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E. Papageorgiou, G. Hardiess, F. Schaeffel, H. Wiethoelter, H.-O. Karnath, H. Mallot, B. Schoenfisch, U. Schiefer; Vision-Related Quality of Life (QoL) Assessment in Patients With Homonymous Visual Field Defects (HVFDs) Due to Postchiasmal Vascular Lesions. Invest. Ophthalmol. Vis. Sci. 2007;48(13):931.
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(i) To describe the vision-targeted, health-related quality of life (QoL), assessed with the 25-item National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25), in patients with HVFDs due to postchiasmal vascular lesions, and (ii) to determine the relationship between the NEI-VFQ-25 scores and the characteristics of the HVFDs in the binocular visual field, assessed with semi-automated kinetic perimetry (SKP).
The German version of the NEI-VFQ-25 was used in this study. The scores were compared to reference values of healthy subjects, published by Mangione et al. (2001). Extent and location of absolute HVFDs were assessed by binocular SKP within the 90° visual field (stimulus III4e, angular velocity 3°/s, background luminance 10 cd/m²) using the Octopus 101 Perimeter (HAAG-STREIT Inc., Koeniz, Switzerland). Correlations of the NEI-VFQ-25 scores of patients with the area of sparing within the affected hemifield (A-SPAR) were estimated by Spearman`s rS.
The NEI-VFQ-25 composite score for 33 patients was 82.8, which was significantly lower (p<0.0001) than the reference values for 122 normal subjects. This was also the case for the sub-scores regarding general vision, near activities, vision specific mental health, driving, color and peripheral vision. The score for general health was also significantly lower (p<0.0001) in patients than in normals, probably due to the existing cerebrovascular lesion. Only a weak correlation of the composite score with A-SPAR (rS=0.38) was observed.
Our findings suggest that patients with HVFDs due to postchiasmal vascular lesions experience a reduction in vision-targeted QoL. The results reveal only a tendency for increasing QoL with advancing size of the area of sparing within the affected hemifield (A-SPAR). The lack of a strong correlation between NEI-VFQ-25 subscales and A-SPAR suggests that an assessment of the visual field per se may not accurately reflect the perceived ability of the patient to function. Additional assessment of visual exploration via eye and head movements may improve the correlation between visual function and its perception.
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