[Prismatic treatment in low-vision rehabilitation of patients with age-related macular degeneration].
OBJECTIVE
To evaluate visual improvement in an age-related macular degeneration (ARMD) population with bilateral central scotomas, after a 3- to 6-month prismatic treatment.


METHODS
Prisms prescribed for both eyes were oriented according to eccentric fixation. Criteria were visual acuity (VA), reading ability, contrast sensitivity subjective visual comfort, prism wearing frequency and autonomy level.


RESULTS
Thirty-one patients (23 women, 8 men) 65-95 years old (mean, 78 years) were selected. Mean long distance VA remained stable (0.249 at inclusion and 0.261 after prismatic treatment); long distance VA was unchanged for 51.6% of patients, improved by at least one line for 35.5% and decreased for 12.9%. Reading ability was slightly improved (average of 1 line), as was short distance VA (P14 at inclusion, P12 after prismatic treatment); reading ability was unchanged for 45.2% of patients, improved by at least one line for 38.7%, and decreased for 16.1%. Contrast sensitivity was improved for all levels: to 98% of contrasts (mean at inclusion 0.248 and 0.280 after prismatic treatment), to 50% of contrasts (0.214 at inclusion and 0.238 after prismatic treatment) and to 25% of contrasts (0.157 at inclusion and 0.185 after prismatic treatment). Visual comfort improved immediately after prismatic treatment for 90.3% of patients; 80.6% of patients wore their prismatic correction regularly.


CONCLUSIONS
Prismatic treatment in this population mainly improves contrast sensitivity and visual comfort. It provides patients with better initiation and stabilization of their eccentric viewing. Most of the time, prismatic treatment must be associated with low-vision rehabilitation.
Vettard
S
S
Centre Ophtalmologique d'Imagerie et de Laser, 12-14, rue Rabelais, 69003 Lyon. centrerabelais@wanadoo.fr
Dubois
E
E
Quaranta
M
M
Mauget-Faÿsse
M
M
D000368:Aged; D000369:Aged, 80 and over; D005139:Eyeglasses; D005260:Female; D006801:Humans; D008268:Macular Degeneration / Q000150:complications / Q000534:rehabilitation*; D008297:Male; D015354:Vision, Low / Q000209:etiology / Q000534:rehabilitation*