Goldstein Judith E, Massof Robert W, Deremeik James T, Braudway Sonya, Jackson Mary Lou, Kehler K Bradley, Primo Susan A, Sunness Janet S
Arch Ophthalmol. 2012 Aug;130(8):1028-37. doi: 10.1001/archophthalmol.2012.1197.
To characterize the traits of low vision patients who seek outpatient low vision rehabilitation (LVR) services in the United States.
In a prospective observational study, we enrolled 764 new low vision patients seeking outpatient LVR services from 28 clinical centers in the United States. Before their initial appointment, multiple questionnaires assessing daily living and vision, physical, psychological, and cognitive health states were administered by telephone. Baseline clinical visual impairment measures and disorder diagnoses were recorded.
Patients had a median age of 77 years, were primarily female (66%), and had macular disease (55%), most of which was nonneovascular age-related macular degeneration. More than one-third of the patients (37%) had mild vision impairment with habitual visual acuity (VA) of 20/60 or greater. The VA correlated well with contrast sensitivity (r = -0.52) but poorly with self-reported vision quality. The intake survey revealed self-reported physical health limitations, including decreased endurance (68%) and mobility problems (52%). Many patients reported increased levels of frustration (42%) and depressed mood (22%); memory and cognitive impairment (11%) were less frequently endorsed. Patients relied on others for daily living support (87%), but many (31%) still drove.
Most patients seeking LVR are geriatric and have macular disease with relatively preserved VA. The disparity between VA and subjective quality of vision suggests that LVR referrals are based on symptoms rather than on VA alone. Patients seen for LVR services have significant physical, psychological, and cognitive disorders that can amplify vision disabilities and decrease rehabilitation potential.
描述在美国寻求门诊低视力康复(LVR)服务的低视力患者的特征。
在一项前瞻性观察性研究中,我们纳入了764名从美国28个临床中心寻求门诊LVR服务的新的低视力患者。在他们首次就诊前,通过电话发放了多份评估日常生活、视力、身体、心理和认知健康状况的问卷。记录基线临床视力损害指标和疾病诊断结果。
患者的中位年龄为77岁,主要为女性(66%),患有黄斑疾病(55%),其中大部分是非新生血管性年龄相关性黄斑变性。超过三分之一的患者(37%)有轻度视力损害,习惯视力(VA)为20/60或更好。视力与对比敏感度相关性良好(r = -0.52),但与自我报告的视力质量相关性较差。入院调查显示患者自我报告存在身体健康限制,包括耐力下降(68%)和行动问题(52%)。许多患者报告挫折感增加(42%)和情绪低落(22%);记忆力和认知障碍(11%)的报告频率较低。患者在日常生活中依赖他人支持(87%),但许多人(31%)仍在开车。
大多数寻求LVR的患者是老年人,患有黄斑疾病且视力相对保留。视力与主观视力质量之间的差异表明,LVR转诊是基于症状而非仅基于视力。接受LVR服务的患者存在明显的身体、心理和认知障碍,这些障碍会加剧视力残疾并降低康复潜力。