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D.C. Fletcher, U. Nair, R.A. Schuchard, M. MacKeben, A. Fu, G. Watson; Decreased Reading Performance Associated With Maculopathy Independent of Acuity and Demographic Variables . Invest. Ophthalmol. Vis. Sci. 2006;47(13):5201.
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© ARVO (1962-2015); The Authors (2016-present)
To determine if the effect of maculopathy on continuous text and random word reading performance is independent of visual acuity and demographic variables.
181 eyes of 96 consecutive patients in a retinal practice were tested for visual acuity (VA), continuous text reading (MNread) and a new random word reading test (SKread). The new test utilized the same 60 character per font size format as the MNread but instead of sentences, used random words designed to impede cognitive correction of errors as does the Pepper Visual Skills for Reading Test. Eyes not able to read the largest 8M text were excluded. Tested eyes were categorized as normal (NL) n=65, maculopathy (MP) n=50, or other eye disease (OTR) n=66. Age median/range was NL= 56/28–85, MP=74/31–96, and OTR=71/36–86 years. Median education was NL= 16, MP=16 and OTR=16 years. English was the first language of 79% of patients.
Median VA was NL 20/20, MP 20/63 and OTR 20/40. Maximum reading duration (sec/60 character block) for continuous text was NL 2.4, MP 5.6, OTR 3.9 and for random words was NL 7.0, MP 14.0, OTR 11.4. Mean error rate (errors/60 character block) for continuous text was NL 0.03, MP 0.23, OTR 0.11 and for random words was NL 0.43, MP 1.38, OTR 0.74. Maximum reading rates and mean error rates (both MNRead and SKRead) were not significantly associated with age or educational level and only weakly associated with visual acuity (r2 = 0.28 and 0.36 respectively). The correlation between MNRead values and SKRead values were mean error rate 0.40, maximum reading rate 0.75, print size for maximum reading rate 0.81, and errors for largest print size (8M) 0.18 showing that errors found by the two tests were not related as strongly as other reading performance values. MP mean error rate was significantly different (Tukey test) when compared with the other two groups (NL and OTR) while NL maximum reading rate was significantly different from MP and OTR for both reading tests.
Reading performance on these simple tests appeared to vary independent of education, age or first language. Visual acuity was only weakly associated with reading performance. Maculopathy was associated with slower reading and more frequent errors. The new random word reading test was more sensitive to errors but showed less specificity. Reading without the support of grammar and context is a visual function measure decreased in maculopathy that may be useful in addition to acuity for both research and clinical management of retinal diseases.
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