SCHUCHARD et al. AMD and Visual RehabilitationJournal of Rehabilitation Research and
Development Vol. 36 No. 4, October 1999
Characteristics of AMD patients with low vision receiving visual rehabilitation
Ronald A. Schuchard, PhD; Saad Naseer, MD; Kristina de Castro, MD
VA Rehabilitation Research & Development Center, Decatur, GA 30033-4004; University of Missouri-Kansas City School of Medicine, Kansas City, MO 64108-2634
The purpose of this retrospective study done on 255 AMD patients evaluated at a low vision rehabilitation service was: 1) to describe the visual function characteristics (VFCs) of AMD patients presenting to visual rehabilitation, 2) to document changes in these VFCs between initial and follow-up rehabilitation visits, and 3) to investigate the relationship of the VFCs found at rehabilitation intake to the length of time between initial diagnosis and initial rehabilitation visit. Standard clinical testing (visual acuity and contrast sensitivity) as well as Scanning Laser Ophthalmoscope (SLO) visual function testing were performed to determine visual function including: 1) macular perimetry for scotoma boundary mapping and 2) PRL (preferred retinal locus) location and abilities in fixation, saccadic, and pursuit eye movements. The difference between the first and second visit VFCs were compared to the length of time between visits for 44 of the 255 patients returning for a second visit 0.5 to 4.5 years later. Finally, the initial date of AMD diagnosis was found for 51 of the 255 patients to analyze VFCs as a function of the time duration between diagnosis and the intake to the rehabilitation. Most VFCs had a wide range of results at initial intake to rehabilitation while all patients had significant visual impairment by 24 months after initial diagnosis. The majority of low vision patients with AMD have bilateral central scotomas with the corresponding visual function and ADL problems that can often be overcome with visual rehabilitation.
Key words: age-related macular degeneration (AMD), preferred retinal locus, scotomas, visual fields, visual rehabilitation.