MANAGEMENT OF LOW VISION IN PEOPLE WITH MYOPIC MACULAR DEGENERATION
Article Sidebar
Main Article Content
Abstract
Objective: To assess the effectiveness of correction of refractive error, use of contact lenses and low vision aids in visual rehabilitation of people with Myopic Macular Degeneration (MMD).
Methodology: This cross-sectional study included participants with MMD assessed for visual rehabilitation in a low vision clinic at Department of Ophthalmology Hayatabad Medical Complex, Peshawar, from June 2017 to June 2020. Data regarding distance and near visual acuities at the time of presentation with amount of myopia, best corrected visual acuity (VA) with glasses and contact lenses, VA with low vision devices and types of low vision devices prescribed were collected and analyzed. VA was recorded on Logarithm of the Minimum Angle of Resolution (LogMAR) chart. Data was analyzed using SPSS v.19.0.
Results: Out of 78 participants with MMD, 74.4% were male with mean age was 29.13±19.1 years. About 22% had vision impairment with their own glasses, 19% had severe impairment and 59% had blindness. Mean spherical equivalent refractive error amongst participants was -14.56 ± 5.39D and -12.52 ± 6.64D in right and left eyes respectively. With optimum correction (glasses/contact lenses) in 41% of participants distance VA was improved to 6/18 (0.54 Log MAR) or better in the better-seeing eye. With low vision devices, mean distance visual acuity was enhanced to 0.18 Log MAR (p<0.001).
Conclusion: Correction of myopia is very important in visual rehabilitation of people with MMD. Low vision aids can be successfully used to enhance the residual vision among people with MMD in order to improve life efficiency.
Article Details
Work published in JPMI is licensed under a
Creative Commons Attribution-NonCommercial 2.0 Generic License.
Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
References
Fricke TR, Jong M, Naidoo KS, San¬karidurg P, Naduvilath TJ, Ho SM, et al. Global prevalence of visual impairment associated with myopic macular de¬generation and temporal trends from 2000 through 2050: systematic review, meta-analysis and modelling. Br J Oph¬thalmol. 2018;102(7):855-862.
Wong Y-L, Sabanayagam C, Ding Y, Wong C-W, Yeo AC-H, Cheung Y-B, et al. Prevalence, risk factors, and impact of myopic macular degeneration on vi¬sual impairment and functioning among adults in Singapore. Invest Ophthalmol Vis Sci. 2018;59(11):4603-4613.
Holden BA, Fricke TR, Wilson DA, Jong M, Naidoo KS, Sankaridurg P, et al. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmology. 2016;123(5):1036-1042.
Wong YL, Saw SM. Epidemiolo¬gy of pathologic myopia in Asia and worldwide. Asia Pac J Ophthalmol. 2016;5(6):394-402.
Holden B, Sankaridurg P, Smith E, Aller T, Jong M, He M. Myopia, an underrat¬ed global challenge to vision: where the current data takes us on myopia con¬trol. Eye. 2014;28(2):142-146.
Pan CW, Dirani M, Cheng CY, Wong TY, Saw SM. The age-specific prevalence of myopia in Asia: a meta-analysis. Optom Vis Sci. 2015;92(3):258-266.
Chui TY, Yap MK, Chan HH, Thibos LN. Retinal stretching limits peripher¬al visual acuity in myopia. Vision Res. 2005;45(5):593-605.
De Jong PT. Myopia: its histor¬ical contexts. Br J Ophthalmol. 2018;102(8):1021-1027.
Wong CW, Phua V, Lee SY, Wong TY, Cheung CMG. Is choroidal or scleral thickness related to myopic macular degeneration? Invest Ophthalmol Vis Sci. 2017;58(2):907-913.
Wong TY, Ferreira A, Hughes R, Carter G, Mitchell P. Epidemiology and disease burden of pathologic myopia and my¬opic choroidal neovascularization: an evidence-based systematic review. Am J Ophthalmol. 2014;157(1):9-25. e12.
Iwase A, Araie M, Tomidokoro A, Ya¬mamoto T, Shimizu H, Kitazawa Y, et al. Prevalence and causes of low vision and blindness in a Japanese adult pop¬ulation: the Tajimi Study. Ophthalmolo¬gy. 2006;113(8):1354-1362. e1351.
Wu L, Sun X, Zhou X, Weng C. Caus¬es and 3-year-incidence of blindness in Jing-An District, Shanghai, Chi¬na 2001-2009. BMC Ophthalmol. 2011;11(1):10.
Yamada M, Hiratsuka Y, Roberts CB, Pezzullo ML, Yates K, Takano S, et al. Prevalence of visual impairment in the adult Japanese population by cause and severity and future projections. Ophthalmic Epidemiol. 2010;17(1):50- 57.
Chong MF, Jackson AJ, Wolffsohn JS, Bentley SA. An update on the charac¬teristics of patients attending the Kooy¬ong Low Vision Clinic. Clin Exp Optom. 2016;99(6):555-558.
Kalloniatis M, Johnston A. Visual char¬acteristics of low vision children. Optom Vis Sci. 1990;67(1):38-48.
Shah M, Khan MD. Causes of low vision amongst the low-vision patients attend¬ing the low-vision clinic at Khyber in¬stitute of ophthalmic medical sciences (KIOMS), Hayatabad medical complex Peshawar, Pakistan. Vis Impair Res. 2004;6(2-3):89-97.
Frick KD. What the comprehensive eco¬nomics of blindness and visual impair¬ment can help us understand. Indian J Ophthalmol. 2012;60(5):406.
Naidoo KS, Fricke TR, Frick KD, Jong M, Naduvilath TJ, Resnikoff S, et al. Poten¬tial lost productivity resulting from the global burden of myopia: systematic review, meta-analysis, and modeling. Ophthalmology. 2019;126(3):338-346.
Sunness JS, El Annan J. Improve¬ment of visual acuity by refraction in a low-vision population. Ophthalmology. 2010;117(7):1442-1446.
Chiang PP-C, Fenwick E, Cheung CMG, Lamoureux EL. Public health impact of pathologic myopia. Pathologic myopia: Springer. 2014. p. 75-81.