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Tan ACS, Peterson CL, Htoon HM, Tan LLY, Tan Y, Sim KT, Ong L, Tan ZK, Heng SH, Yeo IYS, Wong TY, Cheung G, Man R, Fenwick EK, Lamoureux E. Development and Validation of Performance-Based Assessment of Daily Living Tasks in Age-Related Macular Degeneration. Transl Vis Sci Technol 2024; 13:9. [PMID: 38884546 PMCID: PMC11185266 DOI: 10.1167/tvst.13.6.9] [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: 09/22/2023] [Accepted: 04/09/2024] [Indexed: 06/18/2024] Open
Abstract
Purpose To establish the reliability and validity of five performance-based activities of daily living task tests (ADLTT), to correlate structure to function, to evaluate the impact of visual impairment (VI) on age-related macular degeneration (AMD), and to develop new outcome measures. Methods A multidisciplinary team developed five ADLTTs: (1) reading test (RT); (2) facial expression (FE) recognition; (3) item search (IS) task; (4) money counting (MC) task; and (5) making a drink (MD), tested with binocular and monocular vision. ADLTTs were tested for known-group (i.e., difference between AMD group and controls) and convergent (i.e., correlation to other measures of visual function), validity metrics, and test-retest reliability in 36 patients with VI (visual acuity (logMAR VA > 0.4) in at least one eye caused by AMD versus 36 healthy controls without VI. Results Compared to controls, AMD patients had a slower reading speed (-77.41 words/min; P < 0.001); took longer to complete MC using monocular worse eye and binocular vision (15.13 seconds and 4.06 seconds longer compared to controls, respectively; P < 0.001); and MD using monocular worse eye vision (9.37 sec; P = 0.033), demonstrating known-group validity. Only RT and MC demonstrated convergent validity, showing correlations with VA, contrast sensitivity, and microperimetry testing. Moderate to good test-retest reliability was observed for MC and MD (interclass correlation coefficient = 0.55 and 0.77; P < 0.001) using monocular worse eye vision. Conclusions Real-world ADL functioning associated with VI-related AMD can be assessed with our validated ADLTTs, particularly MC and MD. Translational Relevance This study validates visual function outcome measures that are developed for use in future clinical practice and clinical trials.
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Affiliation(s)
- Anna C S Tan
- Singapore National Eye Centre, Singapore, Singapore
- Singapore Eye Research Centre, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Claire L Peterson
- Singapore National Eye Centre, Singapore, Singapore
- Singapore Eye Research Centre, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Hla M Htoon
- Singapore Eye Research Centre, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Lynn L Y Tan
- Singapore National Eye Centre, Singapore, Singapore
| | - Yanwen Tan
- Singapore General Hospital, Singapore, Singapore
| | - Kai Ting Sim
- Singapore National Eye Centre, Singapore, Singapore
| | - Lisa Ong
- Singapore National Eye Centre, Singapore, Singapore
| | - Zhen K Tan
- Singapore National Eye Centre, Singapore, Singapore
| | - Shih H Heng
- Singapore General Hospital, Singapore, Singapore
| | - Ian Y S Yeo
- Singapore National Eye Centre, Singapore, Singapore
- Singapore Eye Research Centre, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Tien Y Wong
- Singapore National Eye Centre, Singapore, Singapore
- Singapore Eye Research Centre, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Gemmy Cheung
- Singapore National Eye Centre, Singapore, Singapore
- Singapore Eye Research Centre, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Ryan Man
- Singapore National Eye Centre, Singapore, Singapore
- Singapore Eye Research Centre, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Eva K Fenwick
- Singapore Eye Research Centre, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Ecosse Lamoureux
- Singapore Eye Research Centre, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
- University of Melbourne, Melbourne, Australia
