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The experience of a randomized clinical trial of closed-circuit television versus eccentric viewing training for people with age-related macular degeneration
- Source :
- Scopus-Elsevier
-
Abstract
- IntroductionIn addition to optical devices, closed-circuit televisions (CCTVs) and eccentric viewing training are both recognized interventions to improve reading performance in individuals with vision loss secondary to age-related macular degeneration. Both are relatively expensive, however, either in the cost of the device or in the amount of time personnel need to provide training. In this randomized trial, we compared the effectiveness of these two interventions.MethodsParticipants with age-related macular degeneration and visual acuity between 6/48 (20/160) and 6/120 (20/400) first received basic low vision care, including optical devices. At the subsequent baseline visit, they undertook a battery of measures including logMAR visual acuity; reading speed and accuracy for text in 1.3M and 1M fonts; reading information on medicine bottles, utility bills, and food packages; the NEI-VFQ; the Geriatric Depression Scale; and a reading inventory questionnaire. They were then randomized to either obtaining a CCTV for home use or eccentric viewing training over the following six weeks.ResultsRecruitment was more difficult than expected for this population. Of 145 patients referred, 29 met the inclusion-exclusion criteria, 14 were willing to enroll, and 10 completed the trial. For the primary outcome (reading speed for 1.3M print), there was a significant improvement between baseline and outcome for the CCTV group (p = 0.005), but not for the eccentric viewing training group (p = 0.28), and the CCTV group showed significantly greater change (p = 0.04). There was a nonsignificant improvement in reading speed for 1M text and a decrease in the amount of time taken to read utility bill information in the CCTV group. There was a significant improvement in near visual acuity with current glasses with eccentric viewing training. The other measures did not reach statistical significance.DiscussionRandomized clinical trials for low vision rehabilitation, particularly in the elderly population with vision loss, are challenging, but such trials are important for the allocation of resources. This trial showed early indications of more impact on reading performance from CCTV than eccentric viewing training.
- Subjects :
- medicine.medical_specialty
business.industry
media_common.quotation_subject
Rehabilitation
Psychological intervention
Macular degeneration
medicine.disease
law.invention
03 medical and health sciences
Ophthalmology
0302 clinical medicine
Physical medicine and rehabilitation
Randomized controlled trial
law
Eccentric viewing
Reading (process)
Age related
030221 ophthalmology & optometry
medicine
business
030217 neurology & neurosurgery
Closed circuit
media_common
Subjects
Details
- Database :
- OpenAIRE
- Journal :
- Scopus-Elsevier
- Accession number :
- edsair.doi.dedup.....8992659f8c5a3fee954dfb225f8958d8