The Veterans Affairs Low-Vision Visual Functioning Questionnaire-48 (VA LV VFQ-48): Performance of the Italian version

2019 ◽  
Vol 30 (5) ◽  
pp. 1014-1018
Author(s):  
Ilaria Di Maggio ◽  
Gianni Virgili ◽  
Giovanni Giacomelli ◽  
Vittoria Murro ◽  
Giovanni Sato ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Visual Information ◽  
Low Vision ◽  
Reading Speed ◽  
Veterans Affairs ◽  
Age Related Macular Degeneration ◽  
Italian Version ◽  
Visual Functioning ◽  
Age Related ◽  
Patient Reported

Purpose: The Veterans Affairs Low-Vision Visual Functioning Questionnaire-48 is among the most validated tools to collect patient-reported outcomes in a low-vision population. We have aimed to conduct a pilot validation of the Italian version of the Veterans Affairs Low-Vision Visual Functioning Questionnaire-48. Methods: The Veterans Affairs Low-Vision Visual Functioning Questionnaire-48 was translated using a standardized procedure and then administered to consecutive low-vision patients attending rehabilitation services in three centers. Patients were interviewed by a trained psychologist regarding the individual items of the tool. Results: We included 131 patients with a mean visual acuity of 0.91 logMAR (standard deviation: 0.42 logMAR), mostly affected by age-related macular degeneration. The Veterans Affairs Low-Vision Visual Functioning Questionnaire-48 showed high internal consistency (Cronbach’s alpha: 0.98) and good item-test and item-rest correlation (median: 0.73 and 0.71, respectively). Both the overall score and the subscale (reading, visual motor, mobility and visual information) scores significantly correlated with visual acuity, reading acuity and speed. Reading speed achieved the best absolute correlation with the Veterans Affairs Low-Vision Visual Functioning Questionnaire-48 scores (Spearman r: 0.39–0.49). Conclusion: The Italian version of the Veterans Affairs Low-Vision Visual Functioning Questionnaire-48 is a valid tool to assess patients attending low-vision services. Revising a few items may further improve the tool.

scholarly journals Vision Rehabilitation in Patients with Age-related Macular Degeneration

2014 ◽  
Vol 3 ◽  
pp. RPO.S12364 ◽  
Author(s):  
Filippo M. Amore ◽  
Stefania Fortini ◽  
Valeria Silvestri ◽  
Marco Sulfaro ◽  
Alessia Pacifici ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Degeneration ◽  
Visual Stimulation ◽  
Low Vision ◽  
Reading Speed ◽  
Age Related Macular Degeneration ◽  
International Agency ◽  
Visual Rehabilitation ◽  
Age Related ◽  
Fixation Stability

Background The aim of this study was to investigate the rehabilitative process and visual rehabilitation outcomes in patients with central vision loss due to age-related macular degeneration (AMD). Methods Ninety-five subjects with AMD selected from the attendees of the National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of Low Vision Patients—International Agency for Prevention of Blindness—IAPB Italia Onlus, were evaluated for this retrospective study. Low vision examination included psychological counseling, best corrected visual acuity (BCVA), near visual acuity, Pelli-Robson contrast sensitivity, and fixation stability analysis. Once the clinical assessment was completed, patients attended a low-vision rehabilitative pathway based on visual stimulation, devices training and, if needed, psychological support. Required magnification and reading speed were also evaluated. Results For the whole sample, the mean BCVA of the better eye was 0.7 (±0.2) LogMAR and of the worse eye was 1 (±0.2) LogMAR. Restoring reading ability was the most important focus for the patients examined as it was requested by 85% of the whole sample. Mean power of optical magnifying aids for near activities was 10.6 (±9.1) positive spherical diopters. Mean reading speed for the whole sample was 33.1 (±18.2) words per minute (wpm) before visual rehabilitation sessions and increased to 55.2 (±33.1) wpm after visual rehabilitation path. To cope with distance difficulties, 78 distance refractive correction, 10 Galilean telescopes, and 7 Keplerian telescopes were prescribed. For intermediate distance activities, 22 compensation lenses and 10 Galilean telescopes were suggested. Moreover, PC magnifier softwares were prescribed to nine patients. Sixty-five polarized medical filters were prescribed to reduce glare of sunlight. Because of unstable fixation in their better eye (32.3% (±19.7) within 2° circle and 54.8% (±22.9) within 4° circle) and visual acuity < 1.2 LogMAR in the fellow eye, 38 subjects, before starting the devices training sessions, attended a bio-feedback rehabilitation session with flickering pattern stimulus. In these subjects, fixation stability increased significantly to 75.6 (±14.9) within 2° and 89.4 (±19.5) within 4° ( P < 0.05), respectively. Conclusions Attending a customized low-vision intervention based on a multidisciplinary approach seems to be effective for improving visual functions in AMD. Both optical/electronic magnifiers and specific visual stimulation program can enhance visual performances.

