September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Visual outcomes and vision-related quality of life in veterans with dementia or cognitive impairment: Results from the Veterans Affairs Ophthalmic Surgery Outcomes Data Project
Author Affiliations & Notes
  • Abhishek R Payal
    Ophthalmology, Veterans Affairs Boston Healthcare System, Jamaica Plains, Massachusetts, United States
    Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
  • Tulay Cakiner-Egilmez
    Ophthalmology, Veterans Affairs Boston Healthcare System, Jamaica Plains, Massachusetts, United States
  • Luis A Gonzalez
    Ophthalmology, Veterans Affairs Boston Healthcare System, Jamaica Plains, Massachusetts, United States
  • Amy Chomsky
    Ophthalmology, Veteran Affairs Tennessee Valley Healthcare System Center, Nashville, Tennessee, United States
    Vanderbilt Eye Institute, Vanderbilt University Medical , Nashville, Tennessee, United States
  • David E Vollman
    Ophthalmology, St. Louis Veteran Affairs Medical Center, St. Louis, Missouri, United States
    Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri, United States
  • Elizabeth Baze
    Ophthalmology, Michael E. DeBakey Veteran Affairs Medical Center, Houston, Texas, United States
    Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, United States
  • Mary G Lawrence
    Department of Defense/Veterans Affairs Vision Center of Excellence, Bethesda, Maryland, United States
  • Mary K Daly
    Ophthalmology, Veterans Affairs Boston Healthcare System, Jamaica Plains, Massachusetts, United States
    Ophthalmology, Boston University School of Medicine, Boston, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Abhishek Payal, None; Tulay Cakiner-Egilmez, None; Luis Gonzalez, None; Amy Chomsky, None; David Vollman, None; Elizabeth Baze, None; Mary Lawrence, None; Mary Daly, None
  • Footnotes
    Support  The opinions expressed are those of the authors and not necessarily those of the Department of Veterans Affairs or the United States Government. This material is the result of work supported with resources and the use of facilities at the Veterans Affairs Boston Healthcare System, Boston, Massachusetts, USA.
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 2007. doi:
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    • Get Citation

      Abhishek R Payal, Tulay Cakiner-Egilmez, Luis A Gonzalez, Amy Chomsky, David E Vollman, Elizabeth Baze, Mary G Lawrence, Mary K Daly; Visual outcomes and vision-related quality of life in veterans with dementia or cognitive impairment: Results from the Veterans Affairs Ophthalmic Surgery Outcomes Data Project. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2007.

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

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Abstract

Purpose : To analyze visual acuity outcomes and functional visual improvement after cataract surgery in veterans who have a diagnosis of dementia or cognitive impairment.

Methods : We analyzed 3154 of 4,923 cataract surgery cases, either without (Group A) or with dementia or cognitive impairment (Group B), who completed both pre- and postoperative National Eye Institute-Visual Function Questionnaire (NEI-VFQ 25), in the Veterans Affairs (VA) Ophthalmic Surgical Outcomes Data (OSOD) Project. The two groups were compared on best-corrected visual acuity (BCVA, logMAR scale) and all NEI-VFQ 25 subscales. Data were analyzed using analysis of variance and nonparametric tests. Correlation was estimated using Pearson’s correlation coefficient.

Results : 3052 (96.8%) of 3154 cases were in Group A, 93 (2.9%) cases were in Group B, and 9 (0.3%) had missing data. BCVA improved significantly from pre-to post-surgery in Group A (0.08 ± 0.23, P<.0001) and in Group B (0.14 ± 0.31, P<.0001). There was comparable improvement in BCVA in both the groups from pre-to post-surgery (P=.91). Dementia or cognitive impairment, as defined by the OSOD, did not increase the risk of postoperative BCVA worse than 20/40 compared to Group A (A:6.6% vs B:9.4%, OR 1.36, 95% CI 0.59 – 2.73, P=.45, adjusted for systemic comorbidities)
VFQ composite scores increased significantly from pre- to post-surgery in Group A (83.8 ± 16.9, P<.0001), as well as in Group B (74.3 ± 21.8, P<.0001). The improvement in VFQ composite scores in Group A was comparable to improvement in Group B (P=.17). For veterans in Group A, the improvement in BCVA correlated significantly with improvement in VFQ composite scores (Pearson’s r =0.17, P<.0001). In Group B, the correlation between the improvements in vision and vision-related quality of life (VRQoL) was not significant (r=0.13, P=0.24).

Conclusions : Cataract surgery offers significant and comparable improvement in vision and VRQoL for eyes in both groups. Among veterans with dementia or cognitive impairment, there was no significant correlation between improvement in BCVA and VRQoL. So factors other than improvement in vision may be affecting the gains in VrQoL. Further research is necessary to explore this aspect.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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