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Jones L, Lee M, Castle CL, Heinze N, Gomes RSM. Scoping review of remote rehabilitation (telerehabilitation) services to support people with vision impairment. BMJ Open 2022; 12:e059985. [PMID: 35914903 PMCID: PMC9345072 DOI: 10.1136/bmjopen-2021-059985] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Telerehabilitation for individuals with vision impairment aims to maintain maximum physical and/or psychological functioning through remote service delivery. This review aims to describe the type of telerehabilitation services available to people with vision impairment and summarise evidence on health-related outcomes, well-being and cost-effectiveness. DESIGN Scoping review. DATA SOURCES CINAHL Plus, MEDLINE, PsycARTICLES, PsychINFO, Embase, PubMed, HMIC and Ovid Emcare were searched, without date restrictions up to 24 May 2021. Charity and government websites, conference proceedings and clinical trial databases were also examined. ELIGIBILITY CRITERIA Eligible studies evaluated benefits of telerehabilitation services for adults with vision impairment. Studies were excluded if they were not available in English, or focused on distance learning of visually impaired students. DATA EXTRACTION AND SYNTHESIS Two independent reviewers screened articles and extracted data. A risk of bias analysis was performed. OUTCOME MEASURES Measures of benefit included performance-based assessment, patient-reported outcomes and cost-effectiveness. RESULTS Of 4472 articles, 10 eligible studies were included. Outcomes addressed patient satisfaction (n=4;33.3%), quality-of-life, activities of daily living and well-being (n=4;33.3%), objective visual function (n=2;16.6%) and knowledge relating to ocular symptoms (n=1;8.3%). Two studies addressed multiple outcomes. Cost-effectiveness was addressed in one article (8.3%). Patients were generally satisfied with their experiences, which had a range of positive benefits on functional and quality-of-life outcomes in areas relating to daily activities (eg, reading, making phone calls). Telerehabilitation allowed patients to undertake vision optimisation training to prevent vision deterioration. Grey literature indicated that there are no completed clinical trials relating to low vision telerehabilitation. Charity services had implemented digital skills training to help beneficiaries communicate remotely. CONCLUSION While acceptability of telerehabilitation was mostly high, limited real-world data are available which raises questions around the long-term desirability of this approach. Further trials are needed to evaluate telerehabilitation using a robust set of outcome measures. PROSPERO REGISTRATION NUMBER CRD42021254825.
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Affiliation(s)
- Lee Jones
- Research, BRAVO VICTOR, London, UK
- Institute of Ophthalmology, UCL, London, UK
| | - Matthew Lee
- Research, BRAVO VICTOR, London, UK
- Operations, Blind Veterans UK, London, UK
| | | | | | - Renata S M Gomes
- Research, BRAVO VICTOR, London, UK
- Department of Nursing, Midwifery and Health, Northumbria University, Newcastle upon Tyne, UK
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Oviedo-Cáceres MDP, Hernández-Padilla ML, Suárez-Escudero JC. Percepción de la rehabilitación visual: Una mirada desde las personas con baja visión. REVISTA CUIDARTE 2020. [DOI: 10.15649/cuidarte.1139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introducción: la baja visión es una categoría de discapacidad visual que requiere un proceso de rehabilitación para maximizar la función visual y permitir a la persona desarrollar habilidades compensatorias para mejorar su funcionalidad. Objetivo: describir las percepciones de las personas con baja visión que recibieron servicios de rehabilitación funcional visual en dos centros de atención, frente al aporte de los servicios y barreras identificadas en el proceso. Metodología: Estudio cualitativo de tipo exploratorio. Se realizaron 14 entrevistas semiestructuradas a personas que realizaron su rehabilitación visual en dos centros de atención: Uno en Bogotá con un proceso de atención interdisciplinario y otro en Bucaramanga con un proceso de atención de menor interdisciplinariedad. El análisis siguió el proceso de descubrimiento, codificación y relativización de los datos. Resultados: Las personas que asistieron al centro de menor interdisciplinariedad, reconocieron el aporte de la rehabilitación para el desarrollo de actividades cotidianas básicas e instrumentales. Quienes asistieron al centro de mayor interdisciplinariedad destacaron los aportes de psicología, orientación y movilidad, y trabajo social como fundamentales. Pese a lo anterior, en las dos ciudades persisten barreras: dificultades para adquirir ayudas ópticas, de movilidad, arquitectónicas y para la inclusión laboral. Discusión: Se evidencia la necesidad de garantizar una rehabilitación funcional interdisciplinaria que contemple intervenciones adicionales a la prescripción de ayudas ópticas. Conclusiones: Los servicios interdisciplinarios obtienen mejores resultados en cuanto a las transformaciones que logran las personas en: aceptación de la condición de baja visión, movilidad, acceso a tecnología, y reconocimiento de derechos.
