Abstract
Purpose :
It has been hypothesized that the deterioration of objectively measured visual function components (VFCs) in those with visual impairment (VI) may precede patient-reported reductions in their ability to complete vision-based tasks, i.e., visual functioning (VF) outcomes. However, such data are lacking as few studies have explored the VI-VFC and VI-VF relationships in detail. We aimed to address this knowledge gap using data from a large cross-sectional and population-based sample of older Asian adults aged ≥ 60 years.
Methods :
We included 2468 participants (median [interquartile range] age: 72 [66-81] years; 54.7% female) from the Population Health and Eye Disease Profile in Elderly Singaporeans (PIONEER) study. VI was categorized using binocular LogMAR presenting visual acuity into mild (≥ 0.3 LogMAR to < 0.5 LogMAR) and moderate-severe (≥ 0.5 LogMAR) VI. VFCs assessed included binocular contrast sensitivity (CS; Pelli-Robson charts); stereo-acuity (SA; Frisbee Stereo Test); and binocular central motion-sensitivity (CMS; a computer-based random-dot kinematogram). Patient-reported VF was assessed with the 8-item VF domain of the brief impact of visual impairment questionnaire (B-IVI) and the instrumental activities of daily living (IADL) scale. Multivariable linear regression models were constructed to evaluate the associations between VI severity and VFC and VF outcomes, adjusted for sociodemographic and clinical confounders.
Results :
In total, 426 (17.3%) participants had binocular VI (265 [62.2%] mild and 161 [37.8%] moderate-severe). While VI was independently associated with poor VFC and VF outcomes across its severity spectrum (all P<0.05), we found that VFC deficits were consistently greater than that of patient-reported VF reductions at all stages of VI (8% to 60% deficits for VFCs versus 2% to 4% reductions for VF at the mild VI stage; 19% to 169% deficits in VFCs versus 6% to 27% for VF reductions at moderate-severe VI).
Conclusions :
The greater magnitude of reductions across all VFCs compared to patient-reported VF outcomes especially at the mild VI stage suggests the likelihood of differential trajectories in the development of VFC and VF deficits in persons with VI. Longitudinal studies to evaluate the temporality of the VFC-VF relationships are warranted.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.