Vision-related Quality of Life when considering both eyes: Results from the German population-based Gutenberg Health Study (GHS)

Abstract

Purpose : Most definitions of visual impairment focus on the status of the better-seeing eye, but there is increasing evidence that this approach underestimates the influence of the fellow eye. Therefore, we compared vision-related Quality of Life (VRQoL) taking into account both eyes to taking into account only the better-seeing eye a large population-based cross-sectional sample.

Methods : We assessed distance-corrected visual acuity in both eyes and VRQoL using the German version of the “National Eye Institute 25-Item Visual Function Questionnaire” (NEI VFQ-25) in a subset of the Gutenberg Health Study (GHS). The GHS is a population-based, prospective, observational cohort study in Germany, including 15,010 participants aged between 35 and 74. We calculated the Rasch-transformed visual functioning scale (VFS) and the socio-emotional scale (SES) based on NEI VFQ-25 raw data. We categorized the visual acuity of the better-seeing eye (BE) and the worse-seeing eye (WE) as follows: (1) No vision impairment (VI) (<0.32 logMAR)), (2) mild VI (0.32-0.5 logMAR), and (3) moderate to severe VI (>0.5 logMAR). Then, the subjects were categorized with respect to the visual impairment group for both eyes: both eyes with no VI (no/no), the better-seeing eye with no VI and the worse-seeing eye with mild VI (no/mild), no VI/severe VI (no/severe), both eyes with mild VI (mild/mild), light VI/severe VI (mild/severe), and both eyes with severe VI (severe/severe). We calculated the median and inter-quartile range for both VFS and SES for each group. We used linear regression to estimate the influence of the combination of BE/WE on VFS and SES.

Results : We included 11941 participants (51.1% male) with available information on visual acuity of both eyes and VRQoL and. Median VFS/SES scores were 90/100 in the no/no VI group, 84/97 (no/mild), 81/94 (no/severe), 70/90 (mild/mild), 67/74 (mild/severe), and 63/76 (severe/severe). These differences were supported by the results of the regression analysis, with only small differences between the different adjustment models.

Conclusions : Relying on the function of the better-seeing eye only is likely to underestimate the impact of visual impairment on VRQoL. Whenever possible, the function of both eyes should be considered.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.