Abstract
Purpose: :
To examine the association between the severity of visual field loss (VFL) and self–reported vision–targeted quality of life (QOL) in Latinos participating in The Los Angeles Latino Eye Study (LALES).
Methods: :
Participants in the LALES – a population–based prevalence study of eye disease in Latinos aged 40 years and older, residing in Los Angeles, California – underwent a detailed eye examination including an assessment of their visual field using the Humphrey Automated Field Analyzer (SITA Standard 24–2). Mean Deviation (MD) data from each eye was used to determine the severity of VFL in each person. The severity of VFL was classified as none (MD≥0 in both eyes), unilateral mild (–4<MD<0 in the worse eye), unilateral moderate/severe (MD≤–4 in one eye, no visual impairment in the other eye), bilateral mild (–4≤MD<0 in the better eye), or bilateral moderate/severe impairment (MD≤–4 in both eyes). QOL was assessed by the National Eye Institute Visual Function Questionnaire (NEI–VFQ–25). Analysis of covariance was used to compare adjusted mean scores across the different levels of unilateral and bilateral VFL. Models were adjusted for age, gender, employment status, income, acculturation, comorbidities, health insurance, vision insurance, and visual acuity.
Results: :
Of the 5,270 participants that were included in this study, 594 had no VFL, 808 had unilateral mild or moderate/severe VFL, 3,249 had bilateral mild VFL, and 619 had bilateral moderate/severe VFL. Severity of VFL was significantly associated with QOL scores (p<0.001 for composite score). After adjusting for covariates, mean subscale scores for QOL were significantly lower for participants with bilateral moderate/severe VFL compared to participants with no VFL. These differences were greatest for driving difficulties (13.3), vision specific dependency (12.7), and vision specific mental health (12.3). Differences in QOL scores were not significantly different when comparing participants without VFL to those with any level of unilateral VFL.
Conclusions: :
Bilateral moderate /severe VFL was associated with lower QOL. The largest differences were noted for driving difficulties. These data suggest that prevention and eye care management of patients with less severe forms of visual field impairment are important for reducing visual related loss of quality of life.
Keywords: visual fields • quality of life • clinical (human) or epidemiologic studies: prevalence/incidence