Severity of Visual Field Loss and Health-related Quality of Life

• Published in: American journal of ophthalmology Vol. 143; no. 6; pp. 1013 - 1023
• Main Authors: McKean-Cowdin, Roberta, Varma, Rohit, Wu, Joanne, Hays, Ron D, Azen, Stanley P
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.06.2007; Elsevier; Elsevier Limited
• Subjects: Acculturation; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Censuses; Confidence intervals; Cross-Sectional Studies; Diabetic retinopathy; Diseases of visual field, optic nerve, optic chiasma and optic tracts; Eye diseases; Female; Field study; Glaucoma; Health Status; Hispanic Americans - ethnology; Humans; Los Angeles - epidemiology; Male; Medical sciences; Mental health; Middle Aged; Miscellaneous; Mortality; Older people; Ophthalmology; Population; Quality of life; Quality of Life - psychology; Review boards; Severity of Illness Index; Sickness Impact Profile; Surveys and Questionnaires; Vision Disorders - ethnology; Vision Disorders - psychology; Visual Field Tests; Visual Fields; Visual impairment; Visually Impaired Persons - psychology; Los Angeles; California; Human; Eye disease; Visual field disease; Health; Visual field defect; Ophthalmology; Quality of life
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2007.02.022

Purpose To examine the association between severity of visual field loss (VFL) and self-reported health-related quality of life (HRQOL) in a population-based sample. Design Population-based cross-sectional study. Methods Participants in the Los Angeles Latino Eye Study (LALES) underwent a comprehensive ophthalmic examination including visual field testing by the Humphrey Automated Field Analyzer II (Swedish Interactive Thresholding Algorithm [SITA] Standard 24-2) [Carl Zeiss Meditec, Dublin, California, USA]. Mean deviation (MD) scores were used to determine severity of VFL both as a continuous variable and stratified by severity: no VFL (MD ≥ −2 decibels [dB]), mild VFL (−6 dB < MD < −2 dB), and moderate to severe VFL (MD < −6 dB). HRQOL was assessed by the Medical Outcomes Study 12-item Short-Form Health Survey (SF-12) and the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25). Linear regression analyses and analysis of covariance were used to assess the relationship between HRQOL scores and VFL. Results Of the 5,213 participants included in this study, 18% had unilateral mild, 1.5% unilateral moderate to severe, 19% bilateral mild, and 6.5% bilateral moderate to severe VFL. Worse NEI-VFQ-25 and SF-12 HRQOL scores were associated with VFL in a linear manner. Four- to 5-dB differences in VFL were associated with a five-point difference in the NEI-VFQ-25 composite and most subscale scores. Persons with VFL had the greatest difficulty with driving activities, dependency, mental health, distance vision, and peripheral vision. Conclusions HRQOL is diminished even in persons with relatively mild VFL on the basis of MD scores. Prevention and management of persons with VFL may be important in preventing or reducing poor HRQOL related to difficulties in driving, distance and peripheral vision activities, and a sense of dependency.