US researchers have reported that hearing impairment may reduce the functional benefit patients gain from low-vision rehabilitation, even when their baseline visual ability is similar to that of patients without hearing loss.

The Johns Hopkins-led study, published in JAMA Ophthalmology, is a cross-sectional analysis drawn from the prospective Low Vision Rehabilitation Outcomes Study. The Wilmer Eye Institute team assessed 611 adults (mean age 73 years and 66% women) receiving outpatient low-vision rehabilitation at 28 US centres. Of the total cohort, 253 participants self-reported hearing impairment and 407 had complete post-rehabilitation follow-up data. The primary outcome was change in general ability measured using the Activity Inventory, with success defined as achieving a minimum clinically important difference.

Baseline ability did not differ significantly by hearing status, but patients with hearing impairment were less likely to achieve a clinically meaningful improvement after low-vision rehabilitation, said authors. Among those with follow-up, 23% of participants with hearing impairment reached the minimum clinically important difference compared with 31% of those with normal hearing, equating to an odds ratio of 0.58. The association remained after adjustment for age, sex, visual, psychological, physical and cognitive
factors. Hearing aid possession did not appear to improve the likelihood of meaningful functional gain.

The authors said the findings support more interdisciplinary rehabilitation approaches for people with dual sensory impairment. They also noted that patients with more severe vision impairment were more likely to achieve meaningful improvement, as were those with higher depressive symptom scores, possibly reflecting greater scope for measurable change.