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Duquette J, Loiselle J, Fréchette C, Déry L, Senécal MJ, Wittich W, Wanet-Defalque MC. Reliability and validity of the Canadian-French ecological adaptation of the weighted version of the Melbourne low-vision ADL Index. Disabil Rehabil 2019; 42:1021-1030. [PMID: 30714431 DOI: 10.1080/09638288.2018.1516813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: The Mesure de l'impact de la déficience visuelle dans les activités quotidiennes (MIDVAQ) is the Canadian-French adaptation of the Melbourne Low-Vision ADL Index. It measures performance, personal importance and handicap situation in 16 instrumental activities requiring near vision (standardized material, part A) and in 9 self-care and domestic activities (self-report questionnaire, part B). This study aimed at measuring the MIDVAQ reliability and its relationship with measures of visual functions and functional vision.Methods: The MIDVAQ was administered twice to 100 visually impaired participants, at home, with their personal visual and non-visual aid. A second rater was present at T1. Two different versions of part A were used alternately at T1 and T2.Results: The total Handicap scale demonstrates good internal reliability (Cronbach's alpha coefficient = 0.82) and very high inter-rater and test-retest reliability (ICCs = 1.00 and 0.86). Part A alternative versions are highly comparable. Vision function measures are significantly correlated with total Handicap score, for which 48% of the variance is explained by functional vision estimates, age, and education.Conclusions: The MIDVAQ is highly valid and reliable. It can be useful to measure the functional impact of the visual impairment, its progression, and the outcomes of low vision rehabilitation services.Implications for rehabilitationEven if administered at home in an ecological way, this measure of the impact of the visual impairment in daily activities is very reliable.Given its good metric properties, this tool can be confidently used to assess the functional impact of visual impairment, outcomes of the low vision rehabilitation services, etc.This measurement tool provides complementary information to those obtained from clinical measures of visual functions, by reflecting the interaction between the functional abilities with the requirements of the environment.
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Affiliation(s)
- Josée Duquette
- Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Longueuil, Canada.,Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, Montréal, Canada
| | | | | | - Lise Déry
- Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Longueuil, Canada.,Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, Montréal, Canada
| | - Marie-Josée Senécal
- Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Longueuil, Canada.,Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, Montréal, Canada
| | - Walter Wittich
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, Montréal, Canada.,School of Optometry, University of Montreal, Montreal, Canada
| | - Marie-Chantal Wanet-Defalque
- Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Longueuil, Canada.,Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, Montréal, Canada.,School of Optometry, University of Montreal, Montreal, Canada
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Duquette J, Loiselle J, Fréchette C, Déry L, Senécal MJ. Occupational performance in the basic and instrumental daily activities of persons with low vision who received rehabilitation services. Br J Occup Ther 2018. [DOI: 10.1177/0308022618808734] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction The objective was to describe the occupational performance in basic and instrumental daily activities of persons living in the community who have received comprehensive interdisciplinary low vision rehabilitation services. Method The Mesure de l'impact de la déficience visuelle dans les activités quotidiennes (a measure of the impact of visual impairment in daily activities) was administered at home to 102 individuals who participated in a comprehensive low vision rehabilitation program. Performance in 16 near-vision activities was measured with the person's aids and strategies; nine more global tasks were questionnaire-based. Handicap scores were obtained by multiplying performance × importance ratings. Results Average performance was satisfactory or very satisfactory for 21/25 items, even if 92% of the participants had a moderate or severe visual impairment. A severe or total handicap was present in at least one activity for 79% of the subjects. The most handicapping activities required visual searches of finely printed information on a complex or visually crowded document, or shopping and mobility. Conclusion People with low vision who took part in a comprehensive rehabilitation program generally face no or slight handicap situations in their basic and instrumental daily activities. However, major handicap situations may remain in some important activities.
