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Gianfrancesco M Villani, Silvia Pellegrini, Fabio Di Cerbo, Yuri Nalini; Partnership Between Private And Public Institutions To Deliver Comprehensive Low Vision Care: First-Year Experience In Verona, Italy. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4158.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the efficacy of the rehabilitative intervention at the Low Vision Center of Verona (CRIM) from Dec 2012 to Nov 2013
Efficacy of treatment was evaluated in terms of achievement of independent performance for the desired (visual) task (e.g., main outcome measure for reading was independent reading of IReST text). Cost-effectiveness of the intervention was measured by the number of low vision rehabilitation sessions (LVR-S) per patient. Patients's satisfaction was investigated by a structured phone survey
59 patients were referred. Age median (range) was 76 (12-97) years. ETDRS BCVA median (range) was 20/200 (32-NLP). 44 patients (74.6%) had “low vision” according to the VA ranges in ICD-9-CM. Among patients's goals, reading was stated by all but two patients (96.6%), followed by glare control (40.7%), and face recognition (20%). LVR-S were 155 overall, with a median (range) of 2 (1-8) per patient. 29 patients (49.2%) successfully completed a LVR pathway, consisting of evaluation, training, and prescription of a device (group “y”). 11 patients (18.6%) were not prescribed any device, and were not expected to benefit from further intervention in a reasonable period of time (group “n”). 19 patients (32.2%) were considered to be still in the process (group “ny”). LVR-S total, median (range), and average for each group are as follows: 93, 2 (1-8), 3.2 [group y]; 20, 2 (1-4), 1.8 [group n]; 42, 2 (1-8), 2.21 [group ny]. In terms of LVR-S, a significant difference was found between group y and n (p<0.01), and a weaker difference between group y and ny (p=0.08). The phone survey was answered by 34 patients, as the others were out of reach. Among them, 30 (88%) patients declared to be satisfied with the intervention received
Applied low vision care struggles between the ambition to meet patients's needs thoroughly and the shortage of resources. The median of two LVR-S per patient advocates the elaboration of an algorithm that allows a comprehensive, effective, and standardized intervention to be carried out in this limited number of sessions. A more extensive workup will be provided to selected patients (as testified by LVR-S ranging up to 8 in groups y and ny) according to their assessed areas of likely improvement and overall potential.
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