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Bittner AK, Yoshinaga PD, Kaminski JE. Transitioning vision rehabilitation patients from over-the-counter magnifiers to prescribed aids. Disabil Rehabil Assist Technol 2024:1-6. [PMID: 39083649 DOI: 10.1080/17483107.2024.2384512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 06/12/2024] [Accepted: 07/20/2024] [Indexed: 08/02/2024]
Abstract
PURPOSE We determined over-the-counter magnifier usage rates by patients who newly presented for vision rehabilitation services, and sought to elucidate whether patients' ratings of over-the-counter magnifiers were associated with vision rehabilitation management strategies. METHODS Retrospective records reviews of 274 new vision rehabilitation patients seen between 2021-2023 were completed by three optometric providers at an ophthalmic academic center, college of optometry, and private practice. RESULTS Over half (58%) of patients tried an over-the-counter magnifier. Older age was significantly associated with trying over-the-counter magnifiers (OR:1.04; p < 0.001). Patients who tried an over-the-counter magnifier had significantly greater odds of the provider recommending and/or dispensing a prescribed hand-held optical illuminated magnifier (P< =0.04) or recommending a CCTV electronic magnifier (p = 0.049). The majority indicated over-the-counter magnifiers were somewhat (46%) or not helpful (38%). There was a significantly greater odds of rating the over-the-counter magnifier as not helpful when the provider subsequently recommended a CCTV (OR:4.8; p = 0.01) or higher spectacle-based near add power (OR: 2.0; p = 0.02). CONCLUSIONS Since most new patients were unsatisfied with over-the-counter magnifiers, it is encouraging that previous over-the-counter magnifier use often led to upgrades with hand-held optical illuminated magnifiers prescribed by vision rehabilitation providers, or patients were transitioned to CCTV electronic magnifiers or spectacle-based high add powers for near reading. These findings support that older adults who have previously experienced that over-the-counter magnifiers were either helpful or unhelpful are ideal candidates to receive vision rehabilitation by optometric providers who can transition them to a prescribed magnification device to better support their visual functioning needs for near reading.
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Affiliation(s)
- Ava K Bittner
- Department of Ophthalmology, University of California Los Angeles, Stein Eye Institute, Los Angeles, CA, USA
| | - Patrick D Yoshinaga
- Southern California College of Optometry, Marshall B. Ketchum University, Fullerton, CA, USA
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Alam K, Bentley SA, Connor H, Gentle A. Access to low vision rehabilitation services in Australia: practitioner perspective. Clin Exp Optom 2024:1-7. [PMID: 38880508 DOI: 10.1080/08164622.2024.2360544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 04/11/2024] [Indexed: 06/18/2024] Open
Abstract
CLINICAL RELEVANCE The burden of vision loss is both personal and economic. Having reduced vision can restrict access to education, job opportunities, and other activities, and patients can require substantial government funds for treatment and rehabilitation. An in-depth investigation of barriers and enablers is required to improve access to low vision rehabilitation services. BACKGROUND Several clinical trials have demonstrated the effectiveness of low vision rehabilitation services, leading to improved clinical and functional abilities. However not all patients make use of these resources. METHODS A purposive sample of primary eyecare practitioners (optometrists and orthoptists who held a variety of roles in clinical practice, academia and low vision specific organisations) were invited to participate in focus groups that were audio-recorded and transcribed verbatim. The resulting data were de-identified, cleaned, independently coded by two researchers and compared. Data were analysed using an interpretative phenomenological approach that included inductive thematic analysis. RESULTS Of the 21 practitioners attending the five focus groups, 67% were female and 33% were male. The participants were optometrists and orthoptists with a wide range (4 to 20+ years) of clinical experience in eyecare service delivery. Four major themes emerged from the analysis: three themes focus on identifying barriers, while one theme highlighted potential enablers. These themes encompassed barriers impacting referral frequency, practitioner knowledge, patient experience, and enablers that suggest improvement options for enhancing low vision services. CONCLUSION Miscommunication between service providers, miscommunication between patients and clinicians, late referral, cost of services and social stigma were major barriers preventing patients from receiving low vision services. Most practitioners admitted limited knowledge of the scope of services provided by low vision organisations, suggesting there is a need for enablers such as professional development, improved communication between service providers, enhanced referral guidelines and increased public awareness.
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Affiliation(s)
- Khyber Alam
- School of Medicine, Deakin University, Geelong, Australia
- Department of Optometry, Health and Medical Sciences, The University of Western Australia, Perth, Australia
| | - Sharon A Bentley
- Centre of Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
| | - Heather Connor
- School of Medicine, Deakin University, Geelong, Australia
| | - Alex Gentle
- School of Medicine, Deakin University, Geelong, Australia
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Dong Y, Wang A. Health Management Service Models for the Elderly with Visual Impairment: A Scoping Review. J Multidiscip Healthc 2024; 17:2239-2250. [PMID: 38751666 PMCID: PMC11095522 DOI: 10.2147/jmdh.s463894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 05/04/2024] [Indexed: 05/18/2024] Open
Abstract
Background The incidence of visual impairment(VI) in older people is gradually increasing. This review aimed to summarise the evidence on existing health management models and strategies for older adults with VI to improve health-related and vision-related quality of life (QoL) in older people. Methods Based on the framework of the scoping review methodology of Arksey and O'Malley (2005), a comprehensive literature search of relevant literature published between January 2010 and June 2022 in PubMed, CINAHL, EMBASE, Web of Science, Cochrane Library, CNKI, VIP, Wanfang database, Sinomed and the grey literature. Results Finally, 31 articles were included. The health management model had a multidisciplinary team low vision rehabilitation model, medical consortium two-way management model, low vision community comprehensive rehabilitation model, medical consortium-family contract service model, screening-referral-follow-up model, and three-level low vision care model. The health management strategy covers nine aspects, the combination of multi-element strategies is feasible, and network information technology has also shown positive results. Conclusion In the future, under the Internet and hierarchical management model, we should provide demand-based personalized support to rationalize and scientifically achieve hierarchical management and improve resource utilization efficiency and eye health outcomes.
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Affiliation(s)
- Yu Dong
- The First Hospital of China Medical University, Shenyang, People’s Republic of China
| | - Aiping Wang
- The First Hospital of China Medical University, Shenyang, People’s Republic of China
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Nisanova A, Barrios L, Chokshi T, Mannis M, Bloch O, Liu YA. A Feasibility Study on a Portable Vision Device for Patients with Stroke and Brain Tumours. Neuroophthalmology 2024; 48:3-12. [PMID: 38357627 PMCID: PMC10863346 DOI: 10.1080/01658107.2023.2273471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 10/09/2023] [Indexed: 02/16/2024] Open
Abstract
This prospective, single-centre cohort study aimed to evaluate the impact of a portable vision reading device, OrCam Read, on vision-related quality-of-life and independent functional status in patients with low vision due to stroke or brain tumours. Six patients with poor visual acuity or visual field defects due to a stroke or a brain tumour were enrolled at a U.S. Ophthalmology Department. Participants were trained to use OrCam Read and given a loaner device for the 1 month duration of the study. Various assessments, including daily function tests, the National Eye Institute Visual Function Questionnaire-25, and the 10-item neuro-ophthalmic supplement, were administered at the first and last visits. Patients' experience with the device was evaluated with weekly telephone and end-of-study satisfaction surveys. The main outcome measures were the patient satisfaction with OrCam and the mean assessment scores between enrolment and final visits. The intervention with OrCam significantly improved patients' ability to complete daily tasks and participants reported good satisfaction with the device. The results also show non-significant improvement with distant activities, dependency, and role difficulties. Our findings demonstrate the feasibility of studying vision-related quality-of-life using a portable vision device in this patient population and pave the way for a larger study to validate the results of this study.
