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F. Choudhury, K. Mazhar, R. Mckean-Cowdin, S. P. Azen, R. Varma, The LALES Study Group; Impact of Severity and Bilaterality of Diabetic Retinopathy on Health-Related Quality of Life in Latinos. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2147.
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To assess the impact of diabetic retinopathy (DR) and its severity on health-related quality of life (HRQOL) in a population-based sample of Latinos with type II diabetes mellitus.
The Los Angeles Latino Eye Study (LALES) is a population-based prevalence study of eye disease in Latinos (primarily Mexican-Americans) age 40 and older. Generic HRQOL was assessed by the Short Form 12-item Health Survey (SF-12) and self-reported vision-related HRQOL was assessed by the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25). Standardized, detailed ophthalmologic examination, including the stereoscopic fundus photography was used to measure DR. Multivariate regression analyses were done to see the linear relationship of measures of HRQOL and diabetic severity. ANCOVA was used to compare the HRQOL scores across subgroups of no, non-proliferative (NPDR) and proliferative diabetic retinopathy (PDR). All test were done at a significance level of 0.05.
Of the 7789 eligible participants identified for LALES, 6357 (82%) completed an ophthalmic examination and of these, 1263 were identified as having definite type 2 DM. In this analysis only 1064 (84%) participants were included, as they had a gradable fundus photograph and completed the HRQOL questionnaires. There was a statistically significant negative association between DR and all of all NEI VFQ-25 and SF-12 subscales (P<0.05). Stratified analysis by type of DR is suggestive of significantly lower scores for all HRQOL subscales except SF-12 mental composite score in participants with PDR compared to participants with no DR (P<0.05).
Our data is suggestive of a statistically significant decrease in all reported measures of HRQOL with increasing severity of diabetic retinopathy. People with PDR experience significant decrease in quality of life. The findings provide further insight into the relationship between severity level of DR and self-reported HRQOL and may be useful in determining appropriate screening, monitoring, and intervention to prevent or reduce the risk of developing DR, and guiding individualized treatment decisions.
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