Visual Ability of Patients Seeking Outpatient Low Vision Services in the United States

IMPORTANCE: Most patients with low vision are elderly and have functional limitations from other health problems that could add to the functional limitations caused by their visual impairments. OBJECTIVE: To identify factors that contribute to visual ability measures in patients who present for outp...

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Veröffentlicht in:JAMA ophthalmology 2014-10, Vol.132 (10), p.1169-1177
Hauptverfasser: Goldstein, Judith E, Chun, Melissa W, Fletcher, Donald C, Deremeik, James T, Massof, Robert W
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container_end_page 1177
container_issue 10
container_start_page 1169
container_title JAMA ophthalmology
container_volume 132
creator Goldstein, Judith E
Chun, Melissa W
Fletcher, Donald C
Deremeik, James T
Massof, Robert W
description IMPORTANCE: Most patients with low vision are elderly and have functional limitations from other health problems that could add to the functional limitations caused by their visual impairments. OBJECTIVE: To identify factors that contribute to visual ability measures in patients who present for outpatient low vision rehabilitation (LVR) services. DESIGN, SETTING, AND PARTICIPANTS: As part of a prospective, observational study of new patients seeking outpatient LVR, 779 patients from 28 clinical centers in the United States were enrolled in the Low Vision Rehabilitation Outcomes Study (LVROS) from April 25, 2008, through May 2, 2011. The Activity Inventory (AI), an adaptive visual function questionnaire, was administered to measure overall visual ability and visual ability in 4 functional domains (reading, mobility, visual motor function, and visual information processing) at baseline before LVR. The Geriatric Depression Scale, Telephone Interview for Cognitive Status, and Medical Outcomes Study 36-Item Short-Form Health Survey physical functioning questionnaires were also administered to measure patients’ psychological, cognitive, and physical health states, respectively. MAIN OUTCOMES AND MEASURES: Predictors of visual ability and functional domains as measured by the AI. RESULTS: Among the 779 patients in the LVROS sample, the mean age was 76.4 years, 33% were male, and the median logMAR visual acuity score was 0.60 (0.40-0.90 interquartile range). Correlations were observed between logMAR visual acuity and baseline visual ability overall (r = −0.42) and for all functional domains. Visual acuity was the strongest predictor of visual ability (P  
doi_str_mv 10.1001/jamaophthalmol.2014.1747
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OBJECTIVE: To identify factors that contribute to visual ability measures in patients who present for outpatient low vision rehabilitation (LVR) services. DESIGN, SETTING, AND PARTICIPANTS: As part of a prospective, observational study of new patients seeking outpatient LVR, 779 patients from 28 clinical centers in the United States were enrolled in the Low Vision Rehabilitation Outcomes Study (LVROS) from April 25, 2008, through May 2, 2011. The Activity Inventory (AI), an adaptive visual function questionnaire, was administered to measure overall visual ability and visual ability in 4 functional domains (reading, mobility, visual motor function, and visual information processing) at baseline before LVR. The Geriatric Depression Scale, Telephone Interview for Cognitive Status, and Medical Outcomes Study 36-Item Short-Form Health Survey physical functioning questionnaires were also administered to measure patients’ psychological, cognitive, and physical health states, respectively. MAIN OUTCOMES AND MEASURES: Predictors of visual ability and functional domains as measured by the AI. RESULTS: Among the 779 patients in the LVROS sample, the mean age was 76.4 years, 33% were male, and the median logMAR visual acuity score was 0.60 (0.40-0.90 interquartile range). Correlations were observed between logMAR visual acuity and baseline visual ability overall (r = −0.42) and for all functional domains. Visual acuity was the strongest predictor of visual ability (P  &lt; .001) and reading ability (P &lt; .001) and had a significant