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Affiliation(s)
- Arina Nisanova
- School of Medicine, University of California, Davis, California, USA
| | - Laurel Barrios
- School of Medicine, University of California, Davis, California, USA
| | - Tanvi Chokshi
- College of Medicine, California Northstate University, Elk Grove, California, USA
| | - Mark Mannis
- Department of Ophthalmology & Vision Science, University of California, Davis, California, USA
| | - Orin Bloch
- Department of Neurological Surgery, University of California, Davis, California, USA
| | - Yin Allison Liu
- Department of Ophthalmology & Vision Science, University of California, Davis, California, USA
- Department of Neurological Surgery, University of California, Davis, California, USA
- Department of Neurology, University of California, Davis, California, USA
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Cheng CY, Sheu MM, Chen PS, Chuang YT, Cheng HM, Hsieh HP. Assessing low vision care and the utilisation of optical low vision aids among patients with visual impairment in Taiwan. Ophthalmic Physiol Opt 2023; 43:1356-1363. [PMID: 37476932 DOI: 10.1111/opo.13205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 07/22/2023]
Abstract
PURPOSE The aim of this study was to examine the quality of assessment and the utilisation of optical low vision aids (OLVAs) among people with visual impairment (VI) in Taiwan. METHODS The study included 577 participants between 4 and 100 years of age (314 males and 263 females). All participants had been certified by the Ministry of the Interior of Taiwan, indicating that they had undergone a thorough and comprehensive low vision assessment, including evaluation of visual acuity (VA), contrast sensitivity, colour vision, visual fields and glare disability. Furthermore, all participants who consented to refraction had received prescriptions for OLVAs. RESULT All participants were prescribed one or more OLVAs such as eyeglasses, tinted lenses, magnifiers, closed-circuit television magnifiers, telescopes, or screen magnifiers. Among the 577 individuals, 515 received correction for refractive errors, providing the best-corrected VA (BCVA). The improvement in VA was significant at both distance and near, improving from 1.29 ± 0.55 to 1.01 ± 0.52 logMAR (p < 0.001) and from 1.29 ± 0.56 to 1.01 ± 0.52 logMAR (p < 0.001), respectively. Eyeglasses were the primary OLVAs chosen by 333 participants (64.7%), while 53.3%-80.3% of participants combined eyeglasses with other OLVAs to enhance their visual performance. CONCLUSIONS The most commonly used and effective OLVA was eyeglasses. Skilfully utilising appropriate refractive and VA measurements is crucial for determining the most suitable and beneficial OLVA for individuals with VI.
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Affiliation(s)
- Ching-Ying Cheng
- Department of Optometry, Chung Shan Medical University, Taichung, Taiwan
- Department of Ophthalmology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Min-Muh Sheu
- Department of Ophthalmology, Mennonite Christian Hospital, Hualien, Taiwan
- Eye Health Promotion Centre of Eastern Taiwan, Hualien, Taiwan
| | - Po-Sen Chen
- Department of Ophthalmology, Mennonite Christian Hospital, Hualien, Taiwan
- Eye Health Promotion Centre of Eastern Taiwan, Hualien, Taiwan
| | - Yi-Ting Chuang
- Department of Ophthalmology, Mennonite Christian Hospital, Hualien, Taiwan
- Eye Health Promotion Centre of Eastern Taiwan, Hualien, Taiwan
| | | | - Hsi-Pao Hsieh
- Department of Ophthalmology, Mennonite Christian Hospital, Hualien, Taiwan
- Eye Health Promotion Centre of Eastern Taiwan, Hualien, Taiwan
- Department of Special Education, National Taiwan Normal University, Taipei, Taiwan
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Singh RP, Amoaku W, Bandello F, Chen FK, Holz FG, Kodjikian L, Ruiz-Moreno JM, Joshi P, Wykoff CC. Diagnosis and Management of Patients With Geographic Atrophy Secondary to Age-Related Macular Degeneration: A Delphi Consensus Exercise. Ophthalmic Surg Lasers Imaging Retina 2023; 54:589-598. [PMID: 37847167 DOI: 10.3928/23258160-20230824-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
Geographic atrophy (GA) is a progressive and irreversible retinal disease with no comprehensive recommendations for diagnosis or monitoring. We used a Delphi approach to determine consensus in key areas around diagnosis and management of GA. A steering committee of eight retina specialists developed two sequential online surveys administered to eye care professionals (ECPs). Consensus was defined as agreement by ≥ 75% of respondents. Up to 177 ECPs from eight countries completed one or both surveys. Consensus was achieved in several topics related to diagnostic imaging, including the use of optical coherence tomography, and the urgent need for treatments and beneficial interventions to reduce the associated burden. Currently, low-vision aids and smoking cessation are considered the most beneficial interventions. We demonstrate consensus for diagnosis and management of patients with GA including best practices in patient identification and monitoring, and unmet needs. [Ophthalmic Surg Lasers Imaging Retina 2023;54:589-598.].
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Miller A, Crossland MD, Macnaughton J, Latham K. Are wearable electronic vision enhancement systems (wEVES) beneficial for people with age-related macular degeneration? A scoping review. Ophthalmic Physiol Opt 2023. [PMID: 36876427 DOI: 10.1111/opo.13117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 02/08/2023] [Accepted: 02/09/2023] [Indexed: 03/07/2023]
Abstract
INTRODUCTION Age-related macular degeneration (AMD) is the most common cause of irreversible visual impairment in the United Kingdom. It has a wide-ranging detrimental impact on daily living, including impairment of functional ability and quality of life. Assistive technology designed to overcome this impairment includes wearable electronic vision enhancement systems (wEVES). This scoping review assesses the usefulness of these systems for people with AMD. METHODS Four databases (Cumulative Index to Nursing and Allied Health Literature, PubMed, Web of Science and Cochrane CENTRAL) were searched to identify papers that investigated image enhancement with a head-mounted electronic device on a sample population that included people with AMD. RESULTS Thirty-two papers were included: 18 studied the clinical and functional benefits of wEVES, 11 investigated use and usability and 3 discussed sickness and adverse effects. CONCLUSIONS Wearable electronic vision enhancement systems provide hands-free magnification and image enhancement producing significant improvements in acuity, contrast sensitivity and aspects of laboratory-simulated daily activity. Adverse effects were infrequent, minor and spontaneously resolved with the removal of the device. However, when symptoms arose, they sometimes persisted with continued device usage. There are multi-factorial influences and a diversity of user opinions on promotors to successful device use. These factors are not exclusively driven by visual improvement and incorporate other issues including device weight, ease of use and inconspicuous design. There is insufficient evidence of any cost-benefit analysis for wEVES. However, it has been shown that a user's decision to make a purchase evolves over time, with their estimates of cost falling below the retail price of the devices. Additional research is needed to understand the specific and distinct benefits of wEVES for people with AMD. Further patient-centred research should assess the benefits of wEVES in user-led activities when directly compared with alternative coping strategies, allowing professionals and users to make better prescribing and purchasing decisions.
