Improving Function in Age-Related Macular Degeneration

Last updated: April 11, 2025
Sponsor: Thomas Jefferson University
Overall Status: Completed

Phase

3

Condition

Aging

Myopic Macular Degeneration

Geographic Atrophy

Treatment

PST

ST

Clinical Study ID

NCT00572039
5U01EY015839
NEI grant
  • Ages > 65
  • All Genders

Study Summary

This randomized, controlled clinical trial will test the efficacy of Problem-Solving Treatment (PST) to improve vision function in older persons with age-related macular degeneration (AMD). AMD is a highly prevalent, disabling disease of aging that causes severe vision loss and functional decline. It is the leading cause of blindness in older persons in the United States and may affect more than 10 million people. Currently, there are no effective treatments to restore vision. Thus, improving Vision Function is a major goal of treatment. Vision function refers to vision-related abilities to perform daily living activities (e.g. reading recipes to prepare meals). Decrements in vision function will become a major public health problem as the population ages and the prevalence of AMD increases. PST is a brief, standardized, cognitive-behavioral treatment that teaches problem-solving skills.

We believe PST will enable patients with AMD find practical solutions to vision-related problems and thereby improve vision function.

We will recruit 240 AMD patients from the retina clinics of Wills Eye Institute, Philadelphia, PA, with bilateral AMD and visual acuity worse than 20/70 in the better eye. PST-trained therapists will deliver 6 1-hour, in-home sessions to the 120 subjects randomized to PST. The control treatment is Supportive Therapy (ST), a similarly structured, standardized psychological treatment that controls for the non-specific effects of treatment (n=120). ST contains no active elements beyond its non-specific components; in this way it is a placebo treatment. Independent raters, masked to treatment assignment, will assess Targeted Vision Function (primary outcome) and vision-related quality of life (secondary outcome) at 3 months to assess PST's efficacy, and at 6 months to evaluate its long-term effects. As the population ages, the disability of AMD will become more prevalent, costly, and burdensome to patients, families, and ophthalmologists. This makes devising and testing practical and affordable interventions to improve vision function a national priority.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • Being at least 65 years old

  • Having bilateral Age-Related Macular Degeneration (AMD) (atrophic or neovascular)

  • Having a best corrected visual acuity of 20/70 or worse

  • Moderate difficulty in at least one valued vision functional goal

Exclusion

Exclusion Criteria:

  • Ophthalmologic Criteria. Patients who have uncontrolled glaucoma (continued visualfield loss and increase in optic nerve cupping), diabetic retinopathy (due tomacular edema), or cataracts for which surgery within 6 months is likely will not beeligible to participate. This information will be obtained from patients'ophthalmology charts and discussion with the patient's ophthalmologist.

  • Cognitive Impairment Criteria. Cognitive functioning will be evaluated by theProject Director during the telephone screen (see Chapter 9). Patients withcognitive impairment will not be eligible to participate.

  • Health Criteria. Patients with life-threatening illness (e.g., terminal cancer, needfor oxygen) will not be eligible to participate. Information regarding heath statuswill be gleaned from patient's ophthalmology charts.

Study Design

Total Participants: 241
Treatment Group(s): 2
Primary Treatment: PST
Phase: 3
Study Start date:
August 01, 2005
Estimated Completion Date:
June 30, 2013

Study Description

The primary hypothesis will address treatment group differences in Targeted Vision Function at 3-months, and secondary hypotheses will the long-term effect (6-months) of Problem Solving Treatment (PST) on TVF and vision-related quality of life.

Connect with a study center

  • Thomas Jefferson University

    Philadelphia, Pennsylvania 19107
    United States

    Site Not Available

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