Purpose
To examine long-term vision self-monitoring behavior changes over a year in age-related macular degeneration (AMD) subjects randomized to use an enhanced Amsler grid with an educational, interactive diary [Vision and Memory Stimulating (VMS) booklet] or usual care.
Methods
At both 6 and 12 months post-enrollment, 102 subjects with AREDS grade 3 or 4, intermediate, non-neovascular AMD in at least one eye completed a questionnaire on vision self-monitoring and the 4 item perceived stress scale. 49 of these subjects were randomized at baseline to use the VMS diary booklet, and 53 were in the usual care control group that followed their doctor’s instructions for vision monitoring (e.g. Amsler grid).
Results
There was a statistically significant difference in the proportion of subjects in each group who reported vision monitoring at least weekly at 6 and 12 months, respectively: 88% and 84% of the subjects with the VMS booklet vs. 47% and 53% of the control group (p=0.001). Between 6 and 12 months, there was no statistically significant change in weekly vs. less frequent self-monitoring between the groups (p=0.63), with 82% reporting no change in their frequency. At 6 and 12 months, respectively, 32% and 25% of the control subjects (n=17 and 13) indicated that they had not checked their vision in the past 6 months, while 0% and 6% (n=3) of the subjects with the VMS booklet reported that they did not check their vision. There was a statistically significant difference in confidence between the groups at 6 and 12 months, respectively: only 16% and 16% of the subjects with the VMS booklet vs. 53% and 42% of the controls reported that they did not feel confident that they were taking care of their sight by monitoring their vision (p<0.01). 14% of subjects lost confidence from 6 and 12 months, which was not related to group assignment, but was significantly related to increased perceived stress scale scores from 6 to 12 months (p=0.04). There was no significant relationship between changes in weekly monitoring frequency and changes in confidence from 6 to 12 months (p=0.63).
Conclusions
The majority did not report a change in frequency of vision self-monitoring over the course of the year, supporting the preliminary efficacy of the VMS booklet for promoting persistence in weekly monitoring in AMD subjects.
Keywords: 412 age-related macular degeneration