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Affiliation(s)
- Andrew Miller
- Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge, UK
| | | | - Jane Macnaughton
- Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge, UK
| | - Keziah Latham
- Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge, UK
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Amore F, Silvestri V, Guidobaldi M, Sulfaro M, Piscopo P, Turco S, De Rossi F, Rellini E, Fortini S, Rizzo S, Perna F, Mastropasqua L, Bosch V, Oest-Shirai LR, Haddad MAO, Higashi AH, Sato RH, Pyatova Y, Daibert-Nido M, Markowitz SN. Efficacy and Patients' Satisfaction with the ORCAM MyEye Device Among Visually Impaired People: A Multicenter Study. J Med Syst 2023; 47:11. [PMID: 36645535 DOI: 10.1007/s10916-023-01908-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 01/03/2023] [Indexed: 01/17/2023]
Abstract
To evaluate usability of and satisfaction with OrCam MyEye, a finger-size wearable assistive technology device for visually impaired during real-world tasks. This prospective multicenter study was conducted on visually impaired people recruited from 5 vision rehabilitation centers. Patients performed real-world tasks such as near and distance reading, money handling, colour identification and face recognition in 2 different scenarios: without using any low vision aid and with OrCam. System Usability Scale (SUS), Patient's Global Impression of Change (PGIC), the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST 2.0) and the Psychosocial Impact of Assistive Devices Scale (PIADS) were administered after the use of the OrCam device. Among the 100 participants, use of OrCam MyEye device improved many daily-living tasks (F = 1.67, P < .05), and in particular reading and face recognition. Multivariate logistic regression showed that age and visual field defect explained 89% of the variation in efficacy of the device. Nearly half (45%) of the participants indicated a positive rating with the SUS. The PGIC rates showed a minimal improvement with a mean score of 4.2 (SD:1.8). The most highlighted parameter with the QUEST 2.0 test was "ease of use" in 58% (48 subjects). The PIADS indicator showed that the device positively impacted on the daily-living tasks of users (r2 = 0.72, P < .05). Regression modelling demonstrated a good relation between the questionnaires scores and demographic, disease and visual factors (P < .05). OrCam MyEye allowed visually impaired people to read, handle money and face recognition independently. This device may offer to these subjects to be independent.
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Affiliation(s)
- Filippo Amore
- National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of the Visually Impaired, International Agency for the Prevention of Blindness-IAPB Italy Onlus, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli N° 8, 00168, Rome, Italy.
| | - Valeria Silvestri
- National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of the Visually Impaired, International Agency for the Prevention of Blindness-IAPB Italy Onlus, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli N° 8, 00168, Rome, Italy
| | - Margherita Guidobaldi
- National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of the Visually Impaired, International Agency for the Prevention of Blindness-IAPB Italy Onlus, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli N° 8, 00168, Rome, Italy
| | - Marco Sulfaro
- National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of the Visually Impaired, International Agency for the Prevention of Blindness-IAPB Italy Onlus, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli N° 8, 00168, Rome, Italy
| | - Paola Piscopo
- National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of the Visually Impaired, International Agency for the Prevention of Blindness-IAPB Italy Onlus, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli N° 8, 00168, Rome, Italy
| | - Simona Turco
- National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of the Visually Impaired, International Agency for the Prevention of Blindness-IAPB Italy Onlus, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli N° 8, 00168, Rome, Italy
| | - Francesca De Rossi
- National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of the Visually Impaired, International Agency for the Prevention of Blindness-IAPB Italy Onlus, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli N° 8, 00168, Rome, Italy
| | - Emanuela Rellini
- National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of the Visually Impaired, International Agency for the Prevention of Blindness-IAPB Italy Onlus, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli N° 8, 00168, Rome, Italy
| | - Stefania Fortini
- National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of the Visually Impaired, International Agency for the Prevention of Blindness-IAPB Italy Onlus, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli N° 8, 00168, Rome, Italy
| | - Stanislao Rizzo
- Ophthalmology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Fabiana Perna
- Department of Medicine and Aging Sciences, Ophthalmology Clinic, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Leonardo Mastropasqua
- Department of Medicine and Aging Sciences, Ophthalmology Clinic, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Vanessa Bosch
- Departamento de Oftalmología, Instituto Nacional de Pediatría, Secretaría de Salud, Mexico City, Mexico
| | - Luz Ruriko Oest-Shirai
- Departamento de Oftalmología, Instituto Nacional de Pediatría, Secretaría de Salud, Mexico City, Mexico
| | - Maria Aparecida Onuki Haddad
- Clínica Oftalmológica, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brasil
| | - Alez Haruo Higashi
- Clínica Oftalmológica, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brasil
| | - Rodrigo Hideharo Sato
- Clínica Oftalmológica, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brasil
| | - Yulia Pyatova
- Toronto Western Hospital, University of Toronto, Toronto, ON, Canada
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Nekolova J, Kremlacek J, Lukavsky J, Sikl R, Sin M, Langrova J, Szanyi J, Jiraskova N. The intraocular implant and visual rehabilitation improve the quality of life of elderly patients with geographic atrophy secondary to age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol 2023; 261:263-272. [PMID: 35982247 PMCID: PMC9388354 DOI: 10.1007/s00417-022-05803-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/27/2022] [Accepted: 08/05/2022] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION The objective of this prospective study was to evaluate the effects of intraocular macular lens implantation and visual rehabilitation on the quality of life of patients with geographic atrophy (GA) secondary to age-related macular degeneration (AMD). METHODS Patients with bilaterally decreased near vision (not better than 0.3 logMAR with the best correction), pseudophakia, were included in the project. The Scharioth macula lens (SML) was implanted into the patients' better-seeing eye. Intensive visual rehabilitation of the ability to perform nearby activities was performed for 20 consecutive postoperative days. All subjects were examined before and after SML implantation ophthalmologically. The National Eye Institute 25-Item Visual Function Questionnaire (NEI VFQ-25) was administered before and 6 months after surgery. RESULTS Twenty eligible patients with mean age 81 years (63 to 92 years) were included in the project: 7 males and 13 females. Nineteen of them completed the 6-month follow-up. Near uncorrected visual acuity was 1.321 ± 0.208 logMAR before SML implantation and improved to 0.547 ± 0.210 logMAR after 6 months (dz = - 2.846, p < 0.001, BF10 = 3.29E + 07). In the composite score of the NEI VFQ-25, there was an improvement in the general score and the specific domains related to the implantation. Participants reported fewer difficulties in performing near activities (dz = 0.91, p = 0.001, BF10 = 39.718) and upturns in mental health symptoms related to vision (dz = 0.62, p = .014, BF10 = 3.937). CONCLUSION SML implantation, followed by appropriate rehabilitation, improved near vision and increased the quality of life of visually handicapped patients with AMD in our project.