independent effect on the other functional domains. Physical ability was independently associated with (P &lt; .001) overall visual ability as well as mobility and visual motor function. Depression had a consistent independent effect (P &lt; .001) on overall visual ability and on all functional domains, whereas cognition had an effect on only reading and mobility (P &lt; .001). CONCLUSIONS AND RELEVANCE: Visual ability is a multidimensional construct, with visual acuity, depression, physical ability, and cognition explaining more than one-third of the variance in visual ability as measured by the AI. The significant contributions of the nonvisual factors to visual ability measures and the rehabilitation potential (ie, ceiling) effects they may impose on LVR are important considerations when measuring baseline visual ability and ultimately LVR outcomes in ongoing clinical research.</description><identifier>ISSN: 2168-6165</identifier><identifier>EISSN: 2168-6173</identifier><identifier>DOI: 10.1001/jamaophthalmol.2014.1747</identifier><identifier>PMID: 25073745</identifier><language>eng</language><publisher>United States: American Medical Association</publisher><subject>Activities of Daily Living ; Aged ; Aged, 80 and over ; Ambulatory Care - utilization ; Female ; Health Surveys ; Humans ; Male ; Middle Aged ; Prospective Studies ; Psychometrics ; Psychomotor Performance ; Reading ; Sickness Impact Profile ; Surveys and Questionnaires ; United States ; Vision, Low - physiopathology ; Vision, Low - rehabilitation ; Visual Acuity - physiology ; Visual Perception ; Visually Impaired Persons - rehabilitation ; Walking</subject><ispartof>JAMA ophthalmology, 2014-10, Vol.132 (10), p.1169-1177</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a369t-dfad24648884f80e7d6b1d179528dbe6528a910aac5f9ebc12f9a780c600f4aa3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://jamanetwork.com/journals/jamaophthalmology/articlepdf/10.1001/jamaophthalmol.2014.1747$$EPDF$$P50$$Gama$$H</linktopdf><linktohtml>$$Uhttps://jamanetwork.com/journals/jamaophthalmology/fullarticle/10.1001/jamaophthalmol.2014.1747$$EHTML$$P50$$Gama$$H</linktohtml><link.rule.ids>64,230,314,776,780,881,3327,27901,27902,76232,76235</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25073745$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Goldstein, Judith E</creatorcontrib><creatorcontrib>Chun, Melissa W</creatorcontrib><creatorcontrib>Fletcher, Donald C</creatorcontrib><creatorcontrib>Deremeik, James T</creatorcontrib><creatorcontrib>Massof, Robert W</creatorcontrib><creatorcontrib>Low Vision Research Network Study Group</creatorcontrib><title>Visual Ability of Patients Seeking Outpatient Low Vision Services in the United States</title><title>JAMA ophthalmology</title><addtitle>JAMA Ophthalmol</addtitle><description>IMPORTANCE: Most patients with low vision are elderly and have functional limitations from other health problems that could add to the functional limitations caused by their visual impairments. OBJECTIVE: To identify factors that contribute to visual ability measures in patients who present for outpatient low vision rehabilitation (LVR) services. DESIGN, SETTING, AND PARTICIPANTS: As part of a prospective, observational study of new patients seeking outpatient LVR, 779 patients from 28 clinical centers in the United States were enrolled in the Low Vision Rehabilitation Outcomes Study (LVROS) from April 25, 2008, through May 2, 2011. The Activity Inventory (AI), an adaptive visual function questionnaire, was administered to measure overall visual ability and visual ability in 4 functional domains (reading, mobility, visual motor function, and visual information processing) at baseline before LVR. The Geriatric Depression Scale, Telephone Interview for Cognitive Status, and Medical Outcomes Study 36-Item Short-Form Health Survey physical functioning questionnaires were also administered to measure patients’ psychological, cognitive, and physical health states, respectively. MAIN OUTCOMES AND MEASURES: Predictors of visual ability and functional domains as measured by the AI. RESULTS: Among the 779 patients in the LVROS sample, the mean age was 76.4 years, 33% were male, and the