Abstract
Purpose :
To evaluate self-administered questionnaires assessing visual quality of life (VQOL) in patients with symptomatic vitreous opacities causing clinically significant vitreous floaters known as Vision Degrading Myodesopsia (VDM).
Methods :
The Vitreous Floaters Functional Questionnaire (VFFQ) was designed similar to the N.E.I. Visual Function Questionnaire (VFQ-25), but with questions that specifically query the impact of floaters on VQOL, generating a score based on a 100-point scale. Quantitative Ultrasonography (QUS) assessed vitreous echodensity and Contrast Sensitivity (CS) measured visual function. VFFQ and VFQ-25, were obtained from 309 patients (58 ± 14 years of age, 174 males, 135 females), while QUS and CS were measured in 511 eyes. If floaters were significantly bothersome and the diagnosis of VDM was established based on QUS and CS, patients elected limited vitrectomy which was performed with 25G instruments without inducing surgical posterior vitreous detachment. Post-operatively, all testing was repeated at 3 months and the results of VFFQ were compared to the VFQ-25.
Results :
VFFQ correlated with CS (R = -0.555, p < 0.01) and QUS (R = -0.551, p < 0.01), meaning the denser the vitreous body and the more degraded the CS, the worse the VQOL as reflected in a lower VFFQ score. Of 511 eyes, 255 underwent limited vitrectomy and 256 elected observation. The VFFQ score in subjects electing observation was 75.8 ± 9.4 while vitrectomy subjects scored 49.9 ± 8.9 (52% worse, p < 0.001). Post-operatively, vitreous echodensity decreased by 67% (p < 0.001), CS improved by 48% (p < 0.001), and both questionnaires elicited improved scores, although there was only 9% improvement in NEI VFQ-25 (p < 0.01), while VFFQ improved by 81% (p < 0.001).
Conclusions :
VFFQ assessment of patient VQOL correlates with vitreous structure and visual function, such that with denser vitreous and greater degradation in CS there was a lower VFFQ score, indicating decreased VQOL. Following limited vitrectomy, VFFQ improved substantially more than VFQ-25, more sensitively reflecting improved VQOL. Thus, VFFQ may prove useful as an outcome measure of various therapeutic approaches, as well as in screening for treatable Vision Degrading Myodesopsia and evaluating disease severity for individual patients.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.