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Affiliation(s)
- Jana Nekolova
- Department of Ophthalmology, University Hospital Hradec Kralove and Faculty of Medicine, Charles University, Hradec Kralove, Czech Republic
| | - Jan Kremlacek
- Department of Biophysics, Faculty of Medicine, Charles University, Simkova 870, 50003 Hradec Kralove, Czech Republic
- Department of Pathological Physiology, Faculty of Medicine, Charles University, Simkova 870, Hradec Kralove, 50003 Czech Republic
| | - Jiri Lukavsky
- Institute of Psychology, Czech Academy of Sciences, Brno, Czech Republic
| | - Radovan Sikl
- Institute of Psychology, Czech Academy of Sciences, Brno, Czech Republic
| | - Martin Sin
- Military University Hospital Prague, Department of Ophthalmology 1st Faculty of Medicine of Charles University and Military University Hospital Prague, Prague, Czech Republic
| | - Jana Langrova
- Department of Pathological Physiology, Faculty of Medicine, Charles University, Simkova 870, Hradec Kralove, 50003 Czech Republic
| | - Jana Szanyi
- Department of Pathological Physiology, Faculty of Medicine, Charles University, Simkova 870, Hradec Kralove, 50003 Czech Republic
| | - Nada Jiraskova
- Department of Ophthalmology, University Hospital Hradec Kralove and Faculty of Medicine, Charles University, Hradec Kralove, Czech Republic
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Gupta JC, Arora VM, Vollbrecht H, Kappel N, Meltzer DO, Press VG. The Relationship Between Insufficient Vision and Technology Access and Usage among Hospitalized Adults at an Urban Academic Hospital: An Observational Study (Preprint). JMIR Form Res 2022; 7:e40103. [DOI: 10.2196/40103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 03/07/2023] [Accepted: 03/10/2023] [Indexed: 03/12/2023] Open
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Borkenstein AF, Borkenstein EM, Murphy K, Primo SA. Testing Activities of Daily Living (ADL) in Patients with Age-Related Macular Degeneration Undergoing Cataract Surgery: Lessons Learned from the Past and Development of a New Quality of Life (QOL) Test. Clin Ophthalmol 2022; 16:385-387. [PMID: 35185330 PMCID: PMC8847117 DOI: 10.2147/opth.s356423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 02/02/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Andreas F Borkenstein
- Borkenstein & Borkenstein, Private Practice and Privatklinik der Kreuzschwestern, Graz, 8010, Austria
- Correspondence: Andreas F Borkenstein, Borkenstein & Borkenstein, Private Practice and Privatklinik der Kreuzschwestern, Kreuzgasse 35, Graz, 8010, Austria, Tel +433163313880, Email
| | - Eva-Maria Borkenstein
- Borkenstein & Borkenstein, Private Practice and Privatklinik der Kreuzschwestern, Graz, 8010, Austria
| | - Karen Murphy
- VisionWorks Rehabilitation, LLC, Novi, MI, 48374, USA
| | - Susan A Primo
- Emory University School of Medicine, Department of Ophthalmology, Atlanta, GA, 30322, USA
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Beattie KL, Hill A, Horswill MS, Grove PM, Stevenson ARL. Laparoscopic skills training: the effects of viewing mode (2D vs. 3D) on skill acquisition and transfer. Surg Endosc 2021; 35:4332-4344. [PMID: 32876737 PMCID: PMC8263422 DOI: 10.1007/s00464-020-07923-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 08/17/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Three-dimensional (3D) visual displays have been suggested to aid laparoscopic skills training by providing the depth cues not present in traditional two-dimensional (2D) displays. However, few studies have robustly investigated the impact of viewing mode (2D vs. 3D) on learning outcomes. PURPOSE To examine how viewing mode (2D vs. 3D) impacts the acquisition and transferability of basic laparoscopic skills by comparing performance between transfer and control groups on a complete proficiency-based training program. METHOD A counterbalanced between-subjects design was employed. Each participant was randomly allocated to one of four groups, comprising two transfer groups (trained in one viewing mode and tested in the alternate mode: the 2D → 3D and 3D → 2D groups) and two control groups (trained and tested in one viewing mode: the 2D → 2D and 3D → 3D groups). Participants completed proficiency-based training in six laparoscopic training tasks. Testing included two further repetitions of all tasks under test conditions. Objective performance measures included the total number of repetitions to reach proficiency, and total performance scores (i.e. time + error penalties across all repetitions) in training and testing. RESULTS The groups trained in 3D demonstrated superior training performance (i.e. less time + errors) and took fewer repetitions to reach proficiency than the groups trained in 2D. The groups tested in 3D also demonstrated superior test performance compared to those tested in 2D. However, training mode did not yield significant test differences between the groups tested in 2D (i.e. 2D → 2D vs. 3D → 2D), or between the groups tested in 3D (i.e. 3D → 3D vs. 2D → 3D). CONCLUSION Novices demonstrate superior performance in laparoscopic skills training using a 3D viewing mode compared to 2D. However, this does not necessarily translate to superior performance in subsequent testing or enhanced learning overall. Rather, test performance appears to be dictated by the viewing mode used during testing, not that of prior training.
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Affiliation(s)
- Kirsty L Beattie
- School of Psychology, The University of Queensland, St Lucia, Brisbane, 4072, Australia.
| | - Andrew Hill
- School of Psychology, The University of Queensland, St Lucia, Brisbane, 4072, Australia
- Clinical Skills Development Service, Metro North Hospital and Health Service, Brisbane, Australia
- Minerals Industry Safety and Health Centre, Sustainable Minerals Institute, The University of Queensland, Brisbane, Australia
| | - Mark S Horswill
- School of Psychology, The University of Queensland, St Lucia, Brisbane, 4072, Australia
| | - Philip M Grove
- School of Psychology, The University of Queensland, St Lucia, Brisbane, 4072, Australia
| | - Andrew R L Stevenson
- School of Medicine, The University of Queensland, Brisbane, Australia
- Department of Colon and Rectal Surgery, Royal Brisbane and Women's Hospital, Brisbane, Australia
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13
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Mehta H. Management of Cataract in Patients with Age-Related Macular Degeneration. J Clin Med 2021; 10:2538. [PMID: 34201114 PMCID: PMC8228734 DOI: 10.3390/jcm10122538] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/31/2021] [Accepted: 06/02/2021] [Indexed: 11/16/2022] Open
Abstract
Cataract and age-related macular degeneration (AMD) are two of the most common eye diseases of aging. This review addresses the pre-operative, intra-operative, and post-operative considerations in managing cataract in patients with age-related macular degeneration. Surgery for visually significant cataracts in patients with AMD can substantially improve the quality of life and reduce the risk of falls. Pre-operative optical coherence tomography is now recommended where possible to identify pre-existing macula disease. Careful counselling of patients is required before cataract surgery, especially with respect to the expected visual outcome, intraocular lens choice and potential risks of surgery. Real-world data has suggested 6 months of intravitreal anti-VEGF therapy for neovascular AMD before cataract surgery is compatible with optimum long-term visual outcomes. Patients receiving intravitreal therapy for neovascular AMD should be advised of the slightly higher risk of intraoperative complications and the surgeon should be prepared to manage these during the operation. During cataract surgery, unnecessary light exposure should be avoided to reduce phototoxicity. Careful planning of intravitreal therapy for neovascular AMD just before cataract surgery allows the eye greater recovery time in the post-operative period before further planned intravitreal therapy.
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Affiliation(s)
- Hemal Mehta
- Save Sight Registries, University of Sydney, Sydney, NSW 2000, Australia;
- Strathfield Retina Clinic, Strathfield, Sydney, NSW 2135, Australia
- Ophthalmology Department, Royal Free London NHS Foundation Trust, London NW3 2QG, UK
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14
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Starke SD, Golubova E, Crossland MD, Wolffsohn JS. Everyday visual demands of people with low vision: A mixed methods real-life recording study. J Vis 2021; 20:3. [PMID: 32876678 PMCID: PMC7476655 DOI: 10.1167/jov.20.9.3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Research has demonstrated that low vison aids (LVAs) can have a positive impact on the functional sight of those living with sight loss. Step changes in technology are now enabling new wearable LVAs with greater potential than those available previously. For these novel devices to receive increased acceptance and therefore adoption by those with sight loss, visual task demands have to be understood more clearly in order to enable better alignment between device design and user requirements. The aim of this study was to quantify these requirements. Thirty-two participants aged 18 to 87 wore a spectacle-mounted video camera to capture and narrate all everyday situations in which they would use a “perfect” sight aid during 1 week. Captured scenes were analyzed through categorization and computational image analysis. Results showed large variation in activities and lifestyles. Participants reported no available sight aid or coping strategy for 57% of the recorded activities. Reading made up 49% of all recorded tasks, the other half comprising non-textual information. Overall, 75% of captured activities were performed ad hoc (duration of 0–5 minutes), 78% occurred indoors, 58% occurred at home, 48% were lit by natural light, 68% included the object of interest within reach, and 69% required a single focus plane only. Around half of captured objects of interest had a size of 2 degrees visual angle (2.08 logarithm of the minimum angle of resolution [logMAR]) or smaller. This study highlights the need for a sight aid that can make both textual and non-textual scenes accessible while offering flexibility to accommodate individual lifestyles.
