Session Title: AMD I
Session Date/Time: Thursday 17/09/2015 | 08:30-10:30
Paper Time: 09:18
First Author: : A.Tufail -0
Co Author(s): : D. Ferrara E. Souied E. Tschosik M. Kimel R. Varma N. Bressler
PURPOSE:Maintaining reading ability is important to most people with age-related macular degeneration. Reading ability can be measured using objective performance assessments at an ophthalmological clinic, and it can be investigated through patient-reported outcome (PRO) measures. PRO questionnaires can provide insight into the effect of reading impairment on daily life. This study examined objectively measured reading speed and its relationship to patient-reported independence performing everyday activities that require reading.
This study included secondary analyses of data from MAHALO, a multi-center, randomized, sham-controlled, phase 2 trial that evaluated lampalizumab, a monoclonal antibody antigen binding fragment (Fab) designed for intraocular use in patients with geographic atrophy (GA) secondary to age-related macular degeneration.
Subjects received sham or lampalizumab injections in 1 eye monthly or every other month for 18 months. Reading speed, the number of correctly read words per minute (wpm), was measured using MNREAD acuity charts with continuous text representing everyday reading. Reading fluency was defined as ≥80 wpm. Patient-reported reading independence was measured by the 7-item interviewer-administered Functional Reading Independence (FRI) Index. For each reading activity (e.g. writing checks or reading written print), the patient was asked if she/he performed the activity during the past 7 days and the extent to which she/he required low vision aids, adjustments in the activity, or help from another person. Scores ranged from 1 (unable to do) to 4 (totally independent). Both reading assessments were binocular and measured at baseline and every 6 months. Treatment arms were collapsed for these analyses (N=100).
At baseline, the correlation (Spearman’s r) between objectively measured reading speed and functional reading independence was 0.72 (P less than 0.001). Over 18 months, average reading speed declined from 105 wpm (n = 95) at baseline to 82 wpm (n = 80), an average decrease of 26 wpm (SD 44). Fluent readers (≥80 wpm) had higher mean (±SD) FRI Index scores than less fluent readers (those reading less than 80 wpm) at baseline (3.0 ± 0.07 versus 1.9 ± 0.07, P less than 0.0001) and at month 18 (2.7 ± 0.7 versus 1.7 ± 0.8, P less than 0.0001).
In MAHALO, on average patients with GA presented with substantial declines in reading speed over 18 months. Reading speed, an objective measurement, was correlated strongly with patient-reported functional reading independence assessed via questionnaire. These data support the use of both binocular reading speed testing and patient-reported functional reading independence questionnaire as outcome measures in clinical trials of patients with GA.