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Priya Mary Mathews, Michael McCloskey, Gary S Rubin, Pradeep Y Ramulu; Evaluating the Impact of Glaucoma and Word Features on Out-Loud Reading. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4574.
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To assess the impact of glaucoma on specific measures of out loud reading, including time to say individual words, interval time between consecutive words, lexical errors, skipped words, and repetitions.
Glaucoma subjects (n=64) with bilateral visual field loss and glaucoma suspect controls (n=57) were recorded while reading an International Reading Speed Text (IReST) passage out loud. Audio recordings were evaluated by a masked evaluator to determine the start and end of each recorded word and to identify reading errors.
Glaucoma subjects demonstrated a longer duration to recite individual words [265 vs. 243 milliseconds (ms), p<0.001], a longer interval time between words (154 vs. 124 ms, p<0.001), and a longer word/interval complex (defined as the time spanned by the word and the interval preceding the word) (417 vs. 365 ms, p<0.001) than controls, but did not differ in the number of repetitions, skipped words, or lexical errors (p>0.1 for all). In multivariable analyses adjusting for age, race, sex, education, cognition, word length, and word complexity, each 0.1 decrement in log contrast sensitivity was associated with a 6.3 ms longer word time (95% CI=3.8-8.9; p<0.001), an 8.7 ms longer interval time (95% CI=5.3-12.1; p<0.001), and a 15.0 ms longer word/interval complex (95% CI=9.7-20.3; p<0.001). Additionally, severity of glaucoma damage (as determined by contrast sensitivity) was found to significantly interact with word length, word complexity, and word location at the beginning of a new line with regards to word/interval complex duration (p<0.05 for all), suggesting that word length, word complexity, and word location at the beginning of a line all had a greater effect on word/interval duration in patients with lower CS. Glaucoma severity was also associated with increased odds of making a lexical error (OR=1.20 for every 0.1 decrement in log contrast sensitivity; 95% CI=1.02-1.39, p<0.05), but not with odds of skipping or repeating a word (p>0.05 for both).
Glaucoma patients have greater difficulty reciting longer and more complex words, as well as transitioning to new lines of text. Additionally, glaucoma severity is associated with a higher likelihood of making a lexical error. These problem areas may require special attention when designing methods to rehabilitate reading in patients with glaucoma.
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