Age-related macular degeneration and low-vision rehabilitation: a systematic review1

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Abstract

Background: Because of the prevalence and devastating consequences of age-related macular degeneration (AMD), a systematic review devoted to low-vision rehabilitation and AMD seems timely and appropriate.

Methods: Several electronic databases were searched for studies from 1980 to 2006 involving individuals with low vision or visual impairment and rehabilitation interventions. Studies were assessed for quality and level of evidence.

Results: The findings indicate that standard low-vision rehabilitation programs, conventional in-clinic assessments, and optical devices are effective ways of managing and living with vision loss. Areas of unmet need include determining which types of orientation and mobility programs and devices are most effective and developing methods of matching assistive technologies with the individual's visual and environmental requirements.

Interpretation: Additional randomized controlled trials with similar intervention comparisons and outcome measures are needed to form stronger conclusions for the most effective low-vision rehabilitation interventions for individuals with AMD.

Résumé

Contexte: Vu la prévalence et les conséquences désastreuses de la dégénérescence maculaire liée à l’âge (DMLA), il apparaît opportun et pertinent de faire le point sur la réadaptation visuelle et la DMLA.

Méthodes: La recherche a été effectuée dans plusieurs bases de données électroniques allant de 1980 à 2006 et impliquant des personnes atteintes de faible vision ou de déficience visuelle et soumises à des interventions de réadaptation. On en a évalué la qualité et le niveau d’évidence.

Résultats: Les résultats indiquent que les programmes ordinaires de réadaptation visuelle, les évaluations cliniques conventionnelles et les appareils optiques offrent des moyens efficaces d'accommodement et de vie avec perte de vision. Il reste cependant à établir les types de programmes et appareils d’orientation et de mobilité qui présentent les moyens les plus efficaces et à mettre au point des méthodes d’appariement des technologies d’aide avec les besoins visuels et environnementaux de la personne.

Interprétation: Il faudra effectuer d’autres essais randomisés et contrôlés qui permettront de comparer des interventions similaires et leurs résultats afin d’obtenir des conclusions plus solides sur les interventions de réadaptation visuelle les plus efficaces pour les personnes atteintes de DMLA.

References (62)

  • J Bonastre et al.

    The epidemiology, economics and quality of life burden of age-related macular degeneration in France, Germany, Italy, and the United Kingdom

    Eur J Health Econom

    (2002)
  • Prevalence of age-related macular degeneration in the United States

    Arch Ophthalmol

    (2004)
  • DAL Maberley et al.

    The prevalence of low vision and blindness in Canada

    Eye

    (2006)
  • A placebo-controlled clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age-related macular degeneration and vision loss: AREDS Report No. 8

    Arch Ophthalmol

    (2001)
  • Clinical Studies Database. Bethesda, Md.: US National Institutes of Health

  • PJ Rosenfeld et al.

    Ranibizumab for neovascular age-related macular degeneration

    N Engl J Med

    (2006)
  • G Virgili et al.

    New therapies for neovascular age-related macular degeneration: critical appraisal of the current evidence

    Acta Ophthalmol Scand

    (2007)
  • J Jutai et al.
  • S Downs et al.

    The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions

    J Epidemiol Community Health

    (1998)
  • The periodic health examination

    CMAJ

    (1979)
  • NC Foley et al.

    Stroke rehabilitation evidence-based review: methodology

    Top Stroke Rehab

    (2003)
  • Vision Rehabilitation for Elderly Individuals with Low Vision and Blindness. Rockville, Md.

    (2004)
  • E Adams et al.
  • G Virgili et al.

    Reading aids for adults with low vision

    Cochrane Database Syst Rev

    (2006)
  • G Virgili et al.

    Orientation and mobility training for adults with low vision

    Cochrane Database Syst Rev

    (2006)
  • J Mitchell et al.

    Quality of life in age-related macular degeneration: a review of the literature

    Health Qual Life Outcomes

    (2006)
  • BC Reeves et al.

    Enhanced low vision rehabilitation for people with age related macular degeneration: a randomised controlled trial

    Br J Ophthalmol

    (2004)
  • BL Brody et al.

    Age-related macular degeneration: a randomized clinical trial of a self-management intervention

    Ann Behav Med

    (1999)
  • Cited by (307)

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