The Effects of Low-Vision Rehabilitation on Reading Speed and Depression in Age Related Macular Degeneration: A Meta-Analysis

• Published in: PloS one Vol. 11; no. 7; p. e0159254
• Main Authors: Hamade, Noura, Hodge, William G, Rakibuz-Zaman, Muhammad, Malvankar-Mehta, Monali S
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 14.07.2016; Public Library of Science (PLoS)
• Subjects: Adults; Age; Age related diseases; Aged; Analysis; Biofeedback; Biology and Life Sciences; Blindness; Dentistry; Depression (Mood disorder); Depression - therapy; Epidemiology; Eye (anatomy); Feedback; GDP; Gross Domestic Product; Humans; Low vision; Macular degeneration; Macular Degeneration - psychology; Macular Degeneration - rehabilitation; Medical ethics; Medicine; Medicine and Health Sciences; Mental depression; Meta-analysis; Microscopes; Older people; Patients; Physical Sciences; Physiological aspects; Reading; Rehabilitation; Research and Analysis Methods; Risk factors; Science; Social Sciences; Studies; Vision; Visual impairment; Canada; United States > US
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0159254

Age related macular degeneration (AMD) is a progressive eye disease that, as of 2015, has affected 11 million people in the U.S. and 1.5 million in Canada causing central vision blindness. By 2050, this number is expected to double to 22 million. Eccentric vision is the target of low-vision rehabilitation aids and programs for patients with AMD, which are thought to improve functional performance by improving reading speed and depression. This study evaluates the effect of various low-vision rehabilitation strategies on reading speed and depression in patients 55 and older with AMD. Computer databases including MEDLINE (OVID), EMBASE (OVID), BIOSIS Previews (Thomson-Reuters), CINAHL (EBSCO), Health Economic Evaluations Database (HEED), ISI Web of Science (Thomson-Reuters) and the Cochrane Library (Wiley) were searched from the year 2000 to January 2015. Included papers were research studies with a sample size of 20 eyes or greater focused on AMD in adults aged 55 or older with low vision (20/60 or lower). Two independent reviewers screened and extracted relevant data from the included articles. Standardized mean difference (SMD) was chosen as an effect size to perform meta-analysis using STATA. Fixed- and random-effect models were developed based on heterogeneity. Reading Speed and Depression Scores. A total of 9 studies (885 subjects) were included. Overall, a significant improvement in reading speed was found with a SMD of 1.01 [95% CI: 0.05 to 1.97]. Low-vision rehabilitation strategies including micro-perimetric biofeedback, microscopes teaching program significantly improved reading speed. Eccentric viewing training showed the maximum improvement in reading speed. In addition, a non-significant improvement in depression scores was found with a SMD of -0.44 [95% CI: -0.96 to 0.09]. A considerable amount of research is required in the area of low-vision rehabilitation strategies for patients with AMD. Based on current research, low-vision rehabilitation aids improve reading speed. However, they do not have a significant effect on depression scores in those 55 and older with AMD.