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Jeffrey Ryuta Willis, Quan Doan, Michelle Gleason, Lawrence S Morse, Pradeep Ramulu, Ronald A Cantrell; Self-Reported Visual Function among Adults with Diabetic Retinopathy in the United States. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2886.
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© ARVO (1962-2015); The Authors (2016-present)
To assess the self-reported visual function of adults with diabetic retinopathy (DR) in the United States.
Cross-sectional study, utilizing data from the 2005-6/2007-8 National Health and Nutrition Examination Survey (NHANES). Diagnosis of DR was based on grading of fundus photographs. Visual function was assessed during a household questionnaire where survey participants self-reported difficulty with reading, visual-spatial tasks (i.e., close up work or finding things on a crowded shelf), mobility (i.e., walking down steps/stairs/curbs), and driving. The main outcome variable was self-reported functional difficulty, which was defined as present for individuals reporting reporting moderate or severe difficulty in any of the above tasks. Additional multiple logistic regression analysis were conducted to evaluate the association of DR severity on self-reported functional difficulty in models adjusting for better-eye logMAR presenting visual acuity, age, gender, race/ethnicity, self-perceived health status, and education.
A total of 6,797 persons age 40 or older participated in NHANES during the 2005-6 and 2007-8 periods, and 1,436 (21.1%) of these individuals had diabetes. Among those with diabetes, 1,038 had complete retinal imaging data, and 72.2%, 25.5%, and 2.3% had no retinopathy, mild/moderate non-proliferative diabetic retinopathy (NPDR), and severe NPDR or proliferative diabetic retinopathy (PDR), respectively. The weighted prevalence of self-reported functional difficulty was 20.4% [95% Confidence Interval(CI) 16.6-24.3%], 21.6% (95% CI 15.3-27.8%), and 50.6% (95% CI 28.1-73.1%) across those with no retinopathy, mild/moderate NPDR, and severe NPDR/PDR, respectively (p<0.01). In multivariable analysis, the odds of self-reported functional difficulty was significantly greater among those with severe NPDR/PDR relative to those with no retinopathy (Adjusted Odds Ratio 3.56, 95% CI 1.27-9.99, p=0.02).
More than half of adult Americans with severe NPDR/PDR reported difficulty with at least one visual function task. Additionally, these individuals with severe NPDR/PDR reported significantly greater difficulty with visual function tasks relative to those with less severe retinopathy, even after adjusting for visual acuity. Thus, in preserving the visual function of adult Americans with diabetes, it may be important to prevent the progression to severe diabetic retinopathy.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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