Reading rehabilitation of individuals with AMD: relative effectiveness of training approaches

Purpose To quantify the effects of three vision rehabilitation training approaches on improvements in reading performance. Methods Thirty subjects with AMD participated in the training portion of the study. The median age of the subjects was 79 years (range, 54-89 years). The three training modules were: Visual Awareness and Eccentric Viewing (module 1), Control of Reading Eye Movements (module 2), and Reading Practice with Sequential Presentation of Lexical Information (module 3). Subjects were trained for 6 weekly sessions on each module, and the order of training was counterbalanced. All subjects underwent four assessments: at baseline and at three 6-week intervals. Reading performance was measured before and after each training module. A separate group of 6 subjects was randomly assigned to a control condition in which there was no training. These subjects underwent repeated assessments separated by 6 weeks. Results Reading speeds decreased by an average of 8.4 words per minute (wpm) after training on module 1, increased by 27.3 wpm after module 2, and decreased by 9.8 wpm after module 3. Only the increase in reading speed after module 2 was significantly different from zero. Sentence reading speeds for the control group, who had no reading rehabilitation intervention, was essentially unchanged over the 18 weeks (0.96 ± 1.3 wpm). Conclusions A training curriculum that concentrates on eye movement control increased reading speed in subjects with AMD. This finding does not suggest that the other rehabilitation modules have no value; it suggests that they are simply not the most effective for reading rehabilitation.