The Impact of Visual Impairment in Stroke (IVIS) Study – Evidence of Reproducibility

ABSTRACT

Reporting generalisable data across stroke populations is important. We aimed to evaluate the Impact of Visual Impairment after Stroke (IVIS) visual assessment protocol in a different UK geographical area. This was a single-centre acute stroke unit, prospective study (IVIS-extension (IVIS-e) study) with comparison to a multi-centre acute stroke cohort (IVIS study). Orthoptists reviewed all stroke survivors with a standardised assessment of visual acuity, visual fields, ocular alignment, ocular motility, visual inattention and visual perception including a standardised follow-up strategy. 123 stroke survivors underwent visual screening: 42% women, 58% men, mean age 63.6 years and 86% ischaemic strokes. Ethnicity consisted of 68.3% white British and 28.5% being Pakistani, Indian, Caribbean, Bangladeshi, Black and Chinese. Two died and 28 could not be assessed. Of the 93 remaining, 10 stroke survivors (10.8%) had a normal visual assessment and 83 (89.2%) had visual impairments detected. Fifty-seven stroke survivors were assessed at their first orthoptic visit within 3 days of stroke onset; the remainder being assessed at subsequent orthoptic visits to the stroke unit. The visual profile was similar across the IVIS-e and original IVIS cohorts for most types of visual impairment although, overall, more visual impairment was detected in IVIS-e. Differences between the cohorts were primarily related to lower age and smaller white British ethnicity in the IVIS-e cohort. This likely relates to the differing population demographics for the two cohort geographical areas. Further roll-out of the IVIS assessment protocol to other regions and countries would improve detection of post-stroke visual impairment.

KEYWORDS:

• Stroke
• vision
• incidence
• prevalence
• Reproducible

Acknowledgements

We would like to thank the staff supporting this study at Bradford Teaching Hospital NHS Foundation Trust: Dr Alison Bruce; Claire Fowler; Dr Chris Patterson; and Dr Stuart Maguire. We thank the patients involved in the study.

Transparency statement

The lead author confirms that this manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned (and, if relevant, registered) have been explained.

Declaration of interest statement

The authors report no conflicts of interest.

Ethics

This study had institutional ethical approval and was undertaken in accordance with the Tenets of Helsinki. Informed consent was obtained if the participants attended and participated in the focus group meetings.

Data availability statement

Data can be accessed via direct contact with the lead author on reasonable request.

Author contributions

FR provided oversight for the study and led the writing of the paper. LH contributed to data collection, reviewing the draft paper and approving the final version.