Abstract
Purpose: :
to examine the association between improvements in visual acuity (VA) and item specific changes in the NEI-VFQ in Latinos participating in The Los Angeles Latino Eye Study (LALES).
Methods: :
Data included in this analysis were collected for a population-based cohort of eye disease. Distance visual acuity (VA) was measured during a detailed ophthalmologic examination using standard ETDRS protocol at baseline and a follow-up examination, approximately 4 years later. Vision specific quality of life was assessed at the two time points using the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25). Responses were ranked from "always a problem" (score=0) to "never a problem" (score=100) for 25 task-oriented items related to daily visual functioning. Mean differences in item scores from baseline to follow-up were calculated for 131 participants with a 2 line or greater improvement in VA based on presenting, binocular vision. Paired t-tests were used to calculate 2-sided p-values. Mean differences and effect sizes (ES) for NEI-VFQ item means were calculated.
Results: :
Over the 4-year follow-up period, we identified 131 participants with a 2 line or greater improvement in presenting binocular VA. Of these, 92 (70%) improved due to treatment with glasses or cataract surgery. For individuals with improved VA, there were 5 items for which we observed statistically significant improvements in scores of 8 points or greater. These questions concerned: (1) ability to read street signs or names of stores (10 point improvement: p<0.001), (2) difficulty in doing work or hobbies that require seeing up close (9.2 point improvement; p=0.002), (3) time spent worrying about eyesight (9.0 point improvement; p=0.03), (4) difficulty reading ordinary print in newspapers (9.3 point improvement; p=0.004), and (5) pain or discomfort in and around eyes (8.2 point improvement; p<0.001). These differences translated into small effect sizes (ES 0.20-0.49) for all 5 items.
Conclusions: :
Clinically meaningful improvements in VA were associated with significant improvements in quality of life. The greatest improvement were seen for reading at a distance (street signs) or near (books or newsprint), completing work that requires seeing up close, and in the amount worry they had about their vision.
Keywords: clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • visual acuity • quality of life