For low vision specialists and those who consult them
Low vision rehabilitation after anti-VEGF treatment
There is a very interesting paper in the most recent issue of Eye examining fixation characteristics in people who have received ranibizumab (Lucentis) for age-related macular disease. The authors compare fixation stability and position in people who have received treatment to a cohort of people with untreated wet AMD. They showed that fixation is more central, and more stable, in people who have received anti-VEGF therapy.
We know that better fixation stability is related to better visual function on measures such as reading speed. This implies that people who have received injections are likely to read better than those who have not received this treatment.
As this paper is not longitudinal we don’t know whether the treatment improves people’s fixation or not. It is also confounded by the fact that the people who did not receive treatment had worse vision (as this group mostly consisted of people whose vision was too poor to receive treatment). However, it emphasises the point that vision rehabilitation needs are different in people who have received Lucentis or other treatments. In my anecdotal experience, people tend to need more lighting (perhaps as the area of relative scotoma is bigger) and I am more likely to prescribe low power magnifiers to this group of people with low vision.
I am sure more research will examine the rehabilitation of people who have received Lucentis or other agents, and will post more here when I see it.