Factors predicting Visual Acuity Improvement after Refraction and Reading Ability at 1.5 M in Patients with Low Vision

Purpose This retrospective study aimed to identify factors predicting improvements in presenting visual acuity (pVA) after refraction and in reading ability among low-vision (LV) patients aged 50 and older. Objectives To identify predictors of improvement in pVA after refraction and predictors of reading rehabilitation in LV patients. Methods This observational and retrospective study analyzed medical records of patients aged 50+ years from a LV rehabilitation center in Ribeirão Preto, SP, Brazil, between 2009 and 2019. Improvement in pVA was considered positive if there was an increase of at least 2 logMAR lines after manifest refraction. Reading rehabilitation was deemed successful if the patient was able to read 1.5 M-sized texts.The study evaluated the following predictors: age, sex, pVA, best-corrected visual acuity for distance (dBCVA), the anatomical region responsible for LV, educational level, spherical equivalent, and the degree of cylinder. Data analysis and associations were determined using logistic regression, with a p-value of 0.05 set as the threshold for statistical significance. Results There were 558 patients with a mean age of 67 years; predominant retinal involvement; the pVA improved after refraction in 20.3%; pVA and the spherical equivalent are predictors of improving pVA after refraction. Among 346 literate patients, 253 (73.1%) could read 1.5 M texts after rehabilitation. The predictors of reading rehabilitation were dBCVA, anatomic region retina, better educational level, and female sex. The worse the dBCVA and the older age hinder reading rehabilitation. Conclusions The predictors of improvement in pVA after refraction and reading rehabilitation in LV patients highlight the importance of clinical and demographic factors. While age, sex, and education level were not associated with improvements after refraction, both pVA and spherical equivalent emerged as significant predictors. A higher educational level, female sex, and retinal involvement were associated with a greater likelihood of successful reading rehabilitation. Conversely, increasing age and a decrease in dBCVA were linked to a reduced likelihood of reading rehabilitation. These findings underscore the importance of addressing clinical, demographic, and socioeconomic factors in the rehabilitation of individuals with LV.