Baseline Traits of Low Vision Patients Served by Private Outpatient Clinical Centers in the United States
Baseline Traits of Low Vision Patients Served by Private Outpatient Clinical Centers in the United States
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DOI：
10.1001/archophthalmol.2012.1197
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发表时间：
2012-08-01
影响因子：
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通讯作者：
Sunness, Janet S.
中科院分区：
文献类型：
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作者：
Goldstein, Judith E.;Massof, Robert W.;Sunness, Janet S.
目的：了解在美国寻求门诊低视力康复 (LVR) 服务的低视力患者的特征。方法：在一项前瞻性观察研究中，我们招募了来自美国 28 个临床中心寻求门诊 LVR 服务的 764 名新低视力患者。在初次预约之前，通过电话进行了多份评估日常生活和视力、身体、心理和认知健康状况的调查问卷。记录基线临床视力障碍测量和疾病诊断。结果：患者的中位年龄为 77 岁，主要为女性 (66%)，患有黄斑疾病 (55%)，其中大多数为非新生血管性年龄相关性黄斑变性。超过三分之一的患者 (37%) 有轻度视力障碍，习惯性视力 (VA) 为 20/60 或更高。 VA 与对比敏感度相关性良好 (r=-0.52)，但与自我报告的视力质量相关性较差。摄入量调查显示了自我报告的身体健康限制，包括耐力下降（68%）和活动能力问题（52%）。许多患者表示沮丧（42%）和抑郁情绪（22%）的程度增加；记忆和认知障碍（11%）较少得到认可。患者依赖他人提供日常生活支持（87%），但许多人（31%）仍然开车。结论：大多数寻求 LVR 的患者都是老年患者，患有黄斑疾病，视力相对保留。 VA 和主观视力质量之间的差异表明 LVR 转诊是基于症状而不是仅基于 VA。接受 LVR 服务的患者患有严重的身体、心理和认知障碍，这些障碍可能会加剧视力障碍并降低康复潜力。
Objective: To characterize the traits of low vision patients who seek outpatient low vision rehabilitation (LVR) services in the United States.Methods: In a prospective observational study, we enrolled 764 new low vision patients seeking outpatient LVR services from 28 clinical centers in the United States. Before their initial appointment, multiple questionnaires assessing daily living and vision, physical, psychological, and cognitive health states were administered by telephone. Baseline clinical visual impairment measures and disorder diagnoses were recorded.Results: Patients had a median age of 77 years, were primarily female (66%), and had macular disease (55%), most of which was nonneovascular age-related macular degeneration. More than one-third of the patients (37%) had mild vision impairment with habitual visual acuity (VA) of 20/60 or greater. The VA correlated well with contrast sensitivity (r=-0.52) but poorly with self-reported vision quality. The intake survey revealed self-reported physical health limitations, including decreased endurance (68%) and mobility problems (52%). Many patients reported increased levels of frustration (42%) and depressed mood (22%); memory and cognitive impairment (11%) were less frequently endorsed. Patients relied on others for daily living support (87%), but many (31%) still drove.Conclusions: Most patients seeking LVR are geriatric and have macular disease with relatively preserved VA. The disparity between VA and subjective quality of vision suggests that LVR referrals are based on symptoms rather than on VA alone. Patients seen for LVR services have significant physical, psychological, and cognitive disorders that can amplify vision disabilities and decrease rehabilitation potential.