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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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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.
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.
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).
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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