High mitochondrial DNA copy number is a protective factor from vision loss in heteroplasmic leber’s hereditary optic neuropathy (LHON)
2017
Purpose : The PrOVIDe study aimed to investigate the prevalence of a range of vision problems among people with dementias, aged 60-89 years and to examine the extent to which these conditions are undetected or inappropriately managed.
Methods : The study had two stages, a cross-sectional prevalence study followed by qualitative research. In Stage 1, 708 people with dementia (389 living at home and 319 in care homes) had a domiciliary eye examination. The inclusion criteria were people with dementia (any type), aged 60-89 years; individuals lacking mental capacity to provide informed consent to participate required a consultee who could give approval on their behalf.
Results : 22 percent reported not having had a test in the last two years: this included 19 participants who had not been tested in the last 10 years. Prevalence of visual impairment (VI) was 32.4% (95% Confidence Intervals (CI) 28.7 to 36.5) and 16.3% (CI 13.5 to 19.6) for the commonly-used criteria for VI of visual acuity (VA) worse than 6/12 and 6/18 respectively. Of those with VI, 44% (VA<6/12) and 47% (VA<6/18) were correctable with up-to-date spectacles. Almost 50% of remaining un-correctable VI (VA<6/12) was associated with cataract, therefore potentially remediable.
Conclusions : Almost 50% of VI was correctable with spectacles - more with cataract surgery. The prevalence of VI was similar to the best comparator data on the general population but the emerging study findings suggest that eye care for people with dementia could be enhanced. Department of Health Disclaimer: The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the HS&DR Programme, NIHR, NHS or the Department of Health.
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