Predictors of improvement in distance presenting visual acuity after refraction and reading rehabilitation at ≤ 1.5 M print size in older adults with low vision

BACKGROUND: This study aimed to identify factors associated with improvement in distance presenting visual acuity (dpVA) after refraction and with successful reading rehabilitation among patients aged 50 years or older with low vision. METHODS: We conducted a retrospective observational study using medical records from a low-vision rehabilitation center in Ribeirão Preto, São Paulo, Brazil, between 2009 and 2019. Improvement after refraction was defined as a gain of at least two 0.2 logMAR after manifest refraction for distance correction. Successful reading rehabilitation using spectacles and/or magnifiers was defined as the ability to read texts of 1.5 M or smaller. Candidate predictors included age, sex, dpVA, distance best-corrected visual acuity, anatomical region responsible for low vision, educational level, spherical equivalent, and cylinder power. Logistic regression was performed, with statistical significance set at p < 0.05. RESULTS: Overall, 558 patients were included, with a mean age of 67 years. Retinal involvement was the most frequent anatomical finding. Improvement in dpVA after refraction occurred in 20.3% of patients, and dpVA and spherical equivalent were significant predictors of this outcome. Among 346 literate patients, 252 (72.8%) were able to read 1.5 M texts after rehabilitation. Successful reading rehabilitation was associated with better distance best-corrected visual acuity, retinal involvement, higher educational level, and female sex, whereas older age and worse distance best-corrected visual acuity were associated with lower odds of success. CONCLUSIONS: Clinical, refractive, and demographic factors were associated with dpVA improvement after refraction and successful reading rehabilitation in older adults with low vision.