Low Vision Service, (University Health Network Hospitals), Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada.
Eur J Ophthalmol. 2022 Jan;32(1):296-299. doi: 10.1177/1120672120973621. Epub 2020 Nov 21.
Age-related macular degeneration (AMD) is the leading cause of loss of vision in the older age groups. In the absence of a known therapy, low vision rehabilitation aims at preserving residual functional vision at optimal levels. Long term functional outcomes from Low Vision Rehabilitation (LVR) in AMD cases were never scrutinized in the past. This study brings some clarification in this matter.
This is a retrospective case series study including data up to 2 years following the baseline visit. Low Vision Assessments included microperimetry testing and recommendations for low vision devices for distance vision. Outcomes measures selected for this study were best corrected distance visual acuity, fixation stability and preferred retinal locus (PRL) topography and LVR interventions.
Data on 17 patients with an average age of 89.2 ± 4.4 years was collected. In those with better vision than 20/400 loss of vision was about 1.4 letter per year as tested with ETDRS charts compared with losses of four letters per year in a population without LVR interventions. Fixation stability continued to deteriorate while PRL eccentricity seemed to remain the same. In about half of cases there was a change in the topographic location of the PRL to a different retinal quadrant.
Long term, as expected, changes were noticed in visual acuity, fixation stability and PRL topography. However, it seems that LVR interventions for distance vision help patients retain significantly better functional vision at the 2 years follow up interval when compared to others.
年龄相关性黄斑变性（AMD）是老年人视力丧失的主要原因。在缺乏已知疗法的情况下，低视力康复旨在将残留的功能视力保持在最佳水平。过去从未仔细检查过 AMD 患者低视力康复（LVR）的长期功能结果。本研究对此问题进行了一些澄清。
这是一项回顾性病例系列研究，包括基线检查后长达 2 年的数据。低视力评估包括微视野测试和对远距离视力低视力设备的建议。本研究选择的结果测量指标为最佳矫正远视力、固视稳定性和最佳视网膜位置（PRL）地形图以及 LVR 干预。
收集了 17 名平均年龄为 89.2 ± 4.4 岁的患者的数据。在视力优于 20/400 的患者中，与未经 LVR 干预的人群每年损失 4 个字母相比，每年损失视力约为 1.4 个字母。固视稳定性继续恶化，而 PRL 偏心似乎保持不变。大约一半的病例 PRL 的地形图位置发生了变化，转移到了不同的视网膜象限。
正如预期的那样，长期以来，视力、固视稳定性和 PRL 地形图都发生了变化。然而，与其他患者相比，LVR 干预远距离视力似乎有助于患者在 2 年随访时保持更好的功能视力。