median logMAR visual acuity score was 0.60 (0.40-0.90 interquartile range). Correlations were observed between logMAR visual acuity and baseline visual ability overall (r = −0.42) and for all functional domains. Visual acuity was the strongest predictor of visual ability (P  &lt; .001) and reading ability (P &lt; .001) and had a significant independent effect on the other functional domains. Physical ability was independently associated with (P &lt; .001) overall visual ability as well as mobility and visual motor function. Depression had a consistent independent effect (P &lt; .001) on overall visual ability and on all functional domains, whereas cognition had an effect on only reading and mobility (P &lt; .001). CONCLUSIONS AND RELEVANCE: Visual ability is a multidimensional construct, with visual acuity, depression, physical ability, and cognition explaining more than one-third of the variance in visual ability as measured by the AI. The significant contributions of the nonvisual factors to visual ability measures and the rehabilitation potential (ie, ceiling) effects they may impose on LVR are important considerations when measuring baseline visual ability and ultimately LVR outcomes in ongoing clinical research.</description><subject>Activities of Daily Living</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Ambulatory Care - utilization</subject><subject>Female</subject><subject>Health Surveys</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Prospective Studies</subject><subject>Psychometrics</subject><subject>Psychomotor Performance</subject><subject>Reading</subject><subject>Sickness Impact Profile</subject><subject>Surveys and Questionnaires</subject><subject>United States</subject><subject>Vision, Low - physiopathology</subject><subject>Vision, Low - rehabilitation</subject><subject>Visual Acuity - physiology</subject><subject>Visual Perception</subject><subject>Visually Impaired Persons - rehabilitation</subject><subject>Walking</subject><issn>2168-6165</issn><issn>2168-6173</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkU9LAzEQxYMoVrRfwIPk6KU1yWaT7EUo4j8oKGh7DbO72TZ1d1M3WcVvb0q12rnMkHnvl4GHEKZkTAmhVytowK2XYQl14-oxI5SPqeTyAJ0wKtRIUJkc7maRDtDQ-xWJpQjhSXqMBiwlMpE8PUHzufU91HiS29qGL-wq_AzBmjZ4_GLMm20X-KkP6-0bnrpPHB3WtXHbfdjCeGxbHJYGz1obTIlfAgTjz9BRBbU3w59-imZ3t683D6Pp0_3jzWQ6gkRkYVRWUDIuuFKKV4oYWYqcllRmKVNlbkRskFECUKRVZvKCsioDqUghCKk4QHKKrrfcdZ83pizijR3Uet3ZBrov7cDq_U1rl3rhPrSQXKSSRcDlD6Bz773xQTfWF6auoTWu95oKSqSgiZJRqrbSonPed6bafUOJ3iSj95PRm2T0Jplovfh_5s74m0MUnG8FkfCHVYoxRpNvD_aYwQ</recordid><startdate>20141001</startdate><enddate>20141001</enddate><creator>Goldstein, Judith E</creator><creator>Chun, Melissa W</creator><creator>Fletcher, Donald C</creator><creator>Deremeik, James T</creator><creator>Massof, Robert W</creator><general>American Medical Association</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20141001</creationdate><title>Visual Ability of Patients Seeking Outpatient Low Vision Services in the United States</title><author>Goldstein, Judith E ; Chun, Melissa W ; Fletcher, Donald C ; Deremeik, James T ; Massof, Robert W</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a369t-dfad24648884f80e7d6b1d179528dbe6528a910aac5f9ebc12f9a780c600f4aa3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Activities of Daily Living</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Ambulatory Care - utilization</topic><topic>Female</topic><topic>Health Surveys</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Prospective Studies</topic><topic>Psychometrics</topic><topic>Psychomotor Performance</topic><topic>Reading</topic><topic>Sickness Impact Profile</topic><topic>Surveys and Questionnaires</topic><topic>United States</topic><topic>Vision, Low - physiopathology</topic><topic>Vision, Low - rehabilitation</topic><topic>Visual Acuity - physiology</topic><topic>Visual Perception</topic><topic>Visually Impaired Persons - rehabilitation</topic><topic>Walking</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Goldstein, Judith E</creatorcontrib><creatorcontrib>Chun, Melissa W</creatorcontrib><creatorcontrib>Fletcher, Donald C</creatorcontrib><creatorcontrib>Deremeik, James T</creatorcontrib><creatorcontrib>Massof, Robert