Differences in Vision-Specific Quality of Life with Visual Acuity by Race, Ethnicity in the Multiethnic Ophthalmology Cohorts of California Study (MOCCaS)

Abstract

Purpose : To compare racial, ethnic differences in visual acuity (VA) on vision-specific quality of life (VSQOL)

Methods : In the MOCCaS, the impact of VA on VSQOL measured by the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) was evaluated in a population-based sample of African American (AA), Chinese American (CA), and Latino (LAT) adults. A total of 17,071 adults 40 years of age and older participated in a comprehensive ophthalmologic examination and in-person interviews from 2000 to 2018. Distance VA was measured during a detailed ophthalmologic examination using standard ETDRS protocol at baseline. VSQOL was assessed at the end of the clinical examination using the NEI-VFQ-25. Vision-related daily tasks (VRDT) and well-being composite scores were calculated using item response theory (IRT); classical test theory (CTT) was used to score 11 subscales with values ranging from 0 to 100, with higher scores representing better visual functioning.

Results : 14,570 participants (5,171 AA, 4,151 CA, and 5,248 LAT) with complete data were included in the analysis. Predicted VRDT and well-being composite scores were significantly lower for Latinos across level of presenting VA compared to AA or CA participants. An inverse relationship was found with significantly lower levels of patient reported ability to complete vision-related daily tasks after adjustment for covariates using IRT. A 2-line change in VA was associated with a 4.6 point change in vision-related daily tasks score for LAT participants, 3.9 for CA participants, and 2.9 for AA participants. The difference was greater for those 65 years of age and older. No significant differences in change for well-being were identified by race,ethnicity (3.2 Latino, 3.0 Chinese, 3.0 African American). Classical test theory revealed significant interactions for driving difficulty with VA, age, and race.

Conclusions : Each 2-line loss in VA has a significant impact on patient reported ability to complete vision-related daily tasks. The 2 line difference in VA corresponds to a lower difference in VRDT for African American as compared to Latino adults. Disparities in health are at times attributed to differences in income, education, and barriers to care however differences in VA and VSQOL persisted by race, ethnicity after controlling for measured socioeconomic and clinical variables.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.