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评估儿童低视力康复的有效性:一项观察性研究。

Assessing the effectiveness of low vision rehabilitation in children: an observational study.

作者信息

Gothwal Vijaya K, Sumalini Rebecca, Bharani Seelam

出版信息

Invest Ophthalmol Vis Sci. 2015 May;56(5):3355-60. doi: 10.1167/iovs.14-15760.

Abstract

PURPOSE

To evaluate the change in visual functioning (VF) using the L. V. Prasad-Functional Vision Questionnaire II (LVP-FVQ II) following multidisciplinary low vision rehabilitation (LVR) services in children with low vision (LV).

METHODS

Children with LV referred for the first time to the Centre for Sight Enhancement were administered the LVP-FVQ II at baseline and at 3 to 4 months' follow-up to assess the outcomes of LVR. Participants' responses to the LVP-FVQ II at baseline and follow-up were transformed into interval-level estimates of VF using Rasch analysis. Cohen's d values (effect size) were used to estimate the magnitude of change in VF.

RESULTS

A total of 183 participants completed the rehabilitation (mean age, 11.9 years; male, 57%). More than one-half of the participants had retinal disorders (55%) and most were moderately visually impaired (<20/60-20/200, 76.5%). Using the LVP-FVQ II, significant improvement in VF after rehabilitation was recorded (P < 0.0001) and the increase in VF (SD) was 1.20 (1.82) logits. Using Cohen's d, the magnitude of the improvement in LVR intervention at follow-up was found to be 0.75, indicating nearly large treatment effect.

CONCLUSIONS

Ours is the first study to provide strong evidence that LVR services result in nearly large and significant improvements in the overall VF in children with LV, regardless of the cause of LV. These results should encourage eye care professionals to refer children with LV to LVR services. Further investigation is needed to determine if the improvement in VF can be sustained over a longer duration (>4 months).

摘要

目的

使用L.V.普拉萨德功能性视力问卷II(LVP - FVQ II)评估低视力(LV)儿童接受多学科低视力康复(LVR)服务后视觉功能(VF)的变化。

方法

首次转诊至视力增强中心的LV儿童在基线时和随访3至4个月时接受LVP - FVQ II评估,以评估LVR的效果。使用拉施分析将参与者在基线和随访时对LVP - FVQ II的回答转换为VF的区间水平估计值。使用科恩d值(效应大小)来估计VF变化的幅度。

结果

共有183名参与者完成了康复(平均年龄11.9岁;男性占57%)。超过一半的参与者患有视网膜疾病(55%),大多数为中度视力障碍(<20/60 - 20/200,76.5%)。使用LVP - FVQ II,记录到康复后VF有显著改善(P < 0.0001),VF增加(标准差)为1.20(1.82)对数单位。使用科恩d值,发现随访时LVR干预的改善幅度为0.75,表明几乎有较大的治疗效果。

结论

我们的研究首次提供了有力证据,表明LVR服务能使LV儿童的整体VF有近乎较大且显著的改善,无论LV的病因如何。这些结果应鼓励眼科护理专业人员将LV儿童转诊至LVR服务。需要进一步研究以确定VF的改善是否能在更长时间(>4个月)内持续。

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