Core outcomes for geographic atrophy trials

2019 ◽  
pp. bjophthalmol-2019-314949
Author(s):  
Aniela Krystyna Krezel ◽  
Ruth Hogg ◽  
Lynne Lohfeld ◽  
Usha Chakravarthy ◽  
Augusto Azuara-Blanco
Keyword(s):  
Visual Acuity ◽  
Focus Groups ◽  
Reading Speed ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Outer Retina ◽  
Age Related ◽  
Patient Reported ◽  
Core Outcomes ◽  
Delphi Exercise

Background/AimsOngoing and recent clinical trials for geographic atrophy (GA) have used different outcomes. The goal of this study was to identify a core outcome set (COS) important for patients, clinicians and researchers, and to propose the use of COS in the design of future GA trials.MethodsFive-component project including: Delphi method with patients and experts, focus groups and interviews with patients, relatives and workers supporting patients. Three hundred and one patients (301) with age-related macular degeneration participated in round 1 of a Delphi exercise. Most subjects had GA; 183 patients (61%) were females and the median (range) age was 77 (50–99) years. In round 2, of the 301 of the first round, 100 participants were randomly selected of whom 76 agreed to take part. In a parallel Delphi exercise, panellists comprised a mix of non-clinical scientists and clinicians (43 in the initial and 21 in the final round). In addition, interviews and focus groups consisting of patients (n=20), family members (n=4) and support workers (n=5) were undertaken.ResultsCore outcomes identified as important for age-related macular degeneration trials were the health of the outer retina, multimodal estimation of lesion size, reading speed, best corrected distance and near acuity, low luminance visual acuity, patient reported visual performance and safety.ConclusionThis study identified a set of core outcomes that should be used in GA trials. The COS include patient-reported outcome measures, near visual acuity, reading speed and assessment of the outer retina.

The Experience of a Randomized Clinical Trial of Closed-Circuit Television versus Eccentric Viewing Training for People with Age-Related Macular Degeneration

2017 ◽  
Vol 111 (4) ◽  
pp. 354-368 ◽  
Author(s):  
Susan J. Leat ◽  
Francie Fengqin Si ◽  
Deborah Gold ◽  
Dawn Pickering ◽  
Keith Gordon ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Degeneration ◽  
Vision Loss ◽  
Low Vision ◽  
Reading Speed ◽  
Optical Devices ◽  
Reading Performance ◽  
Age Related Macular Degeneration ◽  
Eccentric Viewing ◽  
Age Related

Introduction In addition to optical devices, closed-circuit televisions (CCTVs) and eccentric viewing training are both recognized interventions to improve reading performance in individuals with vision loss secondary to age-related macular degeneration. Both are relatively expensive, however, either in the cost of the device or in the amount of time personnel need to provide training. In this randomized trial, we compared the effectiveness of these two interventions. Methods Participants with age-related macular degeneration and visual acuity between 6/48 (20/160) and 6/120 (20/400) first received basic low vision care, including optical devices. At the subsequent baseline visit, they undertook a battery of measures including logMAR visual acuity; reading speed and accuracy for text in 1.3M and 1M fonts; reading information on medicine bottles, utility bills, and food packages; the NEI-VFQ; the Geriatric Depression Scale; and a reading inventory questionnaire. They were then randomized to either obtaining a CCTV for home use or eccentric viewing training over the following six weeks. Results Recruitment was more difficult than expected for this population. Of 145 patients referred, 29 met the inclusion-exclusion criteria, 14 were willing to enroll, and 10 completed the trial. For the primary outcome (reading speed for 1.3M print), there was a significant improvement between baseline and outcome for the CCTV group (p = 0.005), but not for the eccentric viewing training group (p = 0.28), and the CCTV group showed significantly greater change (p = 0.04). There was a nonsignificant improvement in reading speed for 1M text and a decrease in the amount of time taken to read utility bill information in the CCTV group. There was a significant improvement in near visual acuity with current glasses with eccentric viewing training. The other measures did not reach statistical significance. Discussion Randomized clinical trials for low vision rehabilitation, particularly in the elderly population with vision loss, are challenging, but such trials are important for the allocation of resources. This trial showed early indications of more impact on reading performance from CCTV than eccentric viewing training.

