Improvement of reading speed after providing of low vision aids in patients with age-related macular degeneration.

PURPOSE: Age-related macular degeneration (AMD) is the most common cause of severe visual impairment, including loss of reading ability, among elderly persons in developed countries. The aim of the present study was to evaluate reading ability before and after providing of appropriate low vision aids. METHODS: Five hundred and thirty patients with different stages of AMD (age 82 +/- 8 years) were included in this retrospective study. All patients underwent a standardized ophthalmological examination including evaluation of magnification requirement and careful providing of low vision aids. Before and after the provision of low vision aids, reading speed [words per minute (wpm)] was evaluated using standardized reading texts. RESULTS: For the whole group, the average best-corrected distance visual acuity of the better eye was 0.18 +/- 0.15, with 69% of patients having visual acuity of 0.1 (20/200) or better. The mean magnification requirement was 7.4 +/- 6.3-fold (range 2-25). Visual rehabilitation was achieved with optical visual aids in 58% of patients, whereas 42% of patients needed electronically closed-circuit TV systems. Mean reading speed was 20 +/- 33 wpm before and increased significantly to 72 +/- 35 (p < 0.0001) after the provision of low vision aids for the whole group. Between patients with visual acuity < 0.1 and patients with visual acuity of 0.1 or better, there are highly significant differences in reading speed before (0.4 +/- 3.8 versus 20 +/- 28 wpm, p

Assessment of parafoveal function in maculopathy: a comparison between the Macular Mapping Test and kinetic Manual Perimetry.

BACKGROUND: Parafoveal function is crucial for patients with maculopathies, because they have to use the parafoveal retina for reading after foveal vision loss. Manual perimetry is a reliable but lengthy method for assessing macular function. The Macular Mapping Test (MMTest) was therefore designed as a quick and easy test. In this study both methods were compared in patients with central scotoma. METHODS: In 50 patients with maculopathy (22 Stargardt's, 20 age-related, 5 diabetic, 3 other macular dystrophies), 30 degrees Tuebingen Manual Perimetry was performed kinetically. The MMTest assesses local responses to brief displays of letters in the central visual field (8 degrees radius) on a computer screen. A "wagon-wheel" pattern is used to stabilize gaze in the center. Comparison of the methods was based on the correspondence of field defects in each sector. RESULTS: The overall correspondence was 87.5%. The results could be divided into three groups, depending on fixation behavior: group 1 ( n=27): central fixation in both methods, median correspondence 87.5%, best in Stargardt's disease (95.3%), lowest in diabetic maculopathy (71.8%); group 2 ( n=21): eccentric fixation in both methods (84.3%); group 3 ( n=2): eccentric in TMP, central in MMTest (65.6% and 81.2%). CONCLUSION: Provided that the fixation locus is known, the MMTest is a quick and easy screening method, which shows a high correspondence with the results of manual perimetry.