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EFFECT:Eccentric Fixation From Enhanced Clinical Training

Not Applicable
Completed
Conditions
Age Related Macular Degeneration (ARMD)
Interventions
Behavioral: Supervised Reading
Behavioral: EVT at the PRL
Behavioral: EVT at the TRL
Registration Number
NCT01499628
Lead Sponsor
Moorfields Eye Hospital NHS Foundation Trust
Brief Summary

Age-related macular degeneration (AMD) is the leading cause of severe visual impairment in the UK, Europe and N America. Low vision patients with AMD have great difficulty reading, which leads to a loss of independence and reduced quality of life. Magnifiers alone do not compensate for loss of central vision in AMD. It has been proposed that special low vision training can improve reading ability in patients with AMD. Training programmes are widely available in the US and Scandinavia, but not in the UK, partly because there is a lack of evidence from Randomised Control Trials (RCT) showing that they are effective. The investigators are conducting a clinical trial comparing the conventional hospital-based low vision service to enhanced rehabilitation programmes that include Eccentric Viewing training. Eccentric viewing training involves teaching patients who have lost their central vision to use a new area of retina for visual tasks. Patients are either taught to improve the use of the part of the retina they naturally start using after their central vision is lost, their so-called preferred retinal locus (PRL), or, alternatively, they are taught to use a different retinal area that is thought to be better suited for everyday visual tasks, the so-called trained retinal locus (TRL). The investigators plan to compare the two types of eccentric viewing training to conventional hospital-based low vision care.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
200
Inclusion Criteria
  • Diagnosis of age-related macular degeneration
  • Visual acuity 6/12 to 3/60 inclusive in the better eye
  • Dense central scotoma confirmed by microperimetry
Exclusion Criteria
  • Patients who are not fluent in English or are cognitively impaired
  • Patients with serious hearing impairment
  • Patients who are hospital inpatients, who are living in nursing homes or are otherwise non-independent
  • Ocular co-morbidity (other than mild cataract) in the better eye
  • Recent low vision assessment or eccentric viewing training

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Group 2-Control plus supervised readingSupervised ReadingThe same amount of contact time as Groups 3 and 4 - three 45 minute sessions completed over three weeks.
Group 3-EVT at the PRLEVT at the PRLEccentric viewing training at the Preferred Retinal Locus (PRL), using reading/target cards. Three 45 minute sessions completed over three weeks.
Group 4-EVT at the TRLEVT at the TRLEccentric viewing training at the Trained Retinal Locus (TRL), using reading/target cards and microperimeter. Three 45 minute sessions completed over three weeks.
Primary Outcome Measures
NameTimeMethod
Score on the Massof Activity Inventory - 6 month follow upChange from Baseline in Massof Activity Inventory at 6 month follow up
Secondary Outcome Measures
NameTimeMethod
Reading Speed (ReST) - Final AssessmentChange from Baseline in Reading Speed (ReST) at Final Assessment
Quality of Life (MacDQoL) - Final AssessmentChange from Baseline in Quality of Life (MacDQoL) at Final Assessment
Quality of Life (MacDQoL) - 6 month follow upChange from Baseline in Quality of Life (MacDQoL) at 6 month follow up
Self-reported health status (EQ-5D) - 6 month follow upChange from Baseline in EQ-5D score at 6 month follow up
Self-reported health status (EQ-5D) - 12 month follow upChange from Baseline in EQ-5D score at 12 month follow up
WHO (Five) Well-Being Index (WBI-5) - Final AssessmentChange from Baseline in WBI-5 score at Final Assessment
WHO (Five) Well-Being Index (WBI-5) - 6 month follow upChange from Baseline in WBI-5 score at 6 month follow up
Interpersonal Support Evaluation List (ISEL) - 6 month follow upChange from Baseline in Interpersonal Support Evaluation List (ISEL) at 6 month follow up
Acceptance and Self Worth Adjustment Scale (AS-WAS) - 12 month follow upChange from Baseline in Acceptance and Self Worth Adjustment Scale (AS-WAS) at 12 month follow up
Massof Activity Inventory - Final AssessmentChange from Baseline in Massof Activity Inventory at Final Assessment
Quality of Life (MacDQoL) - 12 month follow upChange from Baseline in Quality of Life (MacDQol) at 12 month follow up
Self-reported health status (EQ-5D) - Final AssessmentChange from Baseline in EQ-5D score at Final Assessment
Time Trade Off (TTO) - 6 month follow upChange from Baseline in Time Trade Off (TTO) score at 6 month follow up
Acceptance and Self Worth Adjustment Scale (AS-WAS) - Final AssessmentChange from Baseline in Acceptance and Self Worth Adjustment Scale (AS-WAS) at Final Assessment
WHO (Five) Well-Being Index (WBI-5) - 12 month follow upChange from Baseline in WBI-5 score at 12 month follow up
Interpersonal Support Evaluation List (ISEL) - Final AssessmentChange from Baseline in Interpersonal Support Evaluation List (ISEL) at Final Assessment
Acceptance and Self Worth Adjustment Scale (AS-WAS) - 6 month follow upChange from Baseline in Acceptance and Self Worth Adjustment Scale (AS-WAS) at 6 month follow up
Interpersonal Support Evaluation List (ISEL) - 12 month follow upChange from Baseline in Interpersonal Support Evaluation List (ISEL) at 12 month follow up
Massof Activity Inventory - 12 month follow upChange from Baseline in Massof Activity Inventory at 12 month follow up

Trial Locations

Locations (1)

Moorfields Eye Hospital

🇬🇧

London, United Kingdom

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