The Veterans Affairs Low Vision Intervention Trial (LOVIT): Design and Methodology

Stelmack, Joan A.; Tang, Xiaoyin; Reda, Domenic J.; Moran, D’Anna; Rinne, Stephen; Mancil, Rickilyn M.; Cummings, Roger W.; Mancil, Gary L.; Stroupe, Kevin T.; Ellis, Nancy; Massof, Robert W.

doi:10.1177/1740774507085274

Cited by 27 publications

(31 citation statements)

References 32 publications

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“…The rationale for the study design and methods used in LOVIT are discussed in a previous publication. 30 The protocol and written informed consents were approved by the institutional review boards at both sites (Edward E. Hines Jr VA Hospital and the W. G. Hefner VA Medical Center). Each study participant gave written informed consent after the purpose and procedures of the trial were explained.…”

Section: Conduct Of the Studymentioning

confidence: 99%

Outcomes of the Veterans Affairs Low Vision Intervention Trial (LOVIT)

et al. 2008

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To evaluate the effectiveness of a lowvision rehabilitation program.Methods: A multicenter randomized clinical trial was conducted from November 2004 to November 2006 with a 4-month follow-up. A total of 126 patients were included, 98% of whom were white and male. The patients were referred from eye or low-vision clinics and blind rehabilitation centers with a visual acuity in the better-seeing eye worse than 20/100 and better than 20/500 and were eligible for Veterans Affairs (VA) services. Telephone interviews of patients were conducted in their homes before and after participation in an outpatient low-vision program at a VA medical care facility or a (waiting list) control group. The interviewer administering questionnaires by telephone was masked to patients' assignments. Interventions included low-vision examination, counseling, and prescription and provision of low-vision devices and 6 weekly sessions provided by a low-vision therapist to teach use of assistive devices and adaptive strategies to perform daily living tasks independently.Main Outcome Measure: Change in patients' visual reading ability estimated from participant responses to the Veterans Affairs Low-Vision Visual Functioning Questionnaire (LV VFQ-48) reading items completed at baseline compared with 4 months after enrollment for the treatment and control groups. The secondary outcomes were changes in other visual ability domains (mobility, visual information processing, visual motor skills) and overall vi-sual ability from baseline to 4 months estimated from VA LV VFQ-48 difficulty ratings for subsets of items.Results: The treatment group demonstrated significant improvement in all aspects of visual function compared with the control group. The difference in mean changes was 2.43 logits (95% confidence interval [CI], 2.07-2.77; P Ͻ.001; effect size, 2.51) for visual reading ability; 0.84 logit (95% CI, 0.58-1.10; P Ͻ .001; effect size, 1.14) for mobility; 1.38 logits (95% CI, 1.15-1.62; PϽ.001; effect size, 2.03) for visual information processing; 1.51 logits (95% CI, 1.22-1.80; P Ͻ .001; effect size, 1.82) for visual motor skills; and 1.63 logits (95% CI, 1.40-1.86; P Ͻ .001; effect size, 2.51) for overall visual function. Conclusion:The program effectively provided lowvision rehabilitation for patients with macular diseases.Applications to Clinical Practice: At least 10 hours of low-vision therapy, including a home visit and assigned homework to encourage practice, is justified for patients with moderate and severe vision loss from macular diseases. Because the waiting-list control patients demonstrated a decline in functional ability, low-vision services should be offered as early as possible.