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Affiliation(s)
- Sandra D Starke
- Aston Business School, Aston University, Birmingham, UK.,Previously School of Engineering (Honorary Research Fellow), University of Birmingham, Birmingham, UK.,Previously GiveVision, iCentrum, Birmingham, UK
| | - Eugenie Golubova
- Aston Business School, Aston University, Birmingham, UK.,Previously GiveVision, iCentrum, Birmingham, UK
| | - Michael D Crossland
- NIHR Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK
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15
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Liu J, Dong J, Chen Y, Zhang W, Tong S, Guo J. Low vision rehabilitation in improving the quality of life for patients with impaired vision: A systematic review and meta-analysis of 52 randomized clinical trials. Medicine (Baltimore) 2021; 100:e25736. [PMID: 34106601 PMCID: PMC8133190 DOI: 10.1097/md.0000000000025736] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 04/03/2021] [Accepted: 04/06/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND AIM Low vision rehabilitation optimizes the use of residual vision after severe vision loss, but also teaches skills to improve visual functioning in daily life. These skills promote independence and active participation in society. This meta-analysis was designed to evaluate the efficacy of low vision rehabilitation in improving the quality of life (QoL) in visually impaired adults. METHODS We searched the Cochrane Library, PubMed, EMBASE, and Web of Science up to January 1, 2020. Randomized controlled trials (RCTs) that compared rehabilitation interventions with active or inactive controls were included. The standardized mean difference (SMD) with a 95% confidence interval (CI) was estimated to compare outcomes. Two reviewers extracted data and assessed trial quality independently. All statistical analyses were performed using the standard statistical procedures of RevMan 5.2. RESULTS A total of 52 RCTs with 6,239 participants were included in this meta-analysis. Compared to inactive comparators including waiting list or no care, low vision rehabilitation improved vision-related QoL, visual functioning (QoL: psychological aspect), and self-efficacy or self-esteem (QoL: psychological aspect), with pooled SMDs of -0.61 (95% CI -0.95 to -0.26; P = .0006), -1.14 (95% CI -1.69 to -0.59; P < .0001), and -0.84 (95% CI -1.47 to -0.22; P < .0001), respectively. Compared to active comparators, low vision rehabilitation improved vision-related QoL (SMD -0.26; 95% CI -0.46 to -0.06; P = .01) and activities of daily living (QoL: physical aspect) (SMD -0.39; 95% CI -0.67 to -0.12 P < .0001). However, no significant difference in health-related QoL and adaptation to vision loss (QoL: psychological aspect) was found between low vision rehabilitation and inactive comparators. CONCLUSIONS This meta-analysis indicated that low vision rehabilitation interventions, particularly psychological therapies and methods of enhancing vision, may improve vision-related QoL and visual functioning in people with sight loss compared to usual care. Further studies should explore longer maintenance effects and the costs of several types of low vision rehabilitation. Studies characterizing the mechanisms of rehabilitation interventions in different settings, including low-income countries, are also required.
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Affiliation(s)
- Jianhua Liu
- Department of Physical Therapy, Beijing Bo'ai Hospital, Chinese Rehabilitation Research Centre
| | - Jige Dong
- Department of Rehabilitation and Treatment, Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine
| | - Yaping Chen
- Department of Rehabilitation Medicine, Beijing Tongren Hospital of Capital Medical University
| | - Weidong Zhang
- Department of Rehabilitation Medicine, Beijing Luhe Hospital Affiliated to Capital Medical University
| | - Shuai Tong
- Department of Rehabilitation Medicine, Beijing Haidian Hospital, Beijing
| | - Jiangzhou Guo
- Department of Rehabilitation and Treatment, Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine
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16
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Fleckenstein M, Keenan TDL, Guymer RH, Chakravarthy U, Schmitz-Valckenberg S, Klaver CC, Wong WT, Chew EY. Age-related macular degeneration. Nat Rev Dis Primers 2021; 7:31. [PMID: 33958600 DOI: 10.1038/s41572-021-00265-2] [Citation(s) in RCA: 375] [Impact Index Per Article: 125.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/23/2021] [Indexed: 02/07/2023]
Abstract
Age-related macular degeneration (AMD) is the leading cause of legal blindness in the industrialized world. AMD is characterized by accumulation of extracellular deposits, namely drusen, along with progressive degeneration of photoreceptors and adjacent tissues. AMD is a multifactorial disease encompassing a complex interplay between ageing, environmental risk factors and genetic susceptibility. Chronic inflammation, lipid deposition, oxidative stress and impaired extracellular matrix maintenance are strongly implicated in AMD pathogenesis. However, the exact interactions of pathophysiological events that culminate in drusen formation and the associated degeneration processes remain to be elucidated. Despite tremendous advances in clinical care and in unravelling pathophysiological mechanisms, the unmet medical need related to AMD remains substantial. Although there have been major breakthroughs in the treatment of exudative AMD, no efficacious treatment is yet available to prevent progressive irreversible photoreceptor degeneration, which leads to central vision loss. Compelling progress in high-resolution retinal imaging has enabled refined phenotyping of AMD in vivo. These insights, in combination with clinicopathological and genetic correlations, have underscored the heterogeneity of AMD. Hence, our current understanding promotes the view that AMD represents a disease spectrum comprising distinct phenotypes with different mechanisms of pathogenesis. Hence, tailoring therapeutics to specific phenotypes and stages may, in the future, be the key to preventing irreversible vision loss.
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Affiliation(s)
- Monika Fleckenstein
- Department of Ophthalmology and Visual Science, John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA.
| | - Tiarnán D L Keenan
- Division of Epidemiology and Clinical Applications, National Eye Institute, National Institutes of Health, Bethesda, MD, USA
| | - Robyn H Guymer
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Melbourne, VIC, Australia.,Ophthalmology, Department of Surgery, The University of Melbourne, Melbourne, VIC, Australia
| | - Usha Chakravarthy
- Department of Ophthalmology, Centre for Public Health, Queen's University of Belfast, Belfast, UK
| | - Steffen Schmitz-Valckenberg
- Department of Ophthalmology and Visual Science, John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA.,Department of Ophthalmology, University of Bonn, Bonn, Germany
| | - Caroline C Klaver
- Department of Ophthalmology, Erasmus MC, Rotterdam, Netherlands.,Department of Epidemiology, Erasmus MC, Rotterdam, Netherlands.,Department of Ophthalmology, Radboud Medical Center, Nijmegen, Netherlands.,Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland
| | - Wai T Wong
- Section on Neuron-Glia Interactions in Retinal Disease, National Eye Institute, National Institutes of Health, Bethesda, MD, USA
| | - Emily Y Chew
- Division of Epidemiology and Clinical Applications, National Eye Institute, National Institutes of Health, Bethesda, MD, USA.
