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Bradley E Dougherty, San-San Cooley, Frederick Davidorf; The Relationship between Perceived Stress and Self-reported Visual Function in Patients with Neovascular Age-related Macular Degeneration (AMD). Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1370.
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Age-related macular degeneration (AMD) is associated with increased rates of depression and decreased quality of life. Previous studies have shown that depression may predict a portion of self-reported visual functioning (e.g. NEI-VFQ scores) independent of visual acuity. The purpose of this study was to assess the relationship between self-reported stress and visual functioning using the Perceived Stress Scale (PSS, Cohen 1983) and the Impact of Vision Impairment Scale (IVI, Lamoureux, 2006) in patients being treated for neovascular AMD.
Patients with a history of neovascular AMD were enrolled during visits to a retinal specialist (FHD) for evaluation of the need for treatment with intraocular anti-VEGF injection. Visual acuity was assessed using a backlit ETDRS chart and by-letter scoring. The ten-item PSS and the reading and accessing information subscale of the IVI were administered to all participants. Participants completed large-print paper versions of the surveys when possible, and the surveys were read aloud to patients who were unable to complete them for visual reasons. Rasch analysis of survey responses was performed using Winsteps with the Andrich rating scale model. Item fit was assessed using infit mean square statistics. Spearman correlation coefficient was used to evaluate the relationships among PSS and IVI score and visual acuity.
Fifty-nine participants (29 male) completed the both the PSS and IVI. Mean age ± SD was 81 ± 8 years. Mean ETDRS letter score visual acuity with habitual correction was 62 ± 19 (approximately 20/50). Response category functioning was good for both surveys, with ordered category probability curves for the specified response structures. There was a significant relationship between IVI score and better-eye visual acuity (P < 0.001). Perceived stress was not correlated with visual acuity (P = 0.893), however it was associated with self-reported visual functioning (rho = −0.31, P = 0.016).
There was a significant inverse correlation between self-reported visual functioning (but not visual acuity) and perceived stress in this group of patients with macular degeneration. This finding has implications for vision rehabilitation programs for patients with AMD.
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