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Affiliation(s)
- Josée Duquette
- Research Officer, CISSS de la
Montérégie-Centre – Institut Nazareth et Louis-Braille, Longueuil, QC, Canada
- Clinician/health care professional
member, Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal,
Montreal, CA, Canada
| | | | | | - Lise Déry
- Clinician/health care professional
member, Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal,
Montreal, CA, Canada
- Low Vision Therapist, CISSS de la
Montérégie-Centre – Institut Nazareth et Louis-Braille, Longueuil, QC, Canada
| | - Marie-Josée Senécal
- Clinician/health care professional
member, Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal,
Montreal, CA, Canada
- Optometrist, CISSS de la
Montérégie-Centre – Institut Nazareth et Louis-Braille, Longueuil, QC, Canada
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Ehrlich JR, Spaeth GL, Carlozzi NE, Lee PP. Patient-Centered Outcome Measures to Assess Functioning in Randomized Controlled Trials of Low-Vision Rehabilitation: A Review. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2017; 10:39-49. [PMID: 27495171 DOI: 10.1007/s40271-016-0189-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Low-vision rehabilitation (LVR) aims to improve the functioning of patients with chronic uncorrectable visual impairment. LVR is inherently a patient-centered intervention since its approach and goals are dictated by the needs and abilities of each individual patient. Accordingly, it is essential to have patient-centered outcome (PCO) measures to assess and compare the efficacy and effectiveness of low-vision interventions; however, there is a lack of evidence on the effectiveness of LVR interventions. We reviewed the literature in order to identify randomized controlled trials (RCTs) in the field of LVR and the outcome measures used to assess patient functioning in these trials. We identified 15 RCTs of LVR that employed nine unique patient-reported, five unique performance-based, and one hybrid (combined patient-reported and performance) outcome measures. Since these trials used distinct tools to assess patient functioning, it is difficult to compare the effectiveness of competing rehabilitation interventions across studies. Selecting valid outcome measures that are both relevant to LVR goals of specific patient populations and that measure functioning across a range of visually demanding tasks could improve the ability to detect the effect of LVR and to compare rehabilitation strategies. There are advantages and limitations to the use of both patient-reported and performance-based outcome measures, and additional work should be undertaken to explore the relationship between these modes of assessment, as well as strategies for optimally integrating these approaches. Careful selection of outcome measures in the design of future RCTs in LVR may lead to improved understanding of the effectiveness of LVR and, ultimately, to improved functioning of patients with low vision.
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Affiliation(s)
- Joshua R Ehrlich
- Department of Ophthalmology and Visual Sciences, University of Michigan, 1000 Wall Street, Ann Arbor, MI, 48103, USA. .,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA. .,Center for Eye Policy and Innovation, University of Michigan, Ann Arbor, MI, USA.
| | - George L Spaeth
- Glaucoma Research Center, Wills Eye Hospital, Philadelphia, PA, USA
| | - Noelle E Carlozzi
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA.,Center for Clinical Outcomes Development and Application (CODA), University of Michigan, Ann Arbor, MI, USA.,Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA
| | - Paul P Lee
- Department of Ophthalmology and Visual Sciences, University of Michigan, 1000 Wall Street, Ann Arbor, MI, 48103, USA.,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA.,Center for Eye Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
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Prem Senthil M, Khadka J, Pesudovs K. Assessment of patient-reported outcomes in retinal diseases: a systematic review. Surv Ophthalmol 2017; 62:546-582. [DOI: 10.1016/j.survophthal.2016.12.011] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 12/19/2016] [Accepted: 12/20/2016] [Indexed: 02/03/2023]
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Deemer AD, Massof RW, Rovner BW, Casten RJ, Piersol CV. Functional Outcomes of the Low Vision Depression Prevention Trial in Age-Related Macular Degeneration. Invest Ophthalmol Vis Sci 2017; 58:1514-1520. [PMID: 28273318 PMCID: PMC5361587 DOI: 10.1167/iovs.16-20001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To compare the efficacy of behavioral activation (BA) plus low vision rehabilitation with an occupational therapist (OT-LVR) with supportive therapy (ST) on visual function in patients with age-related macular degeneration (AMD). Methods Single-masked, attention-controlled, randomized clinical trial with AMD patients with subsyndromal depressive symptoms (n = 188). All subjects had two outpatient low vision rehabilitation optometry visits, then were randomized to in-home BA + OT-LVR or ST. Behavioral activation is a structured behavioral treatment aiming to increase adaptive behaviors and achieve valued goals. Supportive therapy is a nondirective, psychological treatment that provides emotional support and controls for attention. Functional vision was assessed with the activity inventory (AI) in which participants rate the difficulty level of goals and corresponding tasks. Participants were assessed at baseline and 4 months. Results Improvements in functional vision measures were seen in both the BA + OT-LVR and ST groups at the goal level (d = 0.71; d = 0.56 respectively). At the task level, BA + OT-LVR patients showed more improvement in reading, inside-the-home tasks and outside-the-home tasks, when compared to ST patients. The greatest effects were seen in the BA + OT-LVR group in subjects with a visual acuity ≥20/70 (d = 0.360 reading; d = 0.500 inside the home; d = 0.468 outside the home). Conclusions Based on the trends of the AI data, we suggest that BA + OT-LVR services, provided by an OT in the patient's home following conventional low vision optometry services, are more effective than conventional optometric low vision services alone for those with mild visual impairment. (ClinicalTrials.gov number, NCT00769015.)
