Abstract
Purpose: :
This study examined vision-specific quality of life measurements in patients with non-proliferative diabetic retinopathy (NPDR) in relationship to visual function. The purpose was to identify any prominent visual complaint of patients with NPDR and the psychophysical basis for any such complaint.
Methods: :
The NEI VFQ-25 and UAB Low Luminance Questionnaire (LLQ) used to measure vision-specific quality of life. Each patient had the following visual function assessments: visual acuity, contrast sensitivity, dark adaptation, light and dark adapted visual fields, and frequency doubling technology perimetry.
Results: :
The sample consisted of 16 healthy controls, 21 patients with diabetes and normal retinal health, and 50 patients with NPDR. Both QOL questionnaires were unable to discriminate between normal volunteers and patients with diabetes without NPDR. For the NEI-VFQ 25 both near activities and distance activities subscales were depressed in the NPDR group compared with the normal group (all p < 0.05). Decreased acuity, contrast sensitivity and peripheral visual field and FDT sensitivity are correlated to decreased NEI VFQ near activities scores (r = 0.34, p = 0.002; r = 0.22, p =0.04; r = 0.28, p = 0.01; r = 0.24, p = 0.04). Decreased peripheral FDT, visual field, and acuity are correlated to decreased NEI VFQ distance activities scores (r = 0.22; p < 0.0001; r = 0.33; p < 0.001; r = 0.33, p = 0.002). For the LLQ both night driving and extreme lighting subscales were depressed in the NPDR group compared with the normal group (all p < 0.05). Slowed dark adaptation and lower dark-adapted visual sensitivity was correlated with decreased LLQ Driving scores (r = 0.28, p = 0.01; r = 0.24, p = .03). Likewise, slowed dark adaptation and lower dark adapted visual sensitivity was correlated to lower LLQ extreme lighting scores (r = 0.32, p = 0.003; r = 0.32, p = 0.004).
Conclusions: :
Patients with NPDR and good acuity exhibit mild to moderate difficulty with select activities of daily living as assessed by validated vision-specific quality of life questionnaires. The self-reported problems were correlated with decreased visual function measured in the laboratory.
Keywords: diabetic retinopathy • quality of life • vision and action