Investigative Ophthalmology & Visual Science Cover Image for Volume 62, Issue 8
June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Psychometric properties of the Vision Impairment in Low Luminance (VILL) questionnaire in age-related macular degeneration in the MACUSTAR study
Author Affiliations & Notes
  • Jan Henrik Terheyden
    Department of Ophthalmology, University Hospital Bonn, Germany
  • Susanne Gunda Pondorfer
    Department of Ophthalmology, University Hospital Bonn, Germany
  • Charlotte Behning
    Institute for Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, Germany
  • Moritz Berger
    Institute for Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, Germany
  • Donna Rowen
    School of Health and Related Research, University of Sheffield, United Kingdom
  • Jill Carlton
    School of Health and Related Research, University of Sheffield, United Kingdom
  • Frank G Holz
    Department of Ophthalmology, University Hospital Bonn, Germany
  • Thomas Butt
    Institute of Ophthalmology, University College London, United Kingdom
  • John E. Brazier
    School of Health and Related Research, University of Sheffield, United Kingdom
  • Robert Patrick Finger
    Department of Ophthalmology, University Hospital Bonn, Germany
  • Footnotes
    Commercial Relationships   Jan Terheyden, CenterVue (F), Heidelberg Engineering (F), Optos (F), Zeiss Meditec (F); Susanne Pondorfer, CenterVue (F), Heidelberg Engineering (F), Optos (F), Zeiss Meditec (F); Charlotte Behning, None; Moritz Berger, None; Donna Rowen, None; Jill Carlton, None; Frank Holz, Acucela (C), Acucela (F), Aerie (C), Allergan (C), Allergan (F), Apellis (C), Apellis (F), Bayer (C), Bioeq/Formycon (F), Boehringer-Ingelheim (C), Centervue (F), Ellex (F), Geuder (C), Grayburg Vision (C), Ivericbio (C), Kanghong (C), LinBioscience (C), Nightstarx (F), Novartis (C), Optos (F), Oxurion (C), Pixium Vision (C), Roche/Genentech (C), Stealth Biotherapeutics (C), Zeiss (C); Thomas Butt, None; John Brazier, None; Robert Finger, Alimera (C), Bayer (C), CenterVue (F), Ellex (C), Novartis (C), Novartis (F), Ophthea (C), Roche/Genentech (C), Santhera (C), Zeiss Meditec (F)
  • Footnotes
    Support  This project has received funding from the Innovative Medicines Initiative 2 Joint Undertaking under grant agreement No 116076. This Joint Undertaking receives support from the European Union’s Horizon 2020 research and innovation programme and EFPIA.
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 3500. doi:
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      Jan Henrik Terheyden, Susanne Gunda Pondorfer, Charlotte Behning, Moritz Berger, Donna Rowen, Jill Carlton, Frank G Holz, Thomas Butt, John E. Brazier, Robert Patrick Finger; Psychometric properties of the Vision Impairment in Low Luminance (VILL) questionnaire in age-related macular degeneration in the MACUSTAR study. Invest. Ophthalmol. Vis. Sci. 2021;62(8):3500.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Patient-reported difficulties caused by the characteristic functional impact of AMD, in particular in its early and intermediate stages, are only captured in selected patient-reported outcomes (PROs), none of which currently meet the FDA criteria for PRO development. The Vision Impairment in Low Luminance (VILL) questionnaire was designed to meet these criteria as well as to capture the characteristic impact of all AMD stages on patients’ lives. Here we report its psychometric functioning and test-retest reliability in the European multi-center study MACUSTAR.

Methods : Using the baseline VILL data from participants of the MACUSTAR study (intermediate, early, late or no AMD) psychometric characteristics including model fit, person reliability (PR), person separation index (PSI), targeting and dimensionality of the existing VILL subscales (reading, VILL-R; mobility, VILL-M; emotional, VILL-E) were investigated using Rasch analysis (Winsteps, Chicago, IL). In a subset with repeated data test-retest reliability was assessed using mean deviation (MD), intra-class correlation coefficients (ICC) and Bland-Altman analysis.

Results : A baseline dataset including 716 participants was available for analysis. The VILL subscales were unidimensional. Dropping five misfitting items in an iterative process (VILL-R, 3 items; VILL-M, 1 item; VILL-E, 1 item) improved model fit. After removal of a total of 39 single misfitting responses from three additional misfitting items, 32 items could be retained and no item showed misfit. PR and PSI were 0.91 and 3.27 (VILL-R), 0.87 and 2.58 (VILL-M) and 0.73 and 1.65 (VILL-E), respectively. The mean person measure-item measure differences were 2.0 (VILL-R), 2.1 (VILL-M) and 1.6 (VILL-E). 289 participants were included in the evaluation of test-retest reliability of the VILL-32. MD and ICC (95% confidence interval) were 0.30 and 0.92 (0.90-0.94, VILL-R), 0.07 and 0.93 (0.91-0.94, VILL-M) and 0.30 and 0.85 (0.81-0.88, VILL-E).

Conclusions : Our results support internal consistency and test-retest reliability of the VILL in AMD in a large sample. The reading and mobility subscales are reliable measures while the emotional subscale is noticeably less precise. Thus, the emotional subscale was dropped, resulting in 29 items overall. The validation process of the instrument using functional data is ongoing.

This is a 2021 ARVO Annual Meeting abstract.

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