Rehab therapy cuts depression risk for AMD sufferers

Rehab therapy cuts depression risk for AMD sufferers

New research suggests a type of rehabilitation therapy may cut depression risk in half for people who have lost their vision because of age-related macular degeneration (AMD).

"Optometry can play a huge positive role in the lives of patients susceptible to loss of sight from AMD."

AMD is the leading cause of vision loss in the United States, and depression is a common associated risk. A study funded by the National Eye Institute (NEI) offers a potential path to alleviating this risk.

In the Low Vision Depression Prevention Trial, also called VITAL, researchers used an approach called "behavior activation." This approach relies on a team of psychologists, ophthalmologists, optometrists and occupational therapists.

All participants in the study saw an optometrist, who prescribed low-vision devices such as handheld magnifiers. The participants were then randomly split into two groups. The control group spoke to a therapist about their struggles with vision loss and received medical management of AMD as prescribed by their primary eye care provider.

The experimental group received behavior activation, in which an occupational therapist trained them to use low-vision devices, worked with them to make changes in their homes and helped them increase social activities and set personal goals.

When the results were adjusted for vision status, physical health and baseline PHQ-9 (a patient health questionnaire on depression risk), researchers found that behavior activation cut the risk for depression by 50 percent when compared to the control group treatment.

Optometry's role in vision treatment planning
Brenda Heinke Montecalvo, O.D., chair of the AOA's Vision Rehabilitation Section (VRS), believes the NEI study will improve public awareness of the importance of vision and eyesight.

However, she did express concern that the study failed to note the importance of optometric low-vision evaluations prior to behavioral therapy.

"Appropriate optical and eye health measures should always be the first step prior to coordinating care with members of the rehabilitation team. The optometrist who provides low-vision assessments has the best education and training to determine appropriate vision treatment plans," says Dr. Montecalvo.

"Optometry can play a huge positive role in the lives of patients susceptible to loss of sight from AMD. With early detection, the optometrist can begin preparing the patient and their caregivers to learn how to participate in preferred daily living activities once they begin to have deteriorating eyesight," Dr. Montecalvo says.

The purpose of the AOA VRS is to make optometrists more aware of the many aspects of vision impairment—including prescribing consultations with psychologists as needed, which has been a part of low-vision patients' treatment for many years. Find more information about the AOA VRS at this link.

July 31, 2014

comments powered by Disqus