Authors
Cacho, Isabel; Dickinson, Christine Margaret; Smith, Heather Jane; Harper, Robert Anthony

Clinical Impairment Measures and Reading Performance in a Large Age-Related Macular Degeneration Group

publication date
December 21, 2009
Category
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Abstract/Introduction

Purpose

To investigate the relationship between clinical impairment measures and reading performance in a large population with age-related macular degeneration.

 

Methods

The following clinical measures were evaluated on 243 patients with age-related macular degeneration: better eye distance visual acuity (ETDRS chart); threshold near word reading acuity (Bailey-Lovie Word Reading chart); maximum reading speed and critical print size (MNREAD chart); letter contrast sensitivity (Pelli-Robson); and kinetic perimetry (Bjerrum screen) to determine the nearest non-scotomatous point to fovea (NNPF; in degrees) and the central scotoma area (mm2).


Conclusion/Results

Results

Distance acuity correlated well to threshold near word acuity (r = 0.71), but word acuity was usually poorer. Critical print size was strongly related (p < 0.001) to near visual acuity (r2 = 0.31 and β = 0.47) and was poorer than threshold near word visual acuity by a mean difference of −0.41 (range, −1.10 to 0.34), which represents a mean acuity reserve of 2.5:1. On single regression, distance (p < 0.0001, r2 = 0.35, and β = −102.37) and near acuities (p < 0.0001, r2 = 0.52, β = −126.53), critical print size (p = 0.0001, r2 = 19, and β = 0.002), contrast sensitivity (p < 0.0001, r2 = 19, and β = 79.47), scotoma size (p = 0.006, r2 = 12, and β = −0.04), and NNPF (p = 0.001, r2 = 12, and β = −4.39) were all highly significantly related to reading speed although these predicted only a low percentage of variance. Best prediction of reading speed was obtained on multiple regression, where NNPF and near word acuity explained 60% of the variance (p < 0.0001).

 

Conclusions

Optimal prediction of reading speed with clinical parameters appears to be based on the combination of near word acuity and scotoma area, explaining 60% of the variance. Other factors not measured in this study are likely to account for the rest of the prediction.


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Vision Therapy is well worth the expense, time and effort. Our son had a hard time focusing handwriting neatly. After vision therapy Seth could complete a task in half the time it previously took his abilities to focus and improved greatly and so did his handwriting.

Also, he was better at listening. As a parent you wanted learning to be fun for our son and vision therapy made this possible.


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Vision Therapy has given or son the tools he needs to be able to scan and read the written word more effectively and efficiently.

He love working with John and these working sessions give him the motivation to gladly work on his homework assignments.

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When we first came to the practice, my son did not have huge issues, but lots of small ones- trouble with reading, sports (hitting the baseball consistently), coordination, etc- that were not easily detectable,but when put together presented issues. The staff here were all very professional and loving towards him. While I was concerned in the reading, my son was concerned with the athletic side. Seeing improvement night off the bat gave him confidence that i have nor seen in him and made him want to not only Come to therapy, but also made him want to work hard. He has surpassed his grade level and above in reading and hit his first home run this year! Thank you!!!


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