The impact of diabetic retinopathy on health-related quality of life

Abstract

To review recent evidence evaluating the effect of diabetic retinopathy and diabetic macular edema on health-related quality of life. A search of PubMed was conducted according to a strategy that combined the text words 'diabetic retinopathy' and 'quality of life' (n = 91; November 11, 2004) and 'diabetic macular edema' and 'quality of life' (n = 6; November 22, 2004). The Methods sections of all abstracts were reviewed for valid generic or disease-specific instruments used to evaluate health-related quality of life. In addition, abstracts were reviewed to ensure that the study sample was made up predominantly of diabetic individuals. Recent data suggest that persons with diabetic retinopathy are willing to trade off significant time to eliminate their ocular condition (mean time tradeoff score = 0.77-0.8) and that laser photocoagulation can improve health-related quality of life (significant improvement noted in 8 of 11 domains in the National Eye Institute Visual Function Questionnaire). In addition, recent research has noted that health-related quality of life can become affected in persons with diabetic retinopathy prior to visual loss, primarily because of anxiety about the future and emotional reaction to diagnosis and treatment. From a search of the literature, several recent articles could be identified that demonstrated both a qualitative and a quantitative reduction in health-related quality of life in persons with diabetic retinopathy. With many novel treatments being explored for the management of diabetic retinopathy and diabetic macular edema, measuring health-related quality of life will likely play an important role both in the decision to offer treatment and in monitoring relevant health gains that may be derived from intervention.