Improving function in age-related macular degeneration: a randomized clinical trial

Area of Science:

• Ophthalmology
• Psychology
• Rehabilitation

Background:

• Age-related macular degeneration (AMD) significantly impacts patients' quality of life and can lead to disability and depression.
• Current treatments, including anti-vascular endothelial growth factor therapies, do not fully address the functional and psychological burden of AMD.
• There is a need for effective rehabilitative interventions to improve both vision function and quality of life in individuals with AMD.

Purpose of the Study:

• To compare the efficacy of problem-solving therapy (PST) against supportive therapy (ST) in improving targeted vision function (TVF) for patients diagnosed with age-related macular degeneration (AMD).

Main Methods:

• A single-masked, attention-controlled, randomized clinical trial was conducted with 241 patients attending retina practices.
• Participants received either PST, a structured approach to reduce vision-related task difficulty, or ST, a standardized attention-control treatment.
• Outcomes, including TVF, NEI VFQ, AI, and vision-related QoL, were assessed at 3 and 6 months.

Main Results:

• No significant differences in targeted vision function (TVF) were observed between PST and ST groups at 3 or 6 months.
• Both PST and ST groups showed improvements in TVF from baseline to 3 months, with sustained scores at 6 months.
• Vision-related quality of life (QoL) improved significantly more in the PST group compared to the ST group at both 3 and 6 months.
• PST participants also demonstrated development of more adaptive coping strategies compared to ST participants.

Conclusions:

• Problem-solving therapy (PST) is not superior to supportive therapy (ST) for improving vision function in patients with age-related macular degeneration (AMD).
• PST demonstrated a significant benefit in improving vision-related quality of life (QoL) and fostering adaptive coping mechanisms in AMD patients.
• The findings highlight the necessity for novel rehabilitative strategies to enhance both functional vision and overall well-being in individuals affected by AMD.