Abstract
Purpose: :
A randomized controlled trial will evaluate the efficacy of an enhanced grid and interactive diary booklet developed to help patients with age-related macular degeneration (AMD) self-monitor their vision for changes.
Methods: :
70 subjects with AREDS grade 3 or 4, intermediate, non-neovascular AMD in at least one eye completed a 6 month follow-up questionnaire. 29 subjects were randomized at baseline to self-monitor their vision using the interactive diary booklet, and 41 were randomized to a standard of care control group and 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 monitoring their vision at least weekly: 83% of the subjects with the interactive diary booklet vs. 46% of the control group (p=0.002). Subjects with the interactive diary booklet were significantly more likely to check their vision at least weekly: odds ratio (OR)=5.6; 95% CI: 1.8-17.4; p=0.003. Approximately one third of the controls (n=14; 34%) indicated that they had not checked their vision in the past 6 months, while none of the subjects with the interactive diary booklet reported that they did not check their vision. There was a highly statistically significant difference in self-monitoring confidence between the groups: only 17% of the subjects with the interactive diary booklet vs. 56% of the controls reported that they did not feel confident that they were taking care of their sight by monitoring their vision (p=0.001). Patients with previous neovascular AMD in the fellow eye (23%; n=16) were significantly more likely to monitor their vision at least weekly, after adjusting for their group assignment (OR=9; 95% CI: 2.0-40.5; p=0.004). Gender (p=0.25) was not a significant predictor of weekly vision monitoring.
Conclusions: :
These findings support the preliminary efficacy of the interactive diary booklet for increasing vision self-monitoring behavior in AMD subjects. Continued research will help determine if the subjects can accurately detect true vision changes and self-refer for immediate evaluation by their eye care provider.
Clinical Trial: :
http://www.clinicaltrials.gov NCT01337414
Keywords: age-related macular degeneration • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • retina