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K. Evans, J. Walt, S. Law; Impact of Central versus Peripheral Vision Loss on Quality of Life. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4470.
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Diseases associated with impaired vision have a negative impact on functional ability and quality of life (QoL); reduced QoL is associated with increased financial burden on healthcare systems and society. While the impairment of QoL in central-vision loss (CVL) disorders, such as age-related macular degeneration (ARMD), is widely acknowledged, the impact of peripheral-vision loss (PVL) disorders, such as glaucoma, on QoL is less well-known.
We performed a systematic literature search to assess the effect on QoL of PVL compared with CVL. The results from studies employing the most frequently used QoL instruments (Short-Form Health Survey [SF]-36), National Eye Institute Visual Function Questionnaire [NEI-VFQ]-51, -39 and -25), EuroQol EQ-5D, and Impact of Vision Impairment (IVI) instrument are reported here.
Of a total of 87 publications identified, SF-36 was used in 23 (PVL=2 [glaucoma=1]; CVL=21), NEI-VFQ-51 in 11 (PVL=4 [glaucoma=3]; CVL=7), NEI-VFQ-39 in 9 (PVL=1 [glaucoma=1]; CVL=8), NEI-VFQ-25 in 36 (PVL=11 [glaucoma=8]; CVL=25), EQ-5D in 4 (PVL=1 (glaucoma=1]; CVL=2 [cataracts=2]; seasonal allergic conjunctivitis [SAC]=1), and IVI in one (including 3 diseases: glaucoma and retinopathy [PVL] and ARMD [CVL]). According to SF-36 studies, vitality was impacted most in PVL. In general, mental health domains were affected more in PVL than CVL. Physical domains were affected most in CVL. Similarly, NEI-VFQ-51, -39, and -25 results showed that mental aspects of QoL were affected more in PVL than CVL; ARMD and glaucoma impacted different domains. In general, QoL was lower in glaucoma than ARMD although results varied amongst studies. By EQ-5D, a similar degree of QoL impairment was observed in patients with PVL and CVL: mean scores were 0.80 and 0.76, respectively. Using the visual analog scale of EQ-5D, QoL was lower in patients with PVL and CVL than SAC (scores of 74.7, 72.2 and 81.7, respectively). In the IVI study, patients with PVL were slightly more affected than those with CVL (except glaucoma on the social scale); overall, the social domain was affected most in all three vision diseases.
Results showed that, in general, PVL and CVL disorders have a significant impact on QoL. Therefore, more QoL research towards better understanding patients’ concerns with their PVL and CVL disorders are warranted.
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