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Affiliation(s)
- Ashley D Deemer
- Lions Vision Research and Rehabilitation Center, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Robert W Massof
- Lions Vision Research and Rehabilitation Center, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Barry W Rovner
- Departments of Psychiatry, Neurology, and Ophthalmology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, United States
| | - Robin J Casten
- Department of Psychiatry and Human Behavior, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, United States
| | - Catherine V Piersol
- Department of Occupational Therapy, Jefferson Elder Care, Jefferson School of Health Professions, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
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Abstract
PURPOSE To compare low-vision rehabilitation (LVR) clinicians' predictions of the probability of success of LVR with patients' self-reported outcomes after provision of usual outpatient LVR services and to determine if patients' traits influence clinician ratings. METHODS The Activity Inventory (AI), a self-report visual function questionnaire, was administered pre-and post-LVR to 316 low-vision patients served by 28 LVR centers that participated in a collaborative observational study. The physical component of the Short Form-36, Geriatric Depression Scale, and Telephone Interview for Cognitive Status were also administered pre-LVR to measure physical capability, depression, and cognitive status. After patient evaluation, 38 LVR clinicians estimated the probability of outcome success (POS) using their own criteria. The POS ratings and change in functional ability were used to assess the effects of patients' baseline traits on predicted outcomes. RESULTS A regression analysis with a hierarchical random-effects model showed no relationship between LVR physician POS estimates and AI-based outcomes. In another analysis, kappa statistics were calculated to determine the probability of agreement between POS and AI-based outcomes for different outcome criteria. Across all comparisons, none of the kappa values were significantly different from 0, which indicates that the rate of agreement is equivalent to chance. In an exploratory analysis, hierarchical mixed-effects regression models show that POS ratings are associated with information about the patient's cognitive functioning and the combination of visual acuity and functional ability, as opposed to visual acuity or functional ability alone. CONCLUSIONS Clinicians' predictions of LVR outcomes seem to be influenced by knowledge of patients' cognitive functioning and the combination of visual acuity and functional ability-information clinicians acquire from the patient's history and examination. However, clinicians' predictions do not agree with observed changes in functional ability from the patient's perspective; they are no better than chance.
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Binns AM, Bunce C, Dickinson C, Harper R, Tudor-Edwards R, Woodhouse M, Linck P, Suttie A, Jackson J, Lindsay J, Wolffsohn J, Hughes L, Margrain TH. How Effective is Low Vision Service Provision? A Systematic Review. Surv Ophthalmol 2012; 57:34-65. [DOI: 10.1016/j.survophthal.2011.06.006] [Citation(s) in RCA: 145] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2010] [Revised: 06/16/2011] [Accepted: 06/21/2011] [Indexed: 12/31/2022]
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Warrian KJ, Lorenzana LL, Lankaranian D, Dugar J, Wizov SS, Spaeth GL. The assessment of disability related to vision performance-based measure in diabetic retinopathy. Am J Ophthalmol 2010; 149:852-60.e1. [PMID: 20399929 DOI: 10.1016/j.ajo.2009.12.028] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2009] [Revised: 12/08/2009] [Accepted: 12/12/2009] [Indexed: 10/19/2022]
Abstract
PURPOSE To validate a third-generation performance-based measure of visual function titled "Assessment of Disability Related to Vision" (ADREV) in a study population of patients with diabetic retinopathy. DESIGN Prospective, cross-sectional study. METHODS Patients with nonproliferative or proliferative diabetic retinopathy, free from ocular comorbidity, were recruited from a single institute and completed the ADREV, the 25-Item National Eye Institute Visual Functioning Questionnaire (VFQ-25), and a clinical ophthalmic examination. Correlation, regression, and bootstrap analysis were conducted to determine the relationship between ADREV scoring and each of the study's clinical and self-report measures of visual ability, while controlling for potential confounders. RESULTS Ninety-one patients with diabetic retinopathy completed the study and analysis showed that the ADREV total and subscale scores shared a stronger relationship with the clinical measures of visual function than did the VFQ total and subscale scores. Regression analysis revealed that binocular visual acuity, contrast sensitivity, and better eye visual field were the best predictors of ADREV performance. CONCLUSIONS The ADREV performance measure is a valid instrument for the assessment of disability related to vision in patients with diabetic retinopathy. Furthermore, the assessments provided by ADREV were more related to traditional clinical indicators of visual impairment than were the results of the self-report measure, specifically the VFQ-25.
