AMD
Conditions
Keywords
AMD, EV, CCTV, Reading, vision
Brief summary
Patients with advanced Age-Related Macular Degeneration will be randomized into one of two treatment groups. One group will receive eccentric view (EV) training while the other a closed circuit television (CCTV) training for 6 weeks. Reading speed and accuracy will be assessed pre- and post- treatment to determine if one treatment is superior to the other.
Detailed description
Age-related macular degeneration is the single most common cause of visual impairment in Canada, affecting people over the age of 55 years. It causes loss of central, detailed vision, resulting in difficulty with fine vision tasks, such as reading and writing. At present there is no fully effective prevention or treatment for this condition, but people do benefit from visual rehabilitation. Two of the most common rehabilitation techniques are eccentric viewing training and an electronic magnification system called a Closed circuit television (CCTV). In eccentric viewing training the person is taught to use his or her remaining side vision, instead of central vision. The CCTV provides high levels of magnification to compensate for the loss of detail vision. The purpose of this randomized clinical trial is to compare the effectiveness of these two interventions. In the study people will be randomly assigned to either receiving eccentric viewing training or a CCTV. This will happen after they have received basic, optical low vision services and training through the CNIB. We will assess their performance with either the CCTV or EV training with a variety of reading tasks and questionnaires. The results will give evidence for how it is most beneficial to use resources and as such will be very important in future planning of low vision services. Hypothesis: Eccentric Viewing Training will improve reading speed over CCTV by at least 10 words per minute in patients with advanced AMD.
Interventions
BEHAVIORALeccentric viewing (EV) training
Eccentric viewing training for 6 weeks, minimum two 10 minutes per day.
DEVICEClosed circuit television (CCTV)
A CCTV is an electro-optical device mainly used for reading.
Sponsors
London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
50 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* First time AMD patient sent to CNIB for visual rehabilitation * Macular Degeneration reducing visual acuity (VA) to between 20/160 and 20/400 (ETDRS scale) * Over the age of 50 years * English as the first language and able to read
Exclusion criteria
* Expected anti-VEGF or Visudyne treatment over the course of the study * Individuals who do not have reading as a life goal * Mental cognition that makes learning the specific rehabilitation tasks unlikely (determined by mini-mental state exam) * Any other ocular pathology that can reduce central vision including cornea decompensation (scar or thickness), cataract (grade III or more for each type of cataract), vitritis (2+ or more) or advanced glaucoma (C/D ratio of \>0.7)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The primary outcome measures reading speed for 1.3M print (in correct words per minute). | 6 weeks intervention |
Secondary
| Measure | Time frame |
|---|---|
| 2. Reading speed and accuracy for 1M | 6 weeks intervention |
| 3. Reading performance tests. | 6 week's intervention |
| The secondary outcomes measures 1. Reading accuracy for 1.3M; | 6 weeks intervention |
| 5. VFQ-25 plus 2 extra questions). | 6 week's intervention |
| 6. Geriatric depression scale | 6 week |
| 4. Reading Behavior Inventory | 6 week's intervention |
Countries
Canada
Outcome results
None listed