Gaffney Allannah J, Margrain Tom H, Bunce Catey V, Binns Alison M
School of Optometry and Vision Sciences, Cardiff University, Cardiff, UK.
Ophthalmic Physiol Opt. 2014 Jul;34(4):427-37. doi: 10.1111/opo.12132. Epub 2014 Apr 15.
The global prevalence of age-related macular degeneration and associated central vision loss is rising. Central vision loss hinders the performance of many activities of daily living. Adaptive strategies such as eccentric viewing and steady eye strategy may be used to compensate for central vision loss. In order to establish the potential of these rehabilitation strategies, this systematic review evaluates current literature regarding the effectiveness of eccentric viewing and steady eye strategy training in people with central vision loss.
The search strategies identified 2605 publications, 36 of which met the inclusion criteria for the review, but only three of which were randomised controlled trials. This literature shows that eccentric viewing and steady eye strategy training can improve near visual acuity, reading speed, and performance of activities of daily living in people with central vision loss. However, there was insufficient literature to establish a relationship between training and distance visual acuity or quality of life. There is no conclusive evidence to show that a particular model of eccentric viewing training is superior to another, little clear evidence of a relationship between participant characteristics and training outcomes and no data regarding the cost effectiveness of training.
This report highlights the need for further robust research to establish the true potential and cost effectiveness of eccentric viewing and steady eye strategy training as a rehabilitation strategy for individuals with central vision loss.
年龄相关性黄斑变性及相关的中心视力丧失在全球的患病率正在上升。中心视力丧失会妨碍许多日常生活活动的进行。诸如偏心注视和稳定眼策略等适应性策略可用于补偿中心视力丧失。为了确定这些康复策略的潜力,本系统评价评估了关于偏心注视和稳定眼策略训练对中心视力丧失患者有效性的现有文献。
检索策略共识别出2605篇出版物,其中36篇符合该评价的纳入标准,但只有3篇为随机对照试验。这些文献表明,偏心注视和稳定眼策略训练可提高中心视力丧失患者的近视力、阅读速度和日常生活活动能力。然而,现有文献不足以确定训练与远视力或生活质量之间的关系。没有确凿证据表明某一种偏心注视训练模式优于另一种,几乎没有明确证据表明参与者特征与训练结果之间存在关联,也没有关于训练成本效益的数据。
本报告强调需要进一步开展有力的研究,以确定偏心注视和稳定眼策略训练作为中心视力丧失患者康复策略的真正潜力和成本效益。