The Link Between Visual Acuity and Health-Related Quality of Life Among Patients with Diabetic Retinopathy

Rousculp, Matthew D.; Boye, Kristina S.; Matza, Louis S.; Malley, Karen; Oglesby, Alan K.
June 2007
Diabetes;Jun2007 Supplement 1, Vol. 56, pA216
Academic Journal
The purpose of this study was to characterize the degree of change in health related quality of life (HRQL) associated with change in visual acuity (VA) among patients with diabetic retinopathy (DR). Data were from a multicenter study on vision loss in patients with type 1 or type 2 diabetes and moderate to severe nonproliferative DR. Visual acuity was defined at each time point as each individual's best corrected vision as determined by the ETDRS visual acuity chart score. HRQL was assessed with the 25-Item Visual Function Questionnaire (VFQ-25) and the SF-36. Patients were categorized into five groups based on visual acuity change from baseline to month 18: Improved by ≥ 10 letters; Improved by 5 to 9 letters; No change (-4 to +4); Worsened by 5 to 9 letters; and Worsened by ≥ 10 letters. These groups were compared in terms of HRQL change using general linear models (controlling for age, gender, and baseline visual acuity) with post hoc comparisons. 684 patients were enrolled, and analyses were conducted on 535 patients who had at least one VFQ-25 subscale at baseline and month 18. Patients were primarily Caucasian (81.9%) and male (64.1%), with a mean age of 59.3 years. Generally, changes in VA were associated with corresponding changes in HRQL. Compared with the no change group, the group that worsened by ≥ 10 letters in visual acuity had significantly greater decreases in all subscales of the VFQ-25 except ocular pain (e.g., near activities, distance activities, social functioning, role difficulties, dependency, driving, color vision, peripheral vision, and total score) and the mental health subscale of the SF-36. Findings suggest that change in visual acuity, particularly a loss of at least 10 letters, is associated with negative changes in multiple domains of HRQL.


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