual information processing 0.7 vs. 0.4 logits, visual motor 0.8 vs. 0.4 logits, overall visual ability 0.7 vs. 0.4 logits, all p<.05. At one-year, there were no statistically significant differences in improvement between the treatment and control groups except for visual information (p=0.03).
Conclusions: LVR and Basic LV are both effective; but LVR is more effective than basic LV in VA patients with macular diseases and visual acuity from 20/50 to 20/200. After additional treatment, the control group catches up to the treatment group at one-year follow-up.
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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