Loss of vision

2018 ◽  
Author(s):  
Susan Mollan ◽  
Alastair Denniston
Keyword(s):  
Visual Acuity ◽  
Contact Lenses ◽  
Low Vision ◽  
Visual Field Loss ◽  
Age Related Macular Degeneration ◽  
World Health ◽  
Clinical Approach ◽  
Loss Of Vision ◽  
P Loss ◽  
Age Related

Loss of vision describes a reduction in vision that cannot be corrected by glasses or contact lenses. Patients who complain of changes in their vision may have loss of visual acuity, distorted vision, or visual field loss. The World Health Organization classifies visual impairment as blindness or low vision. Blindness is defined as visual acuity of less than 3/60 in the better eye. Low vision is present when the visual acuity is less than 6/18 but equal to or better than 3/60, in the better eye. The etiology of permanent visual loss is diverse and depends on the region studied. In the UK, the leading causes are age-related macular degeneration, glaucoma, diabetic retinopathy, optic atrophy, and cataract. This chapter describes the clinical approach to the patient with loss of vision.

Réapprendre à voir le monde : Rééduquer les personnes atteintes de dégénérescence maculaire en exploitant les capacités perceptives et cognitives de la vision périphérique

2005 ◽  
Vol 24 (4) ◽  
pp. 339-352
Author(s):  
Guillaume Giraudet ◽  
Christian Corbé ◽  
Corinne Roumes
Keyword(s):  
Visual Information ◽  
Vision Loss ◽  
Peripheral Vision ◽  
Low Vision ◽  
Contextual Information ◽  
Age Related Macular Degeneration ◽  
Sensory Data ◽  
Eccentric Fixation ◽  
Age Related ◽  
Vision Care

ABSTRACTAge-related macular degeneration (ARMD) is a frequent cause of vision loss among people over age of 60. It is an aging process involving a progressive degradation of the central retina. It does not induce total blindness, since it does not affect the peripheral vision. Nonetheless, it makes difficult to read, drive, and perform all daily activities requiring fine details perception. Low-vision care consists in inducing an eccentric fixation so that relevant visual targets impact an unaffected retinal locus. It is necessary but not sufficient to enhance visual extraction. The present work aims to draw the attention of low-vision professionals to the necessity of developing new re-education tools. Beyond the perceptual re-education linked to an optimization of visual information extraction, a cognitive re-education should also be provided in order to enhance the interpretation processes. Indeed, the spatial-frequency properties of the visual world no longer match patient perceptual habits. The visually impaired person has to learn again to use these new sensory data in an optimal way. Contextual information can be a precious help in this learning process. An experimental study involving young people provides elements for another method of low-vision care, in terms of visual cognitive re-education.

Long term outcomes in dry age-related macular degeneration following low vision rehabilitation interventions

2020 ◽  
pp. 112067212097362
Author(s):  
Yulia Pyatova ◽  
Monica Daibert-Nido ◽  
Samuel N Markowitz
Keyword(s):  
Visual Acuity ◽  
Low Vision ◽  
Age Related Macular Degeneration ◽  
Age Related ◽  
Low Vision Rehabilitation ◽  
Fixation Stability ◽  
Functional Vision ◽  
Vision Rehabilitation ◽  
Distance Vision

Background: Age-related macular degeneration (AMD) is the leading cause of loss of vision in the older age groups. In the absence of a known therapy, low vision rehabilitation aims at preserving residual functional vision at optimal levels. Long term functional outcomes from Low Vision Rehabilitation (LVR) in AMD cases were never scrutinized in the past. This study brings some clarification in this matter. Methods: This is a retrospective case series study including data up to 2 years following the baseline visit. Low Vision Assessments included microperimetry testing and recommendations for low vision devices for distance vision. Outcomes measures selected for this study were best corrected distance visual acuity, fixation stability and preferred retinal locus (PRL) topography and LVR interventions. Results: Data on 17 patients with an average age of 89.2 ± 4.4 years was collected. In those with better vision than 20/400 loss of vision was about 1.4 letter per year as tested with ETDRS charts compared with losses of four letters per year in a population without LVR interventions. Fixation stability continued to deteriorate while PRL eccentricity seemed to remain the same. In about half of cases there was a change in the topographic location of the PRL to a different retinal quadrant. Conclusion: Long term, as expected, changes were noticed in visual acuity, fixation stability and PRL topography. However, it seems that LVR interventions for distance vision help patients retain significantly better functional vision at the 2 years follow up interval when compared to others.

scholarly journals Correlation between Visual Functions and Retinal Morphology in Eyes with Early and Intermediate Age-Related Macular Degeneration

2020 ◽  
Vol 17 (17) ◽  
pp. 6379
Author(s):  
Rituparna Ghoshal ◽  
Sharanjeet Sharanjeet-Kaur ◽  
Norliza Mohamad Fadzil ◽  
Haliza Abdul Mutalib ◽  
Somnath Ghosh ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Degeneration ◽  
Layer Thickness ◽  
Reading Speed ◽  
Retinal Pigment ◽  
Age Related Macular Degeneration ◽  
Morphological Alteration ◽  
Retinal Layer ◽  
Visual Functions ◽  
Age Related