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17
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Sánchez-González JM, Rocha-de-Lossada C, Rachwani-Anil R, Castellanos-Gómez I, Alonso-Aliste F. Magnification, yellow filter and prisms low-vision aid in age-related macular degeneration: A case report. J Fr Ophtalmol 2021; 44:e351-e352. [PMID: 33608174 DOI: 10.1016/j.jfo.2020.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 07/15/2020] [Indexed: 11/17/2022]
Affiliation(s)
- J-M Sánchez-González
- Departamento de Física de la Materia Condensada, Área de óptica (Universidad de Sevilla), Sevilla, Espagne; Departmento de Oftalmología y Optometría (Tecnolaser Clinic Vision), Centro de Cirugía Refractiva, Calle Juan Antonio Cavestany, 14, 41018 Sevilla, Espagne
| | - C Rocha-de-Lossada
- Hospital Clinic de Barcelona, Instituto de Oftalmología, Calle Sabino de Arana 1, 08028 Barcelona, Espagne
| | - R Rachwani-Anil
- Hospital Regional de Málaga, Hospital Civil, Departamento de Oftalmología, Plaza del Hospital Civil, s/n, 29009 Málaga, Espagne.
| | - I Castellanos-Gómez
- Departmento de Oftalmología y Optometría (Tecnolaser Clinic Vision), Centro de Cirugía Refractiva, Calle Juan Antonio Cavestany, 14, 41018 Sevilla, Espagne; Departmento de Baja Vision y Rehabilitación (Tecnolaser Clinic Vision), Centro de Cirugía Refractiva, Calle Juan Antonio Cavestany, 14, 41018 Sevilla, Espagne
| | - F Alonso-Aliste
- Departmento de Oftalmología y Optometría (Tecnolaser Clinic Vision), Centro de Cirugía Refractiva, Calle Juan Antonio Cavestany, 14, 41018 Sevilla, Espagne
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18
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Czihal M, Lottspeich C, Köhler A, Prearo I, Hoffmann U, Priglinger SG, Mackert MJ. Transocular sonography in acute arterial occlusions of the eye in elderly patients: Diagnostic value of the spot sign. PLoS One 2021; 16:e0247072. [PMID: 33577572 PMCID: PMC7880485 DOI: 10.1371/journal.pone.0247072] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 01/29/2021] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To characterize the diagnostic yield of the spot sign in the diagnostic workup of acute arterial occlusions of the eye in elderly patients. METHODS Clinical characteristics of consecutive patients aged ≥ 50 years with acute central retinal artery occlusion (CRAO), branch retinal artery occlusion (BRAO) or anterior ischemic optic neuropathy (AION) were recorded. Videos of transocular sonography were assessed for the presence of the spot sign by two blinded readers. Group comparisons were made between CRAO-patients with and without the spot sign. Two experienced cardiovascular physicians allocated CRAO-cases to a presumed aetiology, without and with knowledge on the presence/absence of the spot sign. RESULTS One-hundred-twenty-three patients were included, 46 of whom suffered from CRAO. A spot sign was seen in 32 of 46 of patients with CRAO and in 7 of 23 patients with BRAO. Interobserver agreement was excellent (Cohen`s kappa 0.98). CRAO-patients with the spot sign significantly more frequently had a medical history of cardiovascular disease (62.8 vs. 21.4%, p = 0.03) and left heart valve pathologies (51.9 vs. 10%, p = 0.03). The spot sign was not found in any of the three patients with CRAO secondary to cranial giant cell arteritis. The assumed CRAO aetiology differed in 37% of cases between two cardiovascular physicians, regardless whether transocular sonography findings were known or not. CONCLUSION The spot sign is a simple sonographic finding with excellent interobserver agreement, which proofs the embolic nature of CRAO, but does not allow exact attribution of the underlying aetiology.
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Affiliation(s)
- Michael Czihal
- Division of Vascular Medicine, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, LMU München, Munich, Germany
| | - Christian Lottspeich
- Division of Vascular Medicine, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, LMU München, Munich, Germany
- * E-mail:
| | - Anton Köhler
- Division of Vascular Medicine, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, LMU München, Munich, Germany
| | - Ilaria Prearo
- Division of Vascular Medicine, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, LMU München, Munich, Germany
| | - Ulrich Hoffmann
- Division of Vascular Medicine, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, LMU München, Munich, Germany
| | | | - Marc J. Mackert
- Department of Ophthalmology, Klinikum der Universität München, LMU München, Munich, Germany
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19
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Gil A, Hernández CS, Pérez-Merino P, Rubio M, Velarde G, Abellanas-Lodares M, Román-Daza Á, Alejandre N, Jiménez-Alfaro I, Casares I, Dave SR, Lim D, Lage E. Assesment of the QuickSee wavefront autorefractor for characterizing refractive errors in school-age children. PLoS One 2020; 15:e0240933. [PMID: 33112912 PMCID: PMC7592806 DOI: 10.1371/journal.pone.0240933] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 10/05/2020] [Indexed: 11/25/2022] Open
Abstract
Purpose To assess the performance of an open-view binocular handheld aberrometer (QuickSee) for diagnosing refractive errors in children. Methods 123 school-age children (9.9 ± 3.3 years) with moderate refractive error underwent autorefraction (AR) with a standard desktop device and subjective refraction (SR), with or without cycloplegia to determine their eyeglass prescription. Measurements with QuickSee (QS) were taken in 62 of these patients without cycloplegia (NC), and in 61 under cycloplegia (C). Differences in refraction values (AR vs SR vs QS) as well as the visual acuity (VA) achieved by the patients with each method (QS vs SR) were used to evaluate the performance of the device in measuring refractive error. Results The spherical equivalent refraction obtained by QS agreed within 0.5 D of the SR in 71% (NC) and 70% (C) of the cases. Agreement between the desktop autorefractor and SR for the same threshold was of 61% (NC) and 77% (C). VA resulting from QS refractions was equal to or better than that achieved by SR procedure in 77% (NC) and 74% (C) of the patients. Average improvement in VA with the QS refractions was of 8.6 and 13.4 optotypes for the NC and C groups respectively, while the SR procedure provided average improvements of 8.9 (NC) and 14.8 (C) optotypes. Conclusions The high level of agreement between QuickSee and subjective refraction together with the VA improvement achieved in both study groups using QuickSee refractions suggest that the device is a useful autorefraction tool for school-age children.
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Affiliation(s)
- Andrea Gil
- Department of Electronics and Communications Technology, Universidad Autónoma de Madrid, Madrid, Spain
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain
| | - Carlos S. Hernández
- Department of Electronics and Communications Technology, Universidad Autónoma de Madrid, Madrid, Spain
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain
- PlenOptika, Inc., Boston, MA, United States of America
| | - Pablo Pérez-Merino
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain
| | - Marcos Rubio
- Department of Electronics and Communications Technology, Universidad Autónoma de Madrid, Madrid, Spain
- PlenOptika, Inc., Boston, MA, United States of America
| | | | | | - Ángeles Román-Daza
- Department of Ophthalmology, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Nicolás Alejandre
- Department of Ophthalmology, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Ignacio Jiménez-Alfaro
- Department of Ophthalmology, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Ignacio Casares
- Department of Electronics and Communications Technology, Universidad Autónoma de Madrid, Madrid, Spain
- PlenOptika, Inc., Boston, MA, United States of America
| | | | - Daryl Lim
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain
| | - Eduardo Lage
- Department of Electronics and Communications Technology, Universidad Autónoma de Madrid, Madrid, Spain
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain
- PlenOptika, Inc., Boston, MA, United States of America
- * E-mail:
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20
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Dai B, Yu Y, Huang L, Meng Z, Chen L, Luo H, Chen T, Chen X, Ye W, Yan Y, Cai C, Zheng J, Zhao J, Dong L, Hu J. Application of neural network model in assisting device fitting for low vision patients. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:702. [PMID: 32617322 PMCID: PMC7327309 DOI: 10.21037/atm.2020.02.161] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background To explore the application of neural network models in artificial intelligence (AI)-aided devices fitting for low vision patients. Methods The data of 836 visually impaired people were collected in southwestern Fujian from May 2014 to May 2017. After a full eye examination, 629 low vision patients were selected from this group. Based on the visual functions, rehabilitation needs, and living quality scores of the selected patients, the professionals chose assistive devices that were the best fit for the patients. The data of these three factors were then subjected to the quantitative analysis, and the results were digitized and labeled. The final datasets were used to train a fully connected deep neural networks to obtain an AI-aided model for assistive device fitting. Results In this study, the main causes of low vision in southwestern Fujian were congenital diseases, among which congenital cataract was the most common. During the low vision AI-aided devices fitting, we found that the intermediate distance magnifier was suitable for the largest number of patients. Through quantitative analysis of the research results, it was found that AI-aided devices fitting was closely related to visual function, rehabilitation needs and quality of life. If this complex relationship can be mapped into the neural network model, AI-aided device fitting can be realized. We built a fully connected neural network model for AI-aided device fitting. The input of the model was the characteristic data of low vision patients, and the output was the forecast of suitable devices. When the threshold of the model was 0.4, the accuracy was about 80% and the F1 value was about 0.31. This threshold can be used as the classification judgment threshold of the model. Conclusions Low vision AI-aided device fitting is closely related to visual function, rehabilitation needs, and quality of life scores. The neural network model based on full connection can achieve high accuracy in AI-aided devices fitting. It has a great impact on clinical application.
