Vision-related quality of life in patients with occipital stroke.

Abstract

The aim of this study was to detect visual field defects (VFDs) after occipital infarction, investigate the rate of recovery and the impact of VFD upon vision-related quality of life (QoL). Multicenter, prospective study including patients with MRI verified acute occipital infarction (NOR-OCCIP project). Ophthalmological examination including perimetry was performed within 2weeks and after 6months. Vision-related QoL was assessed by the National Eye Institute Visual Function Questionnaire 25 (VFQ-25) at one and 6months post-stroke. We included 76 patients, reliable perimetry results were obtained in 66 patients (87%) at a median of 8days after admittance and VFD were found in 52 cases (79%). Evaluation of VFD after 6months revealed improvement in 52%. Patients with VFD had significantly lower composite score in VFQ-25 at both test points (77 vs 96, P=.001 and 87 vs 97, P=.009), in nine out of eleven subscales of VFQ-25 at 1month and seven subscales after 6months, including mental health, dependency, near and distance activities. Milder VFD had better results on VFQ-25 modified composite score (95 vs 74, P=.002).VFD improvement was related to improved VFQ-25 modified composite score (9.6 vs 0.8, P=.018). About 10% of patients with VFD reported driving 1month post-stroke and 38% after 6months. VFD substantially reduces multiple aspects of vision-related QoL. Severity of VFD is related to QoL and VFD improvement results in better QoL. Neglecting visual impairment after stroke may result in deterioration of rehabilitation efforts. Driving post-stroke deserves particular attention.