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R. McKean-Cowdin, R. Varma, J. Wu, F. Choudhury, S. Azen, R. Hays; Longitudinal Changes in Visual Acuity and Health Related Quality of Life in the Los Angeles Latino Eye Study (LALES). Invest. Ophthalmol. Vis. Sci. 2008;49(13):3756.
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To examine the association between longitudinal changes in visual acuity (VA) and Health Related Quality of Life (HRQOL) in Latinos participating in The Los Angeles Latino Eye Study (LALES).
Data for these analyses were collected for LALES, a population-based cohort study of eye disease in Latinos. Distance visual acuity (VA) was measured during a detailed ophthalmologic examination using standard ETDRS protocol at baseline (LALES I) and a follow-up examination (LALES II), approximately 4 years later. HRQOL was assessed at the LALES I and II examinations by the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25), composed of 12 vision-related scales. Scores were calculated using standard algorithms with a possible range of 0 to 100 and higher scores representing better functioning. Mean differences in HRQOL scores between baseline and follow-up were calculated for 3,169 participants with complete clinical examination and NEI-VFQ data at both time points; paired t-tests were used to estimate the significance of change (2-sided test). Mean differences and effect sizes (ES) for NEI-VFQ scores were calculated for 3 categories of VA change for the same time period (VA improved ≥ 2 lines, no change in VA, VA loss ≥ 2 lines).
We observed statistically significant changes in mean NEI-VFQ-25 scores during the 4 year interval; significant changes (p<0.05) were found for 9 of 12 NEI-VFQ-25 scales and the composite score. For participants with a 2 line loss in VA over the 4 year period, we saw an approximate 5 point loss in the NEI-VFQ-25 composite score; the largest effect sizes were found for the driving difficulties (-0.42), mental health (-0.43), and dependency scales (-0.41). For participants with a 2 line improvement in VA over the 4 year period we also saw an approximate 5 point gain in the NEI-VFQ-25 composite score. The largest effect size (0.80) was observed for the driving difficulties scale. No measurable differences in HRQOL were observed for individuals without change in VA from LALES I to II.
Clinically important changes in VA were associated with significant changes in HRQOL using longitudinal data from a population-based sample of adults. A 2 line improvement in VA was associated with an approximate 5 point gain in the NEI-VFQ-25 composite score and a 2 line loss in VA was associated with an approximate 5 point loss. These results are consistent with previous findings based on cross-sectional data.
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