Elsevier

Ophthalmology

Volume 117, Issue 10, October 2010, Pages 1900-1907.e1
Ophthalmology

Original article
Longitudinal Changes in Visual Acuity and Health-related Quality of Life: The Los Angeles Latino Eye Study

https://doi.org/10.1016/j.ophtha.2010.01.059Get rights and content

Purpose

To examine the association between longitudinal changes in visual acuity (VA) and health-related quality of life (HRQOL) in a population-based sample of adult Latinos.

Design

A population-based cohort study of eye disease in Latinos.

Participants

We included 3169 adult Latino participants who live in the city of La Puente, California.

Methods

Data for these analyses were collected for the Los Angeles Latino Eye Study (LALES). Distance VA was measured during a detailed ophthalmologic examination using the standard Early Treatment Diabetic Retinopathy Study protocol at baseline and a 4-year follow-up examination. We assessed HRQOL by the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) and the Medical Outcomes Study 12-Item Short-Form Health Survey version 1 (SF-12).

Main Outcome Measures

Mean differences in HRQOL composite and subscale scores between baseline and follow-up were calculated for 3169 participants with complete clinical examination and HRQOL data at both time points. Mean differences and effect sizes (ES) for NEI-VFQ and SF-12 scores were calculated for 3 categories of VA change over the 4-year follow-up period (VA improved ≥2 lines, no change in VA or −2 <VA <2, VA loss ≥2 lines).

Results

For participants with a 2-line loss in VA, we noted an approximate 5-point loss in the NEI-VFQ-25 composite score, with the greatest score changes found for the driving difficulties, vision-related mental health, and vision-related dependency subscales (−12.7, −11.5, and −11.3, respectively). For participants with a 2-line improvement in VA, we also noted an approximate 5-point gain in the NEI-VFQ-25 composite score. The greatest change (ES = 0.80) was observed for the driving difficulties subscale. No measurable differences in HRQOL were observed for individuals without change in VA from baseline to follow-up.

Conclusions

Clinically important, longitudinal changes in VA (≥2-line changes) were associated with significant changes in self-reported visual function and well-being. Both the size and direction of VA change influenced change in HRQOL scores.

Financial Disclosure(s)

The authors have no proprietary or commercial interest in any of the materials discussed in this article.

Section snippets

Methods

Data for these analyses were collected as part of a population-based study of eye disease in adults living in California. Details of the study design and data collected have been described previously.1 We completed a census of all residential households in 6 census tracts in La Puente to identify individuals eligible to be included in the study. The definition of eligibility included men and women who were ≥40 years of age, self-described as Latino, and who lived in 1 of the 6 census tracts.

Description of the Health-related Quality of Life Study Cohort

The HRQOL study cohort includes 3169 LALES participants with complete clinical examination and HRQOL data collected at baseline and at 4-years of follow-up. A total of 7789 participants were identified as eligible for LALES at baseline; 6142 (79%) had complete ophthalmic examination data and of these 4650 (76%) also had complete examination data at the 4-year follow-up examination. A total of 1192 participants were excluded from the analyses because they did not answer the NEI-VFQ-25 survey at

Discussion

In this population-based study of adults, we found statistically significant changes in mean HRQOL scores over the 4-year follow-up period for participants who had clinically meaningful changes in VA, although mean changes in HRQOL scores were small for participants with little or no change in VA.

Several studies of clinic-based populations also have examined the relationships between longitudinal changes in VA and HRQOL. Mangione et al5 found that improvements in VA after cataract surgery were

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    Manuscript no. 2009-1241.

    A list of the members of the Los Angeles Latino Eye Study Group is available online in Appendix 1 at http://aaojournal.org).

    Financial Disclosure(s): National Institutes of Health Grants NEI U10-EY-11753 and EY-03040 and an unrestricted grant from the Research to Prevent Blindness, New York, NY. Rohit Varma is a Research to Prevent Blindness Sybil B. Harrington Scholar. Ron D. Hays was supported in part by the UCLA Resource Center for Minority Aging Research/Center for Health Improvement in Minority Elderly (RCMAR/CHIME), NIH/NIA Grant Award Number P30AG021684.

    Conflict of Interest: No conflicting relationship exists for any author.

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