Abstract
Purpose :
There is some evidence that lower socioeconomic status (SES) is related to increased age-related macular degeneration (AMD) prevalence. We recently found that poorer visual acuity (VA) with habitual correction was related to lower education level in a sample of people diagnosed with AMD. The purpose of this study was to evaluate the potential roles of social support, smoking history, refractive correction status, and comorbidities in the relationship between SES and VA and self-reported visual functioning in patients from this sample.
Methods :
SES was represented as highest level of education. The ENRICHD Social Support Inventory, Impact of Vision Impairment Scale, and Charlson Comorbidity Index were administered to patients with AMD. VA with habitual correction was measured using an ETDRS chart with letter-by-letter scoring. Smoking status was assessed (current smoker, former smoker, or never smoker), as was spectacle wear. Multiple regression models and Fisher’s exact tests were used to examine relationships among potential predictors, SES, and vision.
Results :
124 people with AMD (54% female, mean±SD age of 82±9 years, 47% receiving anti-VEGF injections at time of study visit) were recruited. The IVI and ESSI were scored using Rasch analysis. There was a significant univariate relationship between education level and both VA (p=0.009) and self-reported visual functioning (p=0.014), with SES remaining a significant predictor of VA after adjusting for age (p=0.04). There was no significant relationship between SES and comorbidities (p=0.429), social support (p=0.265), or history of smoking (p=0.304). Spectacle wear was significantly related to both SES (p=0.018) and visual acuity (p<0.001). SES was significantly related to response on the “accessing information” item of the IVI (p=0.01), with low SES related to lower scores.
Conclusions :
Lower SES was related to poorer visual acuity in people with AMD. People in low SES categories were less likely to wear spectacles, and this was related to poorer visual acuity. We did not find relationships between SES and several potential mediators of the relationship, including social support, history of smoking, or comorbidities.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.