W</creatorcontrib><creatorcontrib>Low Vision Research Network Study Group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>JAMA ophthalmology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Goldstein, Judith E</au><au>Chun, Melissa W</au><au>Fletcher, Donald C</au><au>Deremeik, James T</au><au>Massof, Robert W</au><aucorp>Low Vision Research Network Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Visual Ability of Patients Seeking Outpatient Low Vision Services in the United States</atitle><jtitle>JAMA ophthalmology</jtitle><addtitle>JAMA Ophthalmol</addtitle><date>2014-10-01</date><risdate>2014</risdate><volume>132</volume><issue>10</issue><spage>1169</spage><epage>1177</epage><pages>1169-1177</pages><issn>2168-6165</issn><eissn>2168-6173</eissn><abstract>IMPORTANCE: Most patients with low vision are elderly and have functional limitations from other health problems that could add to the functional limitations caused by their visual impairments. OBJECTIVE: To identify factors that contribute to visual ability measures in patients who present for outpatient low vision rehabilitation (LVR) services. DESIGN, SETTING, AND PARTICIPANTS: As part of a prospective, observational study of new patients seeking outpatient LVR, 779 patients from 28 clinical centers in the United States were enrolled in the Low Vision Rehabilitation Outcomes Study (LVROS) from April 25, 2008, through May 2, 2011. The Activity Inventory (AI), an adaptive visual function questionnaire, was administered to measure overall visual ability and visual ability in 4 functional domains (reading, mobility, visual motor function, and visual information processing) at baseline before LVR. The Geriatric Depression Scale, Telephone Interview for Cognitive Status, and Medical Outcomes Study 36-Item Short-Form Health Survey physical functioning questionnaires were also administered to measure patients’ psychological, cognitive, and physical health states, respectively. MAIN OUTCOMES AND MEASURES: Predictors of visual ability and functional domains as measured by the AI. RESULTS: Among the 779 patients in the LVROS sample, the mean age was 76.4 years, 33% were male, and the median logMAR visual acuity score was 0.60 (0.40-0.90 interquartile range). Correlations were observed between logMAR visual acuity and baseline visual ability overall (r = −0.42) and for all functional domains. Visual acuity was the strongest predictor of visual ability (P  &lt; .001) and reading ability (P &lt; .001) and had a significant independent effect on the other functional domains. Physical ability was independently associated with (P &lt; .001) overall visual ability as well as mobility and visual motor function. Depression had a consistent independent effect (P &lt; .001) on overall visual ability and on all functional domains, whereas cognition had an effect on only reading and mobility (P &lt; .001). CONCLUSIONS AND RELEVANCE: Visual ability is a multidimensional construct, with visual acuity, depression, physical ability, and cognition explaining more than one-third of the variance in visual ability as measured by the AI. The significant contributions of the nonvisual factors to visual ability measures and the rehabilitation potential (ie, ceiling) effects they may impose on LVR are important considerations when measuring baseline visual ability and ultimately LVR outcomes in ongoing clinical research.</abstract><cop>United States</cop><pub>American Medical Association</pub><pmid>25073745</pmid><doi>10.1001/jamaophthalmol.2014.1747</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record>
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subjects Activities of Daily Living
Aged
Aged, 80 and over
Ambulatory Care - utilization
Female
Health Surveys
Humans
Male
Middle Aged
Prospective Studies
Psychometrics
Psychomotor Performance
Reading
Sickness Impact Profile
Surveys and Questionnaires
United States
Vision, Low - physiopathology
Vision, Low - rehabilitation
Visual Acuity - physiology
Visual Perception
Visually Impaired Persons - rehabilitation
Walking
title Visual Ability of Patients Seeking Outpatient Low Vision Services in the United States
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