A Pilot Study of Perceptual Training to Improve Reading Performance in Patients With Age-Related Macular Degeneration (AMD)

Purpose: Investigate the prevalence of near vision impairment in older adults in a low-middle income urban area of São Paulo city, Brazil. Methods: Cluster sampling based on geographically-defined census sectors was used in randomly selecting individuals ≥50 years of age for visual acuity measurement for near and distance (tumble E logMAR chart), refraction, and slit-lamp examination during 2004-2005. Informed consent was obtained from all participants. Near vision impairment was considered as visual acuity 20/40 or worse in either eye for reading distance (40 cm). Uncorrected/undercorrected presbyopia as cause of near vision impairment was considered as presenting near VA 20/40 or worse in the better vision eye and best-corrected visual acuity of ≥20/40 the better vision eye for distance along with improvement of one or more lines in the near VA chart with additional positive lenses. Results: A total of 4224 eligible persons were enumerated and 3678 (87.1%) were examined. The prevalence of near vision impairment was 59.93% (95% confidence interval [CI]: 57.05%-62.80%). The prevalence of near vision impairment caused by uncorrected/undercorrected presbyopia was 39.49% (95% CI: 36.72%-42.27%). With logistic regression, near vision impairment was associated with male gender and lack of schooling. Conclusions: The high prevalence of near vision impairment caused by presbyopia and its effect on performing activities related to near vision, along with the increasing population aging in developing countries indicates that greater emphasis on strategies to target this issue is needed. Brazilian health authorities should implement actions to improve access to eye care services and provide affordable optical correction for this population, with emphasis on those with lack of formal education. CR: S.R. Salomao, None; A. Berezovsky, None; A. Araujo-Filho, None; M.R. Mitsuhiro, None; R. Belfort, Jr., None. Support: FAPESP Grant 04/06670-9, WHO grant N-01EY-2103 123 A251 A Pilot Study of Perceptual Training to Improve Reading Performance in Patients With Age-Related Macular Degeneration (AMD)