title: Design and evaluation of a customized reading rehabilitation program for patients with age-related macular degeneration.
abstract: OBJECTIVE
  To evaluate the efficacy of a reading rehabilitation program (RRP) specifically designed for patients with impaired central vision from age-related macular degeneration (AMD) and the impact of the program on the quality of life (QoL) and to determine any predictable reading performance improvements between visits.
  
  
  METHODS
  Prospective case series.
  
  
  METHODS
  Forty-one patients with AMD who attended to the Institute of Applied Ophthalmobiology Eye Institute.
  
  
  METHODS
  An ad hoc-created RRP comprising 4 customized in-office training and in-home training visits over 6 weeks was undertaken by AMD patients. The RRP was based on the principle of stepwise progressive goal achievement: the difficulty of training tasks increased depending on the success obtained when performing previous easier ones. Reading performance was evaluated during each in-office training visit, and the individual's perception of his or her QoL was assessed before and after the RRP. Reading performance parameters were assessed to evaluate RRP effectiveness.
  
  
  METHODS
  Best-corrected visual acuity (BCVA), reading speed, reading duration, near visual acuity (VA), font size, and the World Health Organization Quality of Life (WHOQOL-BREF) questionnaire scores. The effect sizes (mean differences and standard deviations) also were calculated.
  
  
  RESULTS
  The mean distance BCVA was 0.81±0.29 logarithm of the minimum angle of resolution units. The mean near VA with the appropriate low-vision aid was 0.91±0.18 (M notation) at baseline. The mean near magnification was 4.32±1.15 at the last in-office visit. The mean reading speed, reading duration, and font size improvement after the reading rehabilitation program were 48.31±22.06 words per minute (P<0.001), 35.46±15.68 minutes (P<0.001), and -4.08±2.19 font points (P<0.001), respectively. The effect sizes of reading speed, reading duration, and font size after the last visit were 2.19, 2.26, and -1.86, respectively. The final score of each WHOQOL-BREF domain improved significantly (P≤0.004) after the RRP. The increased ability to read a smaller font size was correlated with improvement in the physical health domain score of the WHOQOL-BREF (r=0.35; P=0.04).
  
  
  CONCLUSIONS
  This customized RRP significantly enhanced reading performance and perceived QoL in patients with AMD. The improvement between visits seemed to be consistent.
  
  
  BACKGROUND
  The author(s) have no proprietary or commercial interest in any materials discussed in this article.
authors.affiliation: Institute of Applied Ophthalmobiology IOBA, University of Valladolid, Valladolid, Spain. bego@ioba.med.uva.es
authors.forename: María B
authors.initials: MB
authors.lastname: Coco-Martín
authors.forename: Rubén
authors.initials: R
authors.lastname: Cuadrado-Asensio
authors.forename: Alberto
authors.initials: A
authors.lastname: López-Miguel
authors.forename: Agustín
authors.initials: A
authors.lastname: Mayo-Iscar
authors.forename: Miguel J
authors.initials: MJ
authors.lastname: Maldonado
authors.forename: José C
authors.initials: JC
authors.lastname: Pastor
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D060329:Education of Persons with Visual Disabilities / Q000458:organization & administration*; D005260:Female; D006801:Humans; D008268:Macular Degeneration / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation; D011446:Prospective Studies; D011788:Quality of Life; D011932:Reading; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D015354:Vision, Low / Q000534:rehabilitation*; D014792:Visual Acuity / Q000502:physiology; D019987:Persons with Visual Disabilities / Q000534:rehabilitation*