Purpose To investigate abandonment rate of prescribed low vision devices for near tasks and factors associated with abandonment in a U.S. outpatient population. Methods A telephone survey was administered to 88 patients with low vision from four clinical sites approximately one year after examination and prescription of devices. Patients were surveyed on timing and frequency of use and reasons for abandonment of devices. The main outcome measure (abandonment) was defined as patient report of no use of prescribed device in the previous three months. Multivariate logistic regression was used to investigate significant vision and demographic factors related to abandonment. Results Of 119 prescribed devices, 19% (95% CI, 12–26) had not been used within the previous three months. Mean (±SD) better eye visual acuity at examination was 0.61±0.29 logMAR and mean age was 77±17 years. Mean time between device prescription and survey was 11±3 months. Device abandonment was not associated with age (p = 0.863), time since prescription (p = 0.125), visual acuity (p = 0.804), or category of magnification device (spectacle, handheld, stand, or video) (p = 0.412). There was a significant association between documented non-central visual field loss and abandonment of magnification device (p=0.046). Repeat administration of the survey resulted in the same abandonment classification in 15 of 15 patients (100%). Conclusions Abandonment rate was similar for this outpatient population to those previously reported in the U.S. veteran inpatient population and in other countries. Patients with visual field loss may be more likely to abandon prescribed devices.

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Imaging through the visual system in Alzheimer's disease, with the technology currently in widespread use for the diagnosis and management of eye disease such as glaucoma and macular degeneration, is proving to be promising. In vivo cross-section imaging during an annual comprehensive eye exam has been available for a decade for glaucoma and macular degeneration, and this same imaging, using Optical Coherence Tomography, has been demonstrated to show deficits specific to AD and mild cognitive impairment. These deficits are in the form of nerve fiber layer tissue drop out in the retina and optic nerve. The retrograde loss of nerve fiber layer tissue in the retina and optic nerve may be an early biomarker of AD, and these deficits in the nerve fiber layer of the retina and optic nerve may be the earliest sign of AD, even prior to damage to the hippocampal region that impacts memory.

Optical coherence tomography (OCT) is used for the management of diseases affecting the eye. It has the ability to measure the thickness of the nerve fiber layer (NFL) of the retina. OCT is similar to ultrasound, but utilizes light. Unlike ultrasound, there is no tissue contact. OCT measures structures less than 10 m scale. In a study that evaluated individuals with Alzheimer disease (AD) and control individuals, Danesh-Meyer and colleagues 1 found a reduction in NFL in those with AD, but not control individuals. Parisi and colleagues 2 also found significant reductions in the NFL of those with AD and this group included mild AD.

This study was to investigate the feasibility of frequency doubling technology (FDT) visual field testing in Alzheimer's disease (AD) in order to identify early biomarkers of AD in patients already diagnosed with AD and compare the findings to participants not having Alzheimer's disease. This biomarker would be useful in a battery of tests for the early identification of those with AD. It was not the intent to correlate the visual system biomarker with severity of disease, but to determine if the biomarker was present in pass or fail screening criteria. The study showed with very strong significance that the FDT can identify biomarkers of those with AD compared to an age-matched population that does not have AD. FDT is a simple test to take and administer and has been used to screen for eye and retinal diseases such as glaucoma, retinal macular degeneration, and diabetic retinopathy. The results obtained in the FDT readout are analyzed and compared to the age normative database within the system. The FDT ability to screen for AD biomarker in the visual system was significant in those with AD compared to the controls, and the deficits were not related to any ocular pathology.