title: The Effects of Low-Vision Rehabilitation on Reading Speed and Depression in Age Related Macular Degeneration: A Meta-Analysis.
abstract: OBJECTIVE
  Age related macular degeneration (AMD) is a progressive eye disease that, as of 2015, has affected 11 million people in the U.S. and 1.5 million in Canada causing central vision blindness. By 2050, this number is expected to double to 22 million. Eccentric vision is the target of low-vision rehabilitation aids and programs for patients with AMD, which are thought to improve functional performance by improving reading speed and depression.
  
  
  OBJECTIVE
  This study evaluates the effect of various low-vision rehabilitation strategies on reading speed and depression in patients 55 and older with AMD.
  
  
  METHODS
  Computer databases including MEDLINE (OVID), EMBASE (OVID), BIOSIS Previews (Thomson-Reuters), CINAHL (EBSCO), Health Economic Evaluations Database (HEED), ISI Web of Science (Thomson-Reuters) and the Cochrane Library (Wiley) were searched from the year 2000 to January 2015.
  
  
  METHODS
  Included papers were research studies with a sample size of 20 eyes or greater focused on AMD in adults aged 55 or older with low vision (20/60 or lower).
  
  
  METHODS
  Two independent reviewers screened and extracted relevant data from the included articles. Standardized mean difference (SMD) was chosen as an effect size to perform meta-analysis using STATA. Fixed- and random-effect models were developed based on heterogeneity.
  
  
  RESULTS
  Reading Speed and Depression Scores.
  
  
  RESULTS
  A total of 9 studies (885 subjects) were included. Overall, a significant improvement in reading speed was found with a SMD of 1.01 [95% CI: 0.05 to 1.97]. Low-vision rehabilitation strategies including micro-perimetric biofeedback, microscopes teaching program significantly improved reading speed. Eccentric viewing training showed the maximum improvement in reading speed. In addition, a non-significant improvement in depression scores was found with a SMD of -0.44 [95% CI: -0.96 to 0.09].
  
  
  CONCLUSIONS
  A considerable amount of research is required in the area of low-vision rehabilitation strategies for patients with AMD. Based on current research, low-vision rehabilitation aids improve reading speed. However, they do not have a significant effect on depression scores in those 55 and older with AMD.
authors.affiliation: Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.
authors.forename: Noura
authors.initials: N
authors.lastname: Hamade
authors.affiliation: Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.|Department of Ophthalmology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.
authors.forename: William G
authors.initials: WG
authors.lastname: Hodge
authors.affiliation: Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Rakibuz-Zaman
authors.affiliation: Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.|Department of Ophthalmology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.
authors.forename: Monali S
authors.initials: MS
authors.lastname: Malvankar-Mehta
mesh_terms: D000368:Aged; D003863:Depression / Q000628:therapy*; D006801:Humans; D008268:Macular Degeneration / Q000523:psychology / Q000534:rehabilitation*; D011932:Reading