Abstract
Purpose: :
To Evaluate Changes In Reading Ability In Patients Receiving Vision Rehabilitation Care At Outpatient Low Vision Practices.
Methods: :
The Activity Inventory (AI), an adaptive self-report visual functioning questionnaire, was administered by telephone to 455 low vision patients prior to their first office visit, across 26 collaborating outpatient low vision rehabilitation (LVR) clinical sites participating in the ongoing Low Vision Rehabilitation Outcomes Study (LVROS). In the ongoing study, the AI is administered to patients before and after usual LVR care. The only eligibility criteria are that the patient is new to the practice, over 18 years of age, and able to complete the telephone interview. Clinical data are submitted post-rehabilitation. Rasch analysis was performed on difficulty ratings of AI reading tasks at both baseline and 6-months post-rehabilitation. Clinical data were used to stratify participants by entering visual acuity.
Results: :
Based on data of both baseline and post- rehabilitation measures from 76 of the patients being followed across 20 sites, self-report reading ability improved an average of 0.32 logit with a standard deviation of 0.67 logit. Stratifying study patients by entering visual acuity reveals differences between groups in the amount of improvement in reading ability. A statistically significant improvement of 0.6 logit was observed in patients with mild impairment, ≥20/60 in the better eye. A smaller non-significant improvement of 0.3 logit was observed in patients with moderate impairment, <20/60 but >20/200 in the better eye. An insignificant 0.03 logit loss of reading ability was observed in patients with severe impairment, ≤ 20/200 in the better eye.
Conclusions: :
An observational study of usual outpatient LVR care, shows that self-report reading ability outcomes vary between visual acuity subgroups. Participants with better entering visual acuity exhibit greater improvement in reading ability after rehabilitation. Unexpectedly, study participants with moderate to severe impairment showed little to no improvement. This observation sharply contrasts with the results of the VA Low Vision Intervention Trial (LOVIT), which reported a 2.06 logit improvement in reading ability in severely visually impaired patients.
Keywords: clinical (human) or epidemiologic studies: outcomes/complications • quality of life • low vision