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Meta-Analysis
. 2020 Feb 27;2(2):CD011019.
doi: 10.1002/14651858.CD011019.pub3.

Telerehabilitation for people with low vision

Ava K Bittner  1 , Patrick D Yoshinaga  2 , Stephanie L Wykstra  3 , Tianjing Li  4
Affiliations
Meta-Analysis

Telerehabilitation for people with low vision

Ava K Bittner et al. Cochrane Database Syst Rev. .

Update in

  • Telerehabilitation for people with low vision.
    Bittner AK, Yoshinaga PD, Rittiphairoj T, Li T. Bittner AK, et al. Cochrane Database Syst Rev. 2023 Jan 13;1(1):CD011019. doi: 10.1002/14651858.CD011019.pub4. Cochrane Database Syst Rev. 2023. PMID: 36637057 Free PMC article.

Abstract

Background: Low vision affects over 300 million people worldwide and can compromise both activities of daily living and quality of life. Rehabilitative training and vision assistive equipment (VAE) may help, but some visually impaired people have limited resources to attend in-person visits at rehabilitation clinics to receive training to learn to use VAE. These people may be able to overcome barriers to care through remote, Internet-based consultation (i.e. telerehabilitation).

Objectives: To compare the effects of telerehabilitation with face-to-face (e.g. in-office or inpatient) vision rehabilitation services for improving vision-related quality of life and near reading ability in people with visual function loss due to any ocular condition. Secondary objectives were to evaluate compliance with scheduled rehabilitation sessions, abandonment rates for VAE devices, and patient satisfaction ratings.

Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2019, Issue 6); Ovid MEDLINE; Embase.com; PubMed; ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP). We did not use any language restriction or study design filter in the electronic searches; however, we restricted the searches from 1980 onwards because the Internet was not introduced to the public until 1982. We last searched the electronic databases on 24 June 2019.

Selection criteria: We planned to include randomized controlled trials (RCTs) or controlled clinical trials (CCTs) in which participants diagnosed with low vision were undergoing low vision rehabilitation using an Internet, web-based technology compared with an approach involving in-person consultations.

Data collection and analysis: Two review authors independently screened titles and abstracts and then full-text articles against the eligibility criteria. We planned to have two review authors independently abstract data from the included studies. Any discrepancies were resolved by discussion.

Main results: We identified two ongoing studies, but did not find any completed RCTs and CCTs that met the inclusion criteria for this review. We did not conduct a quantitative analysis. We discussed review articles on telemedicine for facilitating communication with elderly individuals or for providing remote ophthalmological care.

Authors' conclusions: We did not find any evidence from RCTs or CCTs on the efficacy of using telerehabilitation for remote delivery of rehabilitation services to individuals with low vision. Given the disease burden and the growing interest in telemedicine, the two ongoing studies, when completed, may provide evidence in understanding the potential for telerehabilitation as a platform for providing services to people with low vision.

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Conflict of interest statement

One reason for conducting this systematic review was to establish the knowledge base for designing a randomized controlled trial to evaluate the efficacy of telerehabilitation for a primarily elderly, visually impaired population. Along with this systematic review, Dr Tianjing Li has received funding to collect pilot data to demonstrate the feasibility of using telerehabilitation as a platform for delivering low‐vision rehabilitation services. The systematic review and the pilot data collected will lay the foundation for preparing a randomized controlled trial application. Dr. Bittner has received funding from the National Eye Institute, National Institutes of Health, the American Academy of Optometry, and Envision Research Institute to conduct pilot studies of telerehabiliation for low vision.

PDY and SLW have no conflicts of interest to declare.

Figures

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1
Study flow diagram.
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