R A Harper¹, W Russell², B Reeves3
¹Manchester Royal Eye Hospital, Academic Department of Ophthalmology, Manchester, United Kingdom; ²Keele University, Centre for Health Policy and Management, Keele, United Kingdom; 3London School of Hygiene & Tropical Medicine, Health Services Research Unit, London, United Kingdom
Purpose: To describe longitudinally visual functions and low vision device use in a population of people with age-related macular degeneration (AMD).
Methods: A cohort of 226 subjects with AMD who participated in a 3-arm randomized controlled trial of low vision services was assessed at baseline and at 12 months. Data collection included visual functions (distance logMAR acuity, MNRead acuity and Pelli-Robson contrast sensitivity), restriction in activities, and generic and vision-related quality of life. Patterns of low vision device use were assessed at both 4 and 12 months after initial attendance at the low vision clinic.
Results: The mean age was 81.6 years (SD=6.1, range 65-96 years), with 150 subjects (66%) being female. Mean visual acuity in the better eye was 0.79 logMAR at baseline, deteriorating by 0.20 logMAR at 12 months (t=9.01, p<0.0001). There was also a significant deterioration in both continuous text reading acuity and contrast sensitivity over time (p<0.001). Obtaining help with a range of reading related tasks and watching TV were the primary assessment goals identified. At 12 months 94% of subjects had at least 1 device (median=2, range 0-6 devices). At 4 months 86% of subjects used at least 1 device (72% on a daily basis), with this percentage increasing to 95% of subjects at 12 months (81% on a daily basis).
Conclusions: Socio-demographic characteristics in this population are in keeping with expected findings for age-related disease. Despite a statistically significant (and probably functionally important) deterioration in visual function, a high proportion of people with AMD make use of low vision devices 4 months after initial assessment, a proportion that increases after 12 months. Most devices are used on a daily basis for short-term spot reading tasks, with evidence for an associated decrease in restriction in activities.
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