Functional outcomes of the low vision depression prevention trial in age-related macular degeneration

Ashley Deemer, Robert W Massof, Barry W. Rovner, Robin J. Casten, Catherine V. Piersol

Research output: Contribution to journalArticle

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.)

Original languageEnglish (US)
Pages (from-to)1514-1520
Number of pages7
JournalInvestigative Ophthalmology and Visual Science
Volume58
Issue number3
DOIs
StatePublished - Mar 1 2017

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Low Vision
Macular Degeneration
Depression
Optometry
Reading
Therapeutics
Rehabilitation
Equipment and Supplies
Vision Disorders
Psychological Adaptation
Group Psychotherapy
Visual Acuity
Outpatients
Randomized Controlled Trials
Psychology

Keywords

  • Age-related macular degeneration
  • Depression
  • Low vision rehabilitation
  • Visual function

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

Cite this

Functional outcomes of the low vision depression prevention trial in age-related macular degeneration. / Deemer, Ashley; Massof, Robert W; Rovner, Barry W.; Casten, Robin J.; Piersol, Catherine V.

In: Investigative Ophthalmology and Visual Science, Vol. 58, No. 3, 01.03.2017, p. 1514-1520.

Research output: Contribution to journalArticle

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