June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
Relationships between HIV-related Neuroretinal Disorder and Measures of Vision-Specific Quality of Life among People with AIDS
Author Affiliations & Notes
  • Davin Ashraf
    Ocular Inflammatory Disease Center, UCLA Stein Eye Institute and the Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA
  • Kevin Patrick May
    Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
  • Gary N Holland
    Ocular Inflammatory Disease Center, UCLA Stein Eye Institute and the Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA
  • Mark L Van Natta
    Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
  • Albert Wu
    Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
    Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
  • Jennifer E Thorne
    Department of Ophthalmology, Wilmer Eye Institute at Johns Hopkins, Baltimore, MD
  • Douglas A Jabs
    Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY
    Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
  • Footnotes
    Commercial Relationships Davin Ashraf, None; Kevin May, None; Gary Holland, Genentech (C), Novartis International AG (C), Santen Pharmaceutical (C), Xoma (US) LLC (C); Mark Van Natta, None; Albert Wu, None; Jennifer Thorne, Gilead (C), National Eye Institute (F), National Institute of Allergy and Infectious Diseases (F); Douglas Jabs, Applied Genetic Technologies, Inc. (S), Novartis Pharmaceutical Corp. (S), Santen Pharmaceutical (C)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 5777. doi:
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      Davin Ashraf, Kevin Patrick May, Gary N Holland, Mark L Van Natta, Albert Wu, Jennifer E Thorne, Douglas A Jabs, ; Relationships between HIV-related Neuroretinal Disorder and Measures of Vision-Specific Quality of Life among People with AIDS. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5777.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: Some HIV-infected individuals have evidence of optic nerve or retinal dysfunction, even with good visual acuity, that manifests as decreased contrast sensitivity (CS), and is termed neuroretinal disorder (NRD). HIV-related NRD is a risk factor for vision impairment, blindness, and mortality, but its effect on vision-specific quality of life (QOL) has not been explored.

Methods: We performed a cross-sectional study of participants in the Longitudinal Study of the Ocular Complications of AIDS (LSOCA) at initial completion of the National Eye Institute 25-item Visual Function Questionnaire (VFQ-25) who met the following inclusion criteria: no evidence of ocular opportunistic infection or cataract and best corrected visual acuity (BCVA) of 20/40 or better. Those with contrast sensitivity <1.50 logCS in either eye were considered to have NRD. QOL was compared between individuals with and those without NRD, with adjustment for age, BCVA, CD4+ T-lymphocyte count, and interval since AIDS diagnosis. The eleven VFQ-25 subscales and composite score were scored from 0 to 100, with higher scores representing better QOL. The relationships between NRD and VFQ-25 scores, and between logCS and VFQ-25 scores, were assessed using multiple linear regression and Spearman correlation, respectively.

Results: A total of 811 individuals met study criteria, 39 (4.8%) of whom had NRD. After adjustment, individuals with NRD had a significantly lower mean VFQ-25 composite score than those without NRD (79 vs. 87, respectively, p=0.0006). NRD was also significantly associated with lower mean scores in the following VFQ-25 subscales: near activities (78 vs. 86, p=0.009); distance activities (85 vs. 91, p=0.04); social functioning (89 vs. 96, p=0.001); mental health (76 vs. 87, p=0.0007); dependency (81 vs. 94, p<0.0001); and color vision (90 vs. 97, p<0.0001). Among those with NRD, the correlation between logCS and VFQ-25 composite score was 0.35 (p=0.03).

Conclusions: HIV-related NRD is associated with reduced vision-specific QOL among people with AIDS. Among those with NRD, decreasing contrast sensitivity is associated with lower VFQ-25 composite scores.

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