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Vijaya Gothwal, Bharani Seelam, Annie Mathai, Divya Balakrishnan, Jay Chhablani, Padmaja Kumari Rani, Mudit Tyagi, Jyoti Khadka, Konrad Pesudovs; Vision-related Quality of Life before and after interventions for Diabetic Retinopathy. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5600.
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© ARVO (1962-2015); The Authors (2016-present)
Diabetic retinopathy (DR) is the leading cause of blindness among working-age adults (20-74 years) worldwide and it negatively impacts the patient’s functioning and quality of life (QoL). The DR-specific QoL item bank (IB) was recently developed to assess comprehensively DR related QoL impact and treatment outcomes. The aim of this study was to use the DR-specific QoL IB to evaluate the vision-related QoL (VRQoL) of patients with DR following different treatment modalities.
Consecutive adults with DR scheduled to undergo laser, anti-vascular endothelial growth factor (VEGF) or vitreoretinal (V-R) surgery from 2012 to 2014 at a tertiary eye care centre, South India were included. Each participant was verbally administered the IB by a trained interviewer before and 6 weeks after the treatment. The IB consists of 370 items representing 9 QoL domains – visual symptoms, ocular surface symptoms, activity limitation, mobility, emotional, health concerns, social, convenience, economic, on a 5-or 4-category rating scale. Rasch-scaled scores were generated using Winsteps software for baseline and follow-up data. Effect sizes (ES) were calculated using Cohen’s d coefficient.
268 patients were included (mean [SD] age= 52.8 [8.7] years; 72% male) and mean [SD] duration of DR was 12.0 [1.6 years]. The majority had vision-threatening DR at least in one eye (94%). One-half of the patients underwent V-R surgeries (50%), 39% received laser and 11% required anti-VEGF. There was no statistically significant difference in mean visual acuity (VA) in better eye following treatment across treatment type (0.46 ± 0.55 vs. 0.41 ± 0.37, p=0.11). However, there were significant improvements in the VRQoL across 8 domains - visual symptoms (ES=-0.78, p=0.001), ocular surface symptoms (ES=-0.27, p=0.001), activity limitation (ES=-0.40, p=0.001), mobility (ES=-0.33, p=0.001), emotional (ES=-0.33, p=0.001), health concerns (ES=-0.47, p=0.001), social (ES=-0.13, p=0.02), convenience (ES=-0.32, p=0.001) following treatment. No significant improvement was found for economic domain (ES=-0.54, p=0.89).
Despite a limited impact on VA following treatment for DR, patients reported a significant improvement in the VRQoL, with largest improvement in visual symptoms. Improvements in VRQoL should be considered a goal in management of patients with DR and the DR-specific QoL IB serves as an ideal tool for this purpose.
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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