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12
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Warrian KJ, Altangerel U, Spaeth GL. Performance-based Measures of Visual Function. Surv Ophthalmol 2010; 55:146-61. [DOI: 10.1016/j.survophthal.2009.06.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2009] [Accepted: 06/09/2009] [Indexed: 10/20/2022]
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Abstract
PURPOSE To validate a new third-generation performance-based measure titled the "assessment of disability related to vision" (ADREV) in a study population of individuals with age-related macular degeneration. METHODS Patients with either exudative or nonexudative age-related macular degeneration, but without ocular comorbidity, completed the ADREV, the 25-item National Eye Institute's visual functioning questionnaire, and a range of clinical assessments. Correlations were calculated between the data provided by the ADREV, visual functioning questionnaire, and clinical ophthalmic measures. Regression and bootstrap analysis were preformed to determine the relative relationship between specific clinical measures and ADREV performance, while controlling for a range of potentially confounding factors. RESULTS One hundred twelve patients completed the study and correlative analysis showed that ADREV total and subscale scores were more related to nearly all measures of clinical ophthalmic status in comparison with the data provided by the visual functioning questionnaire. Significant correlative relationships between ADREV and visual functioning questionnaire scores showed moderate to high correlation. Central visual acuity and contrast sensitivity shared the strongest association with performance of activities. CONCLUSIONS The ADREV is a valid instrument for the assessment of visual disability in patients with age-related macular degeneration. Furthermore, the data provided by this performance measure had stronger relationships with clinical indicators of visual impairment in comparison with self-report.
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De l'Aune W, Williams M, Watson GR, Schuckers P, Ventimiglia G. Clinical Application of a Self-Report, Functional Independence Outcomes Measure in the DVA's Blind Rehabilitation Service. JOURNAL OF VISUAL IMPAIRMENT & BLINDNESS 2004. [DOI: 10.1177/0145482x0409800402] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This article reports on a self-report measure of functional independence that is being used to measure outcomes of blind rehabilitation programs in the Department of Veterans Affairs (DVA). Analyses of the data have resulted in the clinical protocol that is currently in use nationally by the DVA Blind Rehabilitation Service.
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Affiliation(s)
- William De l'Aune
- Rehabilitation R&D Center on Aging and Vision Loss, Atlanta Veterans Affairs Medical Center, 1670 Clairmont Road, Decatur, GA 30033
| | - Michael Williams
- Rehabilitation R&D Center on Aging and Vision Loss, Atlanta Veterans Affairs Medical Center, 1670 Clairmont Road, Decatur, GA 30033
| | - Gale R. Watson
- Rehabilitation R&D Center on Aging and Vision Loss, Atlanta Veterans Affairs Medical Center, 1670 Clairmont Road, Decatur, GA 30033
| | - Penny Schuckers
- Eastern Blind Rehabilitation Service, VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT, 06516
| | - Gale Ventimiglia
- Eastern Blind Rehabilitation Service, VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT, 06516
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Abstract
To evaluate the quality of life (QOL) of elderly Japanese glaucoma patients, we performed a survey of 114 outpatients of a university eye clinic aged from 47 to 86 years. We examined 110 cases using one-way anova, Bonferroni's multiple comparison, non-parametric Mann-Whitney U-test and Pearson's correlation coefficient analysis. The group with better traditional visual measures had better QOL than the group with worse visual acuity. In the elderly groups of patients, the loss of hopes for future life and its consequences caused greater reduction in QOL than did the symptoms of glaucoma. The reliability of our questionnaire was high as determined using alpha-coefficients of Cronbach reliability analysis. Our questionnaire was reliable and useful for the assessment of QOL of elderly Japanese glaucoma patients.
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Affiliation(s)
- Yoko Uenishi
- Division of Community Health, Osaka City University College of Nursing, Abeno-Ku, Japan.
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