Visual Quality Of Life Research Articles

Global, psychological, and visual quality of life after evisceration/enucleation surgery (QOLAE study): A descriptive case series.

To describe the early health-related quality of life (HRQoL) of patients who have undergone an eye removal surgery. A descriptive monocentric study was conducted. Patients with a surgical indication of eye amputation were enrolled. Three standardized surveys were given to each patient 1-3 months after the surgery. The following standardized questionnaires were used: National Eye Institute Visual Function Questionnaire 25 (NEI VFQ-25) (range: 0-100), Short Form-36 (SF-36) (range: 0-100), and Perceived Stress Scale (PSS-10) (range: 0-40). Between January 2021 and January 2022, in the Ophthalmology Department of the University Hospital of Besançon (France), 20 patients who were going to undergo an eye removal surgery were included. The population comprised a majority of men (12 men vs. 8 women) with a mean age of 70 (±16.2) years. The underlying conditions leading to the eye amputation were varied: three infections (15%), three retinal detachments (15%), three chronic uveitis (15%), 11 traumas (55%), three tumors (15%), and five chronic high intraocular pressures (25%). The surgical procedure consisted of an evisceration in 15 cases (75%) or an enucleation in five cases (25%). On average, the composite NEI VFQ-25 scored 68.7 (±22.4). Regarding the SF-36 score, the physical composite score was 63.1 (±15.4), and the mental composite score was 64.7 (±14.4). The overall PSS-10 score was 12.3 (±8.7). The patients who had undergone an eye amputation had an early reduction in their HRQoL in all its domains, especially in the vision, mental, and physical specific quality of life. These patients need personalized preparation before the surgery. These findings need to be assessed in the long term.

Light Scattering by Vitreous of Humans With Vision Degrading Myodesopsia From Floaters.

Vision-degrading myodesopsia (VDM) from vitreous floaters significantly degrades vision and impacts visual quality of life (VQOL), but the relationship to light scattering is poorly understood. This study compared in vitro measures of light scatter and transmission in surgically excised human vitreous to preoperative indexes of vitreous structure, visual function, and VQOL. Pure vitreous collected during vitrectomy from 8 patients with VDM had wide-angle straylight measurements and dark-field imaging, performed within 36hours of vitrectomy. Preoperative VQOL assessment with VFQ-25, contrast sensitivity (CS) measurements with Freiburg acuity contrast testing, and quantitative ultrasonography were compared to light scattering and transmission in vitro. All indices of vitreous echodensity in vivo correlated positively with straylight at 0.5° (R=0.708 to 0.775, P = 0.049 and 0.024, respectively). Straylight mean scatter index correlated with echodensity (R=0.71, P = 0.04) and VQOL (R=-0.82, P = 0.0075). Dark-field measures in vitro correlated with degraded CS in vivo (R=-0.69, P = 0.04). VQOL correlated with straylight mean scatter index (R=-0.823, P = 0.012). Increased vitreous echodensity in vivo is associated with more straylight scattering in vitro, validating ultrasonography as a clinical surrogate for light scattering. Contrast sensitivity in vivo is more degraded in the presence of dark-field scattering in vitro and VQOL is decreased in patients whose vitreous has increased light scattering. These findings could form the basis for the development of optical corrections for VDM or support new laser treatments, as well as novel pharmacotherapy.

Visual functions, ocular characteristics and visual quality of life in patients with homocystinuria

ABSTRACT Background Homocystinuria (HCU) is a rare metabolic disease that affects many organs, including the eyes. Aims: to assess visual functions, ocular characteristics, visual quality of life and time from the onset of ocular manifestations to HCU-diagnosis in patients with HCU. Material and methods Eighteen patients underwent ophthalmological examinations and visual quality of life questionnaires. Results Best corrected decimal visual acuity was median 1.0 (range amaurosis - 1.3) right eye and 1.0 (range amaurosis -1.3) left eye. Five patients presented with severe myopia as first HCU manifestation, duration to HCU diagnosis was mean 13.6 years (range 2-25). Two patients had suffered ectopia lentis as first HCU manifestation, HCU diagnosis was established mean 8.0 years (range 7-9) later. One patient had suffered both from thrombosis and ectopia lentis prior to diagnosis. Another four patients suffered thromboembolic events before diagnosis. Median VFQ-25 composite score was 93 (68-98). Conclusions The prevalence of myopia, ectopia lentis and monocular blindness was high in HCU-patients, which was reflected in their visual quality of life. Diagnosis was often delayed after the first ocular manifestation, increasing the risk of other severe non-ocular complications.