In early and intermediate age related macular degeneration (ARMD), visual acuity alone has failed to explain the complete variation of vision. The aim of the present study was to determine correlation between different visual functions and retinal morphology in eyes with early and intermediate ARMD. In this single center cross sectional study, patients diagnosed as early or intermediate ARMD in at least one eye were recruited. Visual functions measured were best- corrected distance visual acuity (DVA), near vision acuity (NVA), reading speed (RS), and contrast sensitivity (CS). Parameters such as thickness (RT) and volume (RV) of the retina, outer retinal layer thickness (ORLT) and volume (ORLV), outer nuclear layer thickness (ONLT) and volume (ONLV), retinal pigment epithelium layer-Bruch’s membrane complex thickness (RPET) and volume (RPEV) were assessed employing semi-auto segmentation method of Spectralis optical coherence tomography (OCT). Twenty-six eyes were evaluated. DVA, CS, and RS showed significantly good correlation with RPET, ONLT, and ONLV, whereas NVA showed good correlation with ONLV and RPET. The present study concluded that RS, CS, NVA, and DVA represent the morphological alteration in early stages and should be tested in clinical settings. ONLT, ONLV, and RPET morphological parameters can be employed as important biomarkers in diagnosis of early to intermediate ARMD.

scholarly journals Beyond visual acuity: Patient-relevant assessment measures of visual function in retinal diseases

2021 ◽  
pp. 112067212199062
Author(s):  
María Cinta Puell ◽  
Inés Contreras ◽  
Isabel Pinilla ◽  
José Juan Escobar ◽  
Antonio Soler-García ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Clinical Practice ◽  
Outcome Measures ◽  
Visual Function ◽  
Outcome Measure ◽  
Expert Panel ◽  
Reading Speed ◽  
Evidence Synthesis ◽  
Age Related Macular Degeneration ◽  
Patient Reported

Purpose: To identify patient-reported outcomes (PROs) and other clinical outcome measures (contrast sensitivity (CS), low-luminance visual acuity (LLVA) and reading acuity or reading speed (RA-RS)), relevant to patients with age-related macular degeneration (AMD) or diabetic retinopathy (DR), which would be recommended for use in clinical practice. Methods: The RAND/UCLA Appropriateness Method, based on the synthesis of the scientific evidence and the collective judgment of an expert panel using the two-round Delphi method, was applied. The evidence synthesis was performed by searching for articles on outcome measures for AMD and/or DR published between 2005 and 2018 in English or Spanish. The expert panel consisted of 14 Spanish ophthalmologists, who rated the recommendation degree for each outcome measure on a scale of 1 (extremely irrelevant) to 9 (maximum relevance). The recommended outcome measures were established according to the panel median score and the level of the panelists’ agreement. Results: Through the evidence search, 33 PRO-specific questionnaires (21 for visual function, six for AMD, three for DR, one for AMD and DR) and two treatment satisfaction questionnaires (one on AMD and one on DR) were identified. In addition, 21 methods were found for measuring CS, five for LLVA, and nine for RA-RS. According to the panel ratings, 11 of the 64 outcome measures evaluated for AMD, and seven of the 61 evaluated for DR were recommended. Conclusion: The AMD and DR outcome measures recommended will help ophthalmologists choose the outcome measure most appropriate for their patients. Furthermore, the use of PROs will contribute to shifting clinical practice towards patient-centered medicine.

scholarly journals Causes of visual impairment and blindness among the middle-aged and elderly in northern Jordan

2002 ◽  
Vol 8 (2-3) ◽  
pp. 404-408
Author(s):  
A. Haddadin ◽  
I. Ereifej ◽  
F. Zawaida ◽  
H. Haddadin
Keyword(s):  
Visual Acuity ◽  
Low Vision ◽  
The Elderly ◽  
Education Programme ◽  
Population Based ◽  
Age Related Macular Degeneration ◽  
Age Related ◽  
Common Causes ◽  
Northern Jordan ◽  
Population Based Survey

Causes of bilateral low vision [BLLV] and bilateral blindness [BLB] were investigated among 720 outpatients aged > 45 years in Irbid, Jordan, between July 1999 and October 2000. All received full ophthalmic examinations. BLLV was defined as visual acuity < 6/18 but > 3/60 in the better eye; BLB as acuity < 3/60 in the better eye. The leading cause of BLB and BLLV was cataract. Refractive error was the second major cause of BLLV. Other common causes were diabetic retinopathy and glaucoma. Age-related macular degeneration was the single cause of BLB and BLLV for only 1.6% and 2.8% respectively. A population-based survey of BLB and BLLV in the elderly, yearly vision examinations and an ophthalmic education programme are recommended.

Sign in / Sign up

Export Citation Format

Share Document