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P. Grant-Jordan, J. P. Szlyk, W. H. Seiple; The Impact of Depression on the Actual and Perceived Effects of Vision Rehabilitation. Invest. Ophthalmol. Vis. Sci. 2010;51(13):953.
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To investigate the relationship between the psychological status and the outcomes of vision rehabilitation in patients with low vision due to macular disease.
We recruited 18 patients (10 men, 8 women, age range 54 to 87 years) who were enrolled in a reading rehabilitation program focused on eye movement training. The patients’ visual acuities in their better eyes ranged from 0.12 to 1.4 logMAR. We administered the Center for Epidemiologic Studies Depression (CES-D) scale and the Adaptation to Vision Loss (AVL) scale. Reading assessments included the MNRead Acuity Charts (measures reading acuity, reading speed and critical print size). Psychological batteries and reading assessments were administered on the first day of rehabilitation. The AVL and reading assessments were also administered at the end of rehabilitation.
Patients were divided into groups based on their CES-D total scores: minimally, moderately, or severely depressed. Results from the reading and adaptation measures were compared across all three groups to evaluate the effect of depression on rehabilitation outcomes. An analysis of variance revealed the effect of depression was significant on MNRead Acuity (F(2,15)=5.36, p=.02); where those in the minimally depressed group showed significantly more improvement than both the moderately and severely depressed groups. Similar patterns were found for average reading speed (F(2,15)=2.78, p=.09) and critical print size (F(2,15) = 0.51, p=.61); however, these findings were not significant. Regarding adaptation, those in the severely depressed group perceived greater adaptation after rehabilitation than those in the minimally and moderately depressed groups (F(2,15) = 3.25, p=.06).
Depressed patients did not demonstrate an optimal response to reading rehabilitation. Future research should be focused on defining methods to assess and remediate depression as part of the rehabilitation process.
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