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Authors
Stelmack, Joan A. OD, MPH; Tang, Charlene MD, PhD, MPH; Wei, Yongliang MS; Rose, Kenneth OD; Ballinger, Rex OD; Whitman, Olga OD6; Chronister, Connie OD; Sayers, Scott PhD; Massof, Robert W. PhD; for the LOVIT II Study Group

Veterans Affairs Low-vision Intervention Trial II: One-year Follow-up

publication date
July 21, 2019
Category
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Abstract/Introduction

SIGNIFICANCE 

One-year follow-up is recommended for patients with macular diseases to assess functional changes associated with disease progression and to modify low-vision (LV) treatment plans, if indicated.

PURPOSE 

The purpose of this study was to observe 255 patients with macular diseases who received LV rehabilitation (rehabilitation with a therapist) or basic LV services (LV devices dispensed without therapy) during Veterans Affairs Low-vision Intervention Trial II after the trial ended at 4 months until 1-year follow-up.

METHODS 

The primary outcome measure was visual ability measured with the 48-item Veterans Affairs Low-vision Visual Functioning Questionnaire. Mean visual ability scores for the treatment groups were compared from baseline to 4 months, 4 months to 1 year, and baseline to 1 year. Changes from baseline to 1 year were compared between the two groups. Predictors of changes in visual ability from 4 months to 1 year were assessed using linear regression.


Conclusion/Results

RESULTS 

Both groups experienced significant improvement in all measures of visual ability from baseline to 1 year but lost visual reading ability during the observation period (LV rehabilitation group, −0.64 [1.2] logit; 95% confidence interval [CI], −0.84 to −0.44 logit; basic LV group, −0.63 [1.4] logit; 95% CI, −0.88 to −0.38 logit), and overall visual ability was lost in the LV rehabilitation group (−0.20 [0.8] logit; 95% CI, −0.34 to −0.06 logit). Loss of visual reading ability in both groups from 4 months to 1 year was predicted by reading ability scores at 4 months, loss of near visual acuity from 4 months to 1 year, and lower EuroQol-5D utility index scores; loss of overall visual ability in the LV rehabilitation group during the same time period was predicted by lower overall ability scores at 4 months.

CONCLUSIONS 

Visual ability significantly improved in all groups from baseline to 1 year. However, the loss of visual reading ability experienced by both groups from 4 months to 1 year reduced the benefit of the services provided.


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  • Such a nice optician. My grandson is only 4 and needs glasses. We were so sad, but he explained the issues, and we will follow up as he suggested.


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  • Family Vision Clinic changed our lives! My daughter was frequently car sick, and she was getting headaches every day, often painful enough that they brought her to tears. We saw a string of doctors and therapists, but we made no progress. Finally, we found Dr. Levi Zurcher and his eye therapist Rain. After ten weeks of eye therapy my daughter no longer gets headaches, and she no longer gets car sick. Daily tears are a thing of the past. I really can’t say enough about this clinic. It was fascinating to watch Dr. Zurcher work. For the first time, someone who knew what they were doing was intently studying my daughter, really trying to figure out all of her eye issues, and his therapist Rain is one of the most patient and lovely people that I’ve ever had the good fortune to meet. We’re finished with eye therapy—yay!—and I have switched to American Family Vision Clinic for all of my family’s other eye health needs.


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    Justin E.

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