Visual ability of patients seeking outpatient lowvision services in the united states

Judith Goldstein, Melissa W. Chun, Donald C. Fletcher, James T Deremeik, Robert W Massof

Research output: Contribution to journalArticle

Abstract

DESIGN, SETTING, AND PARTICIPANTS As part of a prospective, observational study of new patients seeking outpatient LVR, 779 patients from 28 clinical centers in the United States were enrolled in the Low Vision Rehabilitation Outcomes Study (LVROS) from April 25, 2008, through May 2, 2011. The Activity Inventory (AI), an adaptive visual function questionnaire, was administered to measure overall visual ability and visual ability in 4 functional domains (reading, mobility, visual motor function, and visual information processing) at baseline before LVR. The Geriatric Depression Scale, Telephone Interview for Cognitive Status, and Medical Outcomes Study 36-Item Short-Form Health Survey physical functioning questionnaires were also administered to measure patients' psychological, cognitive, and physical health states, respectively.

MAIN OUTCOMES AND MEASURES Predictors of visual ability and functional domains as measured by the AI.

RESULTS Among the 779 patients in the LVROS sample, the mean age was 76.4 years, 33% were male, and the median logMAR visual acuity score was 0.60 (0.40-0.90 interquartile range). Correlations were observed between logMAR visual acuity and baseline visual ability overall (r = -0.42) and for all functional domains. Visual acuity was the strongest predictor of visual ability (P <.001) and reading ability (P <.001) and had a significant independent effect on the other functional domains. Physical ability was independently associated with (P <.001) overall visual ability as well as mobility and visual motor function. Depression had a consistent independent effect (P <.001) on overall visual ability and on all functional domains, whereas cognition had an effect on only reading and mobility (P <.001).

CONCLUSIONS AND RELEVANCE Visual ability is a multidimensional construct, with visual acuity, depression, physical ability, and cognition explaining more than one-third of the variance in visual ability as measured by the AI. The significant contributions of the nonvisual factors to visual ability measures and the rehabilitation potential (ie, ceiling) effects theymay impose on LVR are important considerations when measuring baseline visual ability and ultimately LVR outcomes in ongoing clinical research.

IMPORTANCE Most patients with low vision are elderly and have functional limitations from other health problems that could add to the functional limitations caused by their visual impairments.

OBJECTIVE To identify factors that contribute to visual ability measures in patients who present for outpatient low vision rehabilitation (LVR) services.

Original languageEnglish (US)
Pages (from-to)1169-1177
Number of pages9
JournalJAMA Ophthalmology
Volume132
Issue number10
DOIs
StatePublished - Oct 1 2014

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Aptitude
Ambulatory Care
Low Vision
Rehabilitation
Visual Acuity
Reading
Outcome Assessment (Health Care)
Depression
Equipment and Supplies
Cognition
Outpatients
Vision Disorders
Health
Health Surveys
Automatic Data Processing
Geriatrics

ASJC Scopus subject areas

  • Ophthalmology
  • Medicine(all)

Cite this

Visual ability of patients seeking outpatient lowvision services in the united states. / Goldstein, Judith; Chun, Melissa W.; Fletcher, Donald C.; Deremeik, James T; Massof, Robert W.

In: JAMA Ophthalmology, Vol. 132, No. 10, 01.10.2014, p. 1169-1177.

Research output: Contribution to journalArticle

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