Rovner Barry W, Casten Robin J, Massof Robert W, Leiby Benjamin E, Tasman William S
Department of Psychiatry, Jefferson Medical College, Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania 19107, USA.
Arch Ophthalmol. 2011 Jul;129(7):885-90. doi: 10.1001/archophthalmol.2011.146.
To investigate the effect of coping strategies, depression, physical health, and cognition on National Eye Institute Visual Function Questionnaire scores obtained at baseline in a sample of older patients with age-related macular degeneration (AMD) enrolled in the Improving Function in AMD Trial, a randomized controlled clinical trial that compares the efficacy of problem-solving therapy with that of supportive therapy to improve vision function in patients with AMD.
Baseline evaluation of 241 older outpatients with advanced AMD who were enrolled in a clinical trial testing the efficacy of a behavioral intervention to improve vision function. Vision function was characterized as an interval-scaled, latent variable of visual ability based on the near-vision subscale of the National Eye Institute Vision Function Questionnaire-25 plus Supplement.
Visual ability was highly correlated with visual acuity. However, a multivariate model revealed that patient coping strategies and cognitive function contributed to their ability to perform near-vision activities independent of visual acuity.
Patients with AMD vary in their coping strategies and cognitive function and in their visual acuity, and that variability determines patients' self-report of vision function. Understanding patient coping mechanisms and cognition may help increase the precision of vision rating scales and suggest new interventions to improve vision function and quality of life in patients with AMD. Trial Registration clinicaltrials.gov Identifier: NCT00572039.
在年龄相关性黄斑变性（AMD）老年患者样本中，调查应对策略、抑郁、身体健康和认知对在基线时获得的美国国立眼科研究所视觉功能问卷分数的影响。这些患者参加了AMD改善功能试验，这是一项随机对照临床试验，比较解决问题疗法与支持性疗法改善AMD患者视觉功能的疗效。
对241名患有晚期AMD的老年门诊患者进行基线评估，这些患者参加了一项测试行为干预改善视觉功能疗效的临床试验。视觉功能被表征为基于美国国立眼科研究所视觉功能问卷-25加补充版近视力子量表的视觉能力的区间量表潜在变量。
视觉能力与视力高度相关。然而，一个多变量模型显示，患者的应对策略和认知功能有助于他们独立于视力进行近视力活动的能力。
AMD患者在应对策略、认知功能和视力方面存在差异，这种差异决定了患者对视觉功能的自我报告。了解患者的应对机制和认知可能有助于提高视力评定量表的准确性，并提出新的干预措施以改善AMD患者的视觉功能和生活质量。试验注册 clinicaltrials.gov标识符：NCT00572039。
