Vision Rehabilitation in Patients with Age-related Macular Degeneration

IF 2.3 Q1 REHABILITATION Rehabilitation Process and Outcome Pub Date : 2014-03-01 DOI:10.4137/RPO.S12364
F. Amore, S. Fortini, V. Silvestri, M. Sulfaro, A. Pacifici, Simona Turco
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引用次数: 4

Abstract

Background The aim of this study was to investigate the rehabilitative process and visual rehabilitation outcomes in patients with central vision loss due to age-related macular degeneration (AMD). Methods Ninety-five subjects with AMD selected from the attendees of the National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of Low Vision Patients—International Agency for Prevention of Blindness—IAPB Italia Onlus, were evaluated for this retrospective study. Low vision examination included psychological counseling, best corrected visual acuity (BCVA), near visual acuity, Pelli-Robson contrast sensitivity, and fixation stability analysis. Once the clinical assessment was completed, patients attended a low-vision rehabilitative pathway based on visual stimulation, devices training and, if needed, psychological support. Required magnification and reading speed were also evaluated. Results For the whole sample, the mean BCVA of the better eye was 0.7 (±0.2) LogMAR and of the worse eye was 1 (±0.2) LogMAR. Restoring reading ability was the most important focus for the patients examined as it was requested by 85% of the whole sample. Mean power of optical magnifying aids for near activities was 10.6 (±9.1) positive spherical diopters. Mean reading speed for the whole sample was 33.1 (±18.2) words per minute (wpm) before visual rehabilitation sessions and increased to 55.2 (±33.1) wpm after visual rehabilitation path. To cope with distance difficulties, 78 distance refractive correction, 10 Galilean telescopes, and 7 Keplerian telescopes were prescribed. For intermediate distance activities, 22 compensation lenses and 10 Galilean telescopes were suggested. Moreover, PC magnifier softwares were prescribed to nine patients. Sixty-five polarized medical filters were prescribed to reduce glare of sunlight. Because of unstable fixation in their better eye (32.3% (±19.7) within 2° circle and 54.8% (±22.9) within 4° circle) and visual acuity < 1.2 LogMAR in the fellow eye, 38 subjects, before starting the devices training sessions, attended a bio-feedback rehabilitation session with flickering pattern stimulus. In these subjects, fixation stability increased significantly to 75.6 (±14.9) within 2° and 89.4 (±19.5) within 4° (P < 0.05), respectively. Conclusions Attending a customized low-vision intervention based on a multidisciplinary approach seems to be effective for improving visual functions in AMD. Both optical/electronic magnifiers and specific visual stimulation program can enhance visual performances.
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老年性黄斑变性患者的视力康复
本研究的目的是探讨老年性黄斑变性(AMD)导致的中央视力丧失患者的康复过程和视力康复结果。方法从国家低视力患者预防失明和康复服务与研究中心-国际防盲机构-意大利Onlus的参与者中选择95名AMD患者进行回顾性研究。低视力检查包括心理咨询、最佳矫正视力(BCVA)、近视力、Pelli-Robson对比敏感度和注视稳定性分析。一旦临床评估完成,患者参加了基于视觉刺激、设备训练和必要时心理支持的低视力康复途径。还评估了所需的放大倍率和阅读速度。结果全样本中,较好眼的平均BCVA为0.7(±0.2)LogMAR,较差眼的平均BCVA为1(±0.2)LogMAR。对于接受检查的患者来说,恢复阅读能力是最重要的焦点,因为整个样本中有85%的人要求恢复阅读能力。近距离活动的平均光学放大倍数为10.6(±9.1)正球面屈光度。整个样本在视力康复前的平均阅读速度为33.1(±18.2)个单词/分钟(wpm),在视力康复路径后增加到55.2(±33.1)个单词/分钟(wpm)。为了解决距离上的困难,规定了78个距离折射校正,10个伽利略望远镜和7个开普勒望远镜。对于中距离活动,建议使用22个补偿透镜和10个伽利略望远镜。此外,还对9例患者开了PC放大镜软件。65种偏振光医用滤光片被用来减少阳光的眩光。由于好眼固定不稳定(2°圆内32.3%(±19.7),4°圆内54.8%(±22.9)),伴眼视力< 1.2 LogMAR, 38名受试者在设备训练开始前参加了闪烁模式刺激的生物反馈康复训练。这些受试者的固定稳定性在2°和4°范围内分别显著提高至75.6(±14.9)和89.4(±19.5)(P < 0.05)。结论:参加基于多学科方法的定制低视力干预似乎可以有效改善AMD患者的视力功能。光学/电子放大镜和特定的视觉刺激程序都可以提高视觉性能。
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来源期刊
自引率
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发文量
4
审稿时长
8 weeks
期刊最新文献
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