Psychosocial Assessment of Potential Retinal Prosthesis Recipients

Abstract

Purpose : Retinal prostheses (or bionic eyes) are now commercially available for people with significant vision loss from outer retinal degeneration, and clinical trials for new devices are underway. As in all novel medical interventions, optimal subject recruitment is vital for patient outcomes and trial success. The aim of this study was to assess the psychosocial characteristics of persons who might be potential recipients of a retinal prosthesis, to identify characteristics that may correlate with their interest in trial participation.

Methods : We conducted a cross sectional study of 72 adults (40 males, age 56yo ± 15) with advanced retinal degeneration. All participants were legally blind by Australian standards (best corrected visual acuity worse than 20/200 and/or visual field constricted to 10 degrees of arc). Psychological assessments were part of a broad assessment process and included personality (NEO Five-Factor Inventory-3 [NEO-FFI-3]), cognitive ability (Wechsler Adult Intelligence Scale [WAIS]), social support (Medical Outcomes Study Social Support Survey [MOS-SSS]), self-efficacy (General Self-Efficacy Scale [GSE]), coping (Vision Specific Optimization in Primary and Secondary Control Scale [Vis-OPS]), optimism (Life Orientation Test – Revised [LOT-R]), depression (Patient Health Questionnaire [PHQ-9]), and quality of life (Impact of Vision Impairment Profile ([IVI] and the Vision and Quality of Life Index [VisQoL]). Level of interest in a retinal prosthesis was also evaluated.

Results : Depression correlated with quality of life (rho = -0.37 and 0.40, P < 0.001 for IVI and VisQoL, respectively). Together, depression, gender and vision specific coping explained 35.2% of variance in IVI quality of life (P < 0.001). 49% of participants were interested in a current-generation retinal prosthesis. Although the personality trait of openness was somewhat predictive of interest (OR 0.78, 95%CI 0.62 to 0.97), neither severity of vision impairment nor any of the psychosocial measures were strong predictors of interest in a retinal prosthesis in a multivariate logistic regression model.

Conclusions : Several existing questionnaires are useful in assessing the psychosocial characteristics of persons with advanced retinal degeneration and in exploring suitability for a retinal prosthesis. However, whether or not a person might be interested in a retinal prosthesis varies considerably and is not clearly predicted by such measures.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.