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Affiliation(s)
- Bingfa Dai
- Department of Ophthalmology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.,Fujian Province University Engineering Research Center of Assistive Technology for Visual Impairment, Quanzhou, China
| | - Yang Yu
- Department of Ophthalmology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.,Fujian Province University Engineering Research Center of Assistive Technology for Visual Impairment, Quanzhou, China
| | - Lijuan Huang
- Department of Ophthalmology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.,Fujian Province University Engineering Research Center of Assistive Technology for Visual Impairment, Quanzhou, China
| | - Zhiyong Meng
- Department of Ophthalmology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.,Fujian Province University Engineering Research Center of Assistive Technology for Visual Impairment, Quanzhou, China
| | - Liang Chen
- Fujian Assistive Devices and Technology Resource Centre for Persons with Disabilities, Fuzhou, China
| | - Hongxia Luo
- Fujian Assistive Devices and Technology Resource Centre for Persons with Disabilities, Fuzhou, China
| | - Ting Chen
- Department of Ophthalmology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.,Fujian Province University Engineering Research Center of Assistive Technology for Visual Impairment, Quanzhou, China
| | - Xuelan Chen
- Department of Ophthalmology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.,Fujian Province University Engineering Research Center of Assistive Technology for Visual Impairment, Quanzhou, China
| | - Wenwen Ye
- Department of Ophthalmology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.,Fujian Province University Engineering Research Center of Assistive Technology for Visual Impairment, Quanzhou, China
| | - Yuyuan Yan
- Department of Ophthalmology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.,Fujian Province University Engineering Research Center of Assistive Technology for Visual Impairment, Quanzhou, China
| | - Chi Cai
- Fujian Province University Engineering Research Center of Assistive Technology for Visual Impairment, Quanzhou, China.,Department of Radiology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Jianqing Zheng
- Fujian Province University Engineering Research Center of Assistive Technology for Visual Impairment, Quanzhou, China.,Department of Radiation Oncology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Jun Zhao
- Department of Ophthalmology, Shenzhen Eye Hospital Affiliated to Jinan University, Shenzhen, China
| | - Liquan Dong
- China Assistive Devices and Technology Centre for Persons with Disabilities, Beijing, China
| | - Jianmin Hu
- Department of Ophthalmology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.,Fujian Province University Engineering Research Center of Assistive Technology for Visual Impairment, Quanzhou, China
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21
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van Nispen RMA, Virgili G, Hoeben M, Langelaan M, Klevering J, Keunen JEE, van Rens GHMB. Low vision rehabilitation for better quality of life in visually impaired adults. Cochrane Database Syst Rev 2020; 1:CD006543. [PMID: 31985055 PMCID: PMC6984642 DOI: 10.1002/14651858.cd006543.pub2] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Low vision rehabilitation aims to optimise the use of residual vision after severe vision loss, but also aims to teach skills in order to improve visual functioning in daily life. Other aims include helping people to adapt to permanent vision loss and improving psychosocial functioning. These skills promote independence and active participation in society. Low vision rehabilitation should ultimately improve quality of life (QOL) for people who have visual impairment. OBJECTIVES To assess the effectiveness of low vision rehabilitation interventions on health-related QOL (HRQOL), vision-related QOL (VRQOL) or visual functioning and other closely related patient-reported outcomes in visually impaired adults. SEARCH METHODS We searched relevant electronic databases and trials registers up to 18 September 2019. SELECTION CRITERIA We included randomised controlled trials (RCTs) investigating HRQOL, VRQOL and related outcomes of adults, with an irreversible visual impairment (World Health Organization criteria). We included studies that compared rehabilitation interventions with active or inactive control. DATA COLLECTION AND ANALYSIS We used standard methods expected by Cochrane. We assessed the certainty of the evidence using the GRADE approach. MAIN RESULTS We included 44 studies (73 reports) conducted in North America, Australia, Europe and Asia. Considering the clinical diversity of low vision rehabilitation interventions, the studies were categorised into four groups of related intervention types (and by comparator): (1) psychological therapies and/or group programmes, (2) methods of enhancing vision, (3) multidisciplinary rehabilitation programmes, (4) other programmes. Comparators were no care or waiting list as an inactive control group, usual care or other active control group. Participants included in the reported studies were mainly older adults with visual impairment or blindness, often as a result of age-related macular degeneration (AMD). Study settings were often hospitals or low vision rehabilitation services. Effects were measured at the short-term (six months or less) in most studies. Not all studies reported on funding, but those who did were supported by public or non-profit funders (N = 31), except for two studies. Compared to inactive comparators, we found very low-certainty evidence of no beneficial effects on HRQOL that was imprecisely estimated for psychological therapies and/or group programmes (SMD 0.26, 95% CI -0.28 to 0.80; participants = 183; studies = 1) and an imprecise estimate suggesting little or no effect of multidisciplinary rehabilitation programmes (SMD -0.08, 95% CI -0.37 to 0.21; participants = 183; studies = 2; I2 = 0%); no data were available for methods of enhancing vision or other programmes. Regarding VRQOL, we found low- or very low-certainty evidence of imprecisely estimated benefit with psychological therapies and/or group programmes (SMD -0.23, 95% CI -0.53 to 0.08; studies = 2; I2 = 24%) and methods of enhancing vision (SMD -0.19, 95% CI -0.54 to 0.15; participants = 262; studies = 5; I2 = 34%). Two studies using multidisciplinary rehabilitation programmes showed beneficial but inconsistent results, of which one study, which was at low risk of bias and used intensive rehabilitation, recorded a very large and significant effect (SMD: -1.64, 95% CI -2.05 to -1.24), and the other a small and uncertain effect (SMD -0.42, 95%: -0.90 to 0.07). Compared to active comparators, we found very low-certainty evidence of small or no beneficial effects on HRQOL that were imprecisely estimated with psychological therapies and/or group programmes including no difference (SMD -0.09, 95% CI -0.39 to 0.20; participants = 600; studies = 4; I2 = 67%). We also found very low-certainty evidence of small or no beneficial effects with methods of enhancing vision, that were imprecisely estimated (SMD -0.09, 95% CI -0.28 to 0.09; participants = 443; studies = 2; I2 = 0%) and multidisciplinary rehabilitation programmes (SMD -0.10, 95% CI -0.31 to 0.12; participants = 375; studies = 2; I2 = 0%). Concerning VRQOL, low-certainty evidence of small or no beneficial effects that were imprecisely estimated, was found with psychological therapies and/or group programmes (SMD -0.11, 95% CI -0.24 to 0.01; participants = 1245; studies = 7; I2 = 19%) and moderate-certainty evidence of small effects with methods of enhancing vision (SMD -0.24, 95% CI -0.40 to -0.08; participants = 660; studies = 7; I2 = 16%). No additional benefit was found with multidisciplinary rehabilitation programmes (SMD 0.01, 95% CI -0.18 to 0.20; participants = 464; studies = 3; I2 = 0%; low-certainty evidence). Among secondary outcomes, very low-certainty evidence of a significant and large, but imprecisely estimated benefit on self-efficacy or self-esteem was found for psychological therapies and/or group programmes versus waiting list or no care (SMD -0.85, 95% CI -1.48 to -0.22; participants = 456; studies = 5; I2 = 91%). In addition, very low-certainty evidence of a significant and large estimated benefit on depression was found for psychological therapies and/or group programmes versus waiting list or no care (SMD -1.23, 95% CI -2.18 to -0.28; participants = 456; studies = 5; I2 = 94%), and moderate-certainty evidence of a small benefit versus usual care (SMD -0.14, 95% CI -0.25 to -0.04; participants = 1334; studies = 9; I2 = 0%). ln the few studies in which (serious) adverse events were reported, these seemed unrelated to low vision rehabilitation. AUTHORS' CONCLUSIONS In this Cochrane Review, no evidence of benefit was found of diverse types of low vision rehabilitation interventions on HRQOL. We found low- and moderate-certainty evidence, respectively, of a small benefit on VRQOL in studies comparing psychological therapies or methods for enhancing vision with active comparators. The type of rehabilitation varied among studies, even within intervention groups, but benefits were detected even if compared to active control groups. Studies were conducted on adults with visual impairment mainly of older age, living in high-income countries and often having AMD. Most of the included studies on low vision rehabilitation had a short follow-up, Despite these limitations, the consistent direction of the effects in this review towards benefit justifies further research activities of better methodological quality including longer maintenance effects and costs of several types of low vision rehabilitation. Research on the working mechanisms of components of rehabilitation interventions in different settings, including low-income countries, is also needed.
