Simulating Macular Degeneration to Investigate Activities of Daily Living: A Systematic Review

Abstract

Purpose: Investigating difficulties during activities of daily living is a fundamental first step for the development of vision-related intervention and rehabilitation strategies. One way to do this is through visual impairment simulations. The aim of this review is to synthesize and assess the types of simulation methods that have been used to simulate age-related macular degeneration (AMD) in normally sighted participants, during activities of daily living (e.g., reading, cleaning, and cooking).Methods: We conducted a systematic literature search in five databases and a critical analysis of the advantages and disadvantages of various AMD simulation methods (following PRISMA guidelines). The review focuses on the suitability of each method for investigating activities of daily living, an assessment of clinical validation procedures, and an evaluation of the adaptation periods for participants.Results: Nineteen studies met the criteria for inclusion. Contact lenses, computer manipulations, gaze contingent displays, and simulation glasses were the main forms of AMD simulation identified. The use of validation and adaptation procedures were reported in approximately two-thirds and half of studies, respectively.Conclusions: Synthesis of the methodology demonstrated that the choice of simulation has been, and should continue to be, guided by the nature of the study. While simulations may never completely replicate vision loss experienced during AMD, consistency in simulation methodology is critical for generating realistic behavioral responses under vision impairment simulation and limiting the influence of confounding factors. Researchers could also come to a consensus regarding the length and form of adaptation by exploring what is an adequate amount of time and type of training required to acclimatize participants to vision impairment simulations.

Virtual Reality in Palliative Care: A Systematic Review

“…We assessed and reported the methodological risk of bias in the included studies in accordance with the Joanna Briggs Critical Appraisal Tools for Quasi-Experimental Studies [ 28 ]. We judged each item as high, low, or with some concerns regarding the risk of bias as set out by criteria used previously by Macnamara et al [ 29 ]. Using this approach, studies were classed on their risk of bias by the percentage of ‘yes’ criteria met, where low risk indicated >70%, 50–69% indicated moderate risk, and <49% indicated high risk.…”

The psychological impact of instrumental activities of daily living on people with simulated age-related macular degeneration

“…Opposingly, it is also possible that the study underestimated the psychological effects of AMD if participants circumvented the simulated scotoma by looking elsewhere through the simulation goggles. 11 In such as case, the normally sighted participants may not have experienced the same level of visual disability that patients with AMD have.…”

“…13 Nonetheless, findings of simulation research generally mimic behaviours exhibited in studies on patients with AMD. 11 For example, reduced reading speed resulting from AMD has been identified in both simulation and patient studies. 14,15 Therefore, an AMD simulation will, at a minimum, provide preliminary insights into the impact of visual impairment on everyday life.…”

The effect of age-related macular degeneration on cognitive test performance

“…To highlight the importance of central vision for cognitive assessments, we simulated visual impairment with AMD simulation goggles, while participants completed a series of cognitive tasks. Since older adults with visual impairments are significantly more vulnerable to physical and mental comorbidities (i.e., Parkinson’s disease, dementia, hearing loss), a vision loss simulation with healthy, normally-sighted participants can more easily isolate vision-related effects on behaviour 8 , 9 . While simulations may never wholly replicate a visual impairment (e.g., due to patient variability in symptom presentation; underdeveloped compensatory strategies; and lack of progressive visual decline) 9 , thus far simulating vision loss has been a simple, yet valid approach to investigate the effects of visual impairments on cognition 10 , 11 .…”

“…While simulations may never wholly replicate a visual impairment (e.g., due to patient variability in symptom presentation; underdeveloped compensatory strategies; and lack of progressive visual decline) 9 , thus far simulating vision loss has been a simple, yet valid approach to investigate the effects of visual impairments on cognition 10 , 11 . Furthermore, AMD simulations have replicated patterns of behaviour and difficulties experienced by AMD patients 9 .…”