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Section: Conduct Of the Studymentioning

confidence: 99%

Outcomes of the Veterans Affairs Low Vision Intervention Trial (LOVIT)

et al. 2008

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“…The primary outcome measures were the changes in visual reading ability and overall visual ability logit scores on the VA LV VFQ-48 between the low-vision treatment group and nonintervention control group 4. Mean changes in three visual ability domains (mobility ability, visual information processing, and visual motor skills) on the VA LV VFQ-48 between the two groups were the secondary outcome measures.…”

Section: Methodsmentioning

confidence: 99%

“…A 0.78 increase in logit score between treatment and control groups for visual ability was considered to be the threshold for clinical significance. This correlates to a 31% improvement in visual ability and an expected accompaniment of a six-line improvement in distance visual acuity on an ETDRS chart 4,5. Differences in the primary and secondary outcomes between treatment and control groups were compared using a two-sample t -test.…”

Section: Methodsmentioning

confidence: 99%

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Clinical effectiveness of currently available low-vision devices in glaucoma patients with moderate-to-severe vision loss

Patodia¹,

Golesic²,

Mao³

et al. 2017

OPTH

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PurposeThe aim of this trial is to study the effectiveness of currently available low-vision devices in glaucoma patients with moderate-to-severe vision loss.DesignThis is a randomized pilot clinical trial.ParticipantsSixteen low-vision glaucoma patients participated in this study.MethodsPatients with a best-corrected visual acuity between 20/70 and 20/400 in the better eye and a diagnosis of stable primary or secondary open-angle glaucoma were randomized to a low-vision treatment group or a nonintervention control group. A telephone interview was conducted before and after the 4-week testing period to assess functional vision. Patients placed in the treatment group received a low-vision examination and used various currently available low-vision aids. Patients placed in the control group received a low-vision examination only. Changes in patients’ reading ability and overall visual ability were chosen as the primary outcomes. Other visual functioning domains (mobility, visual information processing and visual motor skills) were considered as secondary outcomes.ResultsTen patients in the treatment group showed a significant improvement in reading ability and overall visual ability compared to the control group. The difference in mean score for reading ability was 2.52 logits (2.02; P<0.05) and overall visual ability was 0.78 logits (0.64; P<0.05). However, no significant improvement was noted in the other visual functioning domains involving mobility and visual motor skills.ConclusionCurrently available low-vision devices primarily enhance central vision with limited benefits to functional activities relying on peripheral vision.

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“…Yet there is ample evidence that low-vision rehabilitation has substantial utility and value [66]. Both the LOVIT and LOVIT II trials examined the impact of low-vision rehabilitation on veterans, concluding that patients who underwent rehabilitation showed significant improvement in reading, mobility, vision information processing, and visual motor skills compared to those who did not undergo rehabilitation [67][68][69][70].…”

Section: Low-vision Rehabilitationmentioning

confidence: 99%

The Implantable Miniature Telescope and Quality of Life Improvements in Patients with End-Stage Age-Related Macular Degeneration

Primo¹

2017

J Community Med Health Educ

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Age-related macular degeneration (AMD) is a progressive, degenerative eye disease that leads to central vision loss in people older than 60. End-stage AMD, for which there is no cure, is the leading cause of blindness in highincome countries. Often underappreciated by physicians, AMD is an important public health problem as patients can experience significant emotional distress, reduced cognitive function and a decrease in quality of life from depression, isolation, reduced mobility, and independence. These patients are more likely to suffer from falls and injuries, which may result in serious, life-threatening complications and significant medical costs. There are no medical interventions that can halt the visual outcome of end-stage AMD; patients can only make the best of the vision they have left through low-vision rehabilitation and external devices and tools. In 2010, the U.S. Food and Drug Administration approved the implantable miniature telescope (IMT; VisionCare Ophthalmic Technologies, Saratoga, CA) prosthesis for severely visually impaired patients with bilateral end-stage AMD. Patients with no other treatment options may have improved quality of life after implantation due to visual gains, increased mobility and independence, and improved overall function.

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The Veterans Affairs Low Vision Intervention Trial (LOVIT): Design and Methodology

Cited by 27 publications

References 32 publications

Outcomes of the Veterans Affairs Low Vision Intervention Trial (LOVIT)

Outcomes of the Veterans Affairs Low Vision Intervention Trial (LOVIT)

Clinical effectiveness of currently available low-vision devices in glaucoma patients with moderate-to-severe vision loss

The Implantable Miniature Telescope and Quality of Life Improvements in Patients with End-Stage Age-Related Macular Degeneration

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