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Affiliation(s)
- Ruth MA van Nispen
- Amsterdam University Medical Centers, Vrije UniversiteitDepartment of Ophthalmology, Amsterdam Public Health research instituteAmsterdamNetherlands
| | - Gianni Virgili
- University of FlorenceDepartment of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA)Largo Palagi, 1FlorenceItaly50134
| | - Mirke Hoeben
- Amsterdam University Medical Centers, Vrije UniversiteitDepartment of Ophthalmology, Amsterdam Public Health research instituteAmsterdamNetherlands
| | - Maaike Langelaan
- Netherlands institute for health services, NIVEL researchP.O. Box 1568UtrechtNetherlands3500 BN
| | - Jeroen Klevering
- Radboud University Medical CenterDepartment of OphthalmologyNijmegenNetherlands
| | - Jan EE Keunen
- Radboud University Medical CenterDepartment of OphthalmologyNijmegenNetherlands
| | - Ger HMB van Rens
- Amsterdam University Medical Centers, Vrije UniversiteitDepartment of Ophthalmology, Amsterdam Public Health research instituteAmsterdamNetherlands
- Elkerliek HospitalDepartment of OphthalmologyHelmondNetherlands
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22
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Chung STL. Reading in the presence of macular disease: a mini-review. Ophthalmic Physiol Opt 2020; 40:171-186. [PMID: 31925832 PMCID: PMC7093247 DOI: 10.1111/opo.12664] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 12/04/2019] [Indexed: 12/02/2022]
Abstract
Purpose Reading is vital to full participation in modern society. To millions of people suffering from macular disease that results in a central scotoma, reading is difficult and inefficient, rendering reading as the primary goal for most patients seeking low vision rehabilitation. The goals of this review paper are to summarize the dependence of reading speed on several key visual and typographical factors and the current methods or technologies for improving reading performance for people with macular disease. Important findings In general, reading speed for people with macular disease depends on print size, text contrast, size of the visual span, temporal processing of letters and oculomotor control. Attempts at improving reading speed by reducing the crowding effect between letters, words or lines; or optimizing properties of typeface such as the presence of serifs or stroke‐width thickness proved to be futile, with any improvement being modest at best. Currently, the most promising method to improve reading speed for people with macular disease is training, including perceptual learning or oculomotor training. Summary The limitation on reading speed for people with macular disease is likely to be multi‐factorial. Future studies should try to understand how different factors interact to limit reading speed, and whether different methods could be combined to produce a much greater benefit.
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Affiliation(s)
- Susana T L Chung
- School of Optometry, University of California, Berkeley, California, USA
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23
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Benefits of low vision aids to reading accessibility. Vision Res 2018; 153:47-52. [PMID: 30292724 DOI: 10.1016/j.visres.2018.09.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 08/31/2018] [Accepted: 09/17/2018] [Indexed: 11/24/2022]
Abstract
The Reading Accessibility Index (ACC) has been proposed as a single-value reading parameter that can capture information on both reading speed and print sizes that can be read. It is defined as the average reading speed across a relevant range of print sizes (1.3-0.4logMAR), normalised by typical young-adult reading speed of 200 wpm, and with values typically in the range of 0-1. This study determines the impact of low vision aids (LVAs) on reading by evaluating ACC values for visually impaired observers reading both without and with an optical LVA. A secondary analysis of previously published data obtained from 100 visually impaired observers attending low vision assessments was undertaken. Observers had mixed causes of visual impairment but predominantly macular degeneration. All used an LVA for reading, with 88% using it 'often' or 'very often'. MNREAD reading parameters, including ACC, were determined both for reading without an LVA (clinical function) and with the LVA habitually used for reading (aided function). There was a significant improvement in ACC from clinical (0.31) to aided conditions (0.47). Average improvement in ACC with an LVA was 0.16, but the benefits of LVAs in terms of improvement in ACC could not be predicted from clinical visual function. Even with an LVA reading accessibility is, on average, markedly reduced from normal levels. The ACC is a potentially valuable outcome measure for reading rehabilitation interventions.
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Ding H, Hu GL, Zheng XY, Chen Q, Threapleton DE, Zhou ZH. The method quality of cross-over studies involved in Cochrane Systematic Reviews. PLoS One 2015; 10:e0120519. [PMID: 25867772 PMCID: PMC4395015 DOI: 10.1371/journal.pone.0120519] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 01/21/2015] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND It is possible that cross-over studies included in current systematic reviews are being inadequately assessed, because the current risk of bias tools do not consider possible biases specific to cross-over design. We performed this study to evaluate whether this was being done in cross-over studies included in Cochrane Systematic Reviews (CSRs). METHODS We searched the Cochrane Library (up to 2013 issue 5) for CSRs that included at least one cross-over trial. Two authors independently undertook the study selection and data extraction. A random sample of the CSRs was selected and we evaluated whether the cross-over trials in these CSRs were assessed according to criteria suggested by the Cochrane handbook. In addition we reassessed the risk of bias of these cross-over trials by a checklist developed form the Cochrane handbook. RESULTS We identified 688 CSRs that included one or more cross-over studies. We chose a random sample of 60 CSRs and these included 139 cross-over studies. None of these CSRs undertook a risk of bias assessment specific for cross-over studies. In fact items specific for cross-over studies were seldom considered anywhere in quality assessment of these CSRs. When we reassessed the risk of bias, including the 3 items specific to cross-over trials, of these 139 studies, a low risk of bias was judged for appropriate cross-over design in 110(79%), carry-over effects in 48(34%) and for reporting data in all stages of the trial in 114(82%).Assessment of biases in cross-over trials could affect the GRADE assessment of a review's findings. CONCLUSION The current Cochrane risk of bias tool is not adequate to assess cross-over studies. Items specific to cross-over trials leading to potential risk of bias are generally neglected in CSRs. A proposed check list for the evaluation of cross-over trials is provided.
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Affiliation(s)
- Hong Ding
- Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangdong, China
| | - Guang Li Hu
- Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangdong, China
| | - Xue Yan Zheng
- Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangdong, China
| | - Qing Chen
- Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangdong, China
| | - Diane Erin Threapleton
- Division of Epidemiology, School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong, China
| | - Zeng Huan Zhou
- Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangdong, China
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