助视器对年龄相关性黄斑变性患者视功能恢复和阅读速度的影响

Effectiveness of low vision aids in vision rehabilitation and improvement of reading speed in people with age-related macular degeneration

目的:评估助视器对年龄相关性黄斑变性(AMD)患者视功能恢复和阅读速度的影响。方法:对低视力门诊44名AMD患者进行评估。收集并分析使用助视器前和使用助视器时裸眼视力、最佳矫正视力、屈光状态、助视器类型(LVAs)以及阅读速度的相关数据。结果:共44例AMD患者,平均年龄为73±10.8岁,男性36例(82%)。其中,29例(67%)受试者视力较好的眼远视力(DVA)为1.0~1.6 LogMAR,而36例(82%)受试者近视力(NVA)小于3.2 m。使用助视器时平均DVA提高0.67±0.27 LogMAR(P=0.000)。使用LVAs时,42例患者NVA达到1 m甚至更佳,仅有2例(4.5%)没有使用LVAs的患者NVA为1 m。在使用一定时间的助视器后,有阅读能力的患者平均阅读速度从每分钟2.9±4.78字提高到每分钟71.31±29.96字(P<0.001)。15名受试者远距离视觉使用单目望远镜,而戴高倍单目镜片眼镜作为最常用的阅读辅助工具。结论:LVAs对AMD患者的视功能恢复和阅读能力的提高有一定的作用。对于AMD患者而言,接受低视力护理服务是有必要的。

AIM: To assess the effectiveness of low vision devices in visual rehabilitation of people with age-related macular degeneration (AMD).METHODS: Forty-four consecutive people with AMD were assessed in low vision clinic. Data about uncorrected and best corrected visual acuity, refractive errors, types of low vision aids (LVAs) and reading speed prior and with low vision devices were collected and analyzed.RESULTS: Among 44 people with mean age 73±10.8 years suffering from AMD, 36 (82%) were male. 29 (67%) participants had distance visual acuity (DVA) of 1.0-1.6 LogMAR in the better-seeing eyes while 36 (82%) had near visual acuity (NVA) less than 3.2 m. Mean improvement in DVA with low vision devices was 0.67±0.27 LogMAR (P=0.000). With LVAs 42 (95%) participants achieved NVA of 1 m or better whereas only two (4.5%) participants had NVA of 1 m without LVAs. With the provision of adequate LVAs, mean reading speed was improved from 2.9±4.78 words per minute (wpm) to 71.31±29.96 wpm among the group of participants who could read (P<0.001). Monocular telescopes were prescribed to 15 participants for distance vision and high plus monocular lenses in spectacle were the most common aid for reading.CONCLUSION: LVAs can play an effective role in vision rehabilitation of people with AMD and in improvement of reading abilities. Referral to low vision care services must be considered for people with AMD.