Nurse-Led Interventions for Diabetes Education: A Literature Review

Background: The incidence of blindness is escalating to 439 billion patients by 2030. This study aims to review studies of health education related to diabetic retinopathy that have been implemented to inform nurse-led intervention to patients with type 2 diabetes mellitus (T2DM). Methods: A comprehensive search of the database was performed from October 2021 until March 2022. The databases include CINAHL, EMERALD insight, SAGE, Scopus, Web of Science and Science Direct. The Medical Subject Headings database was used to derive the following keywords: ‘T2DM' OR ‘Diabetes Mellitus type 2’, Diabetic Retinopathy’ OR ‘Diabetic eye’ OR ‘retinopathies') AND ‘education’, self-care’, ‘visual quality of life’, ‘mHealth’. All studies in English pertaining to the type of teaching and the effects of education on the visual quality of life among T2DM patients were included. Type 1 diabetes mellitus studies were excluded. Analysis of the themes arising from the results was performed. Results: The search yielded 868 articles, of which 27 met our criteria. The studies ranged from cross-sectional, controlled studies, quasi-experimental studies, and qualitative studies. Overall, there was three types of health education interventions: personalised, group-based, and technology-based. Conclusion: There is paucity in nurse-led health education about diabetic retinopathy in East Asia. It appears that conventional health education helpful, but the mobile application might be an option to provide better health education, with an emphasis on diabetic retinopathy components.

Spectral-based quantitative ultrasound for assessing vision degrading myodesopsia

The presence of clinically significant vitreous opacities, referred to as vision degrading myodesopsia (VDM), reduces contrast sensitivity (CS), and visual quality of life. Quantitative ultrasound (QUS) methods operating on grayscale B-mode images were previously developed and validated for quantifying vitreous echodensities. Although a subsequent study comparing the QUS methods across clinical scanners demonstrated no change in QUS efficacy, the methods are sensitive to differences in system parameters and B-mode image formation unless the backscatter data is normalized. Technological advancements in clinical scanners allow for easy access to raw radiofrequency (RF) data for more advanced processing methods. Here, we develop QUS methods that exploit RF echo data to generate robust user- and system-independent parameters for quantifying vitreous echodensities based on the echo signal power spectrum (PS). However, the sparsity of echodensities in the vitreous body is incompatible with underlying assumptions of QUS methods based on measurements of the backscatter coefficient or envelope statistics. We, therefore, implement QUS methods that parameterize the PS and correlate these parameters with visual function as measured by CS. Results from this study are the first step toward developing and validating robust, user-, and system-independent QUS methods for evaluating VDM.

Vision Quality of Life with Time Survey: Normative Data and Repeatability.

To develop a novel Vision Quality of Life (QoL) survey that emphasizes the amount of time a visual activity can be performed before symptoms occur. The Vision Quality of Life with Time (VisQuaL-T) survey was developed with 10 daily activities and a list of common visual symptoms. Participants were recruited from a university campus. Participants were not excluded based on binocular impairments to obtain a normative dataset. Participants were instructed to denote when they first experience symptoms within certain time ranges. If participants did not engage in one of the 10 activities, they were instructed to denote "N/A". A composite score (range 0-3) was determined by only accounting for the questions that were answered. The normative data cohort had a sample size of 376 participants and the repeatability cohort had 54 participants. The normative, test, and retest datasets had a mean composite score of 2.47±0.54, 2.69±0.42, and 2.67±0.49 and 95% confidence interval of 2.38-2.71, 2.58-2.81, 2.54-2.80, respectively. There was good reliability and high correlation between the test and retest timepoints with an ICC of 0.825 and a Pearson correlation coefficient of 0.839 in the repeatability cohort. The normative data cohort showed good internal consistency with a Cronbach's alpha value of 0.803. Test and retest timepoints showed no statistical significance among the individual questions (p > 0.1). A lower bound score of 2.4 can potentially be used to differentiate visually normal and symptomatic participants. Statistical analysis showed the survey is repeatable and reliable. Using time as a metric for assessing symptomology could be a useful method for identifying patients with QoL issues and for assessing effectiveness of binocular vision, accommodative, and eye movement treatments.

장애인과 비장애인에서 고혈압과 당뇨병 여부와 최대 교정시력이 시각적 삶의 질에 미치는 영향

장애인과 비장애인에서 고혈압과 당뇨병 여부와 최대 교정시력이 시각적 삶의 질에 미치는 영향

Marfan’s syndrome with rhegmatogenous retinal detachment: a case report and literature review

Background: Marfan’s syndrome is known to be a rare, multisystem disorder of connective tissue typically affecting cardiac, skeletal and ocular system. The only definitive diagnosis is by gene testing for autosomal dominant mutation of FBN1 gene encoding the regulation of fibrillin 1 located on chromosome 15q.3. Ocular manifestations appear early in life with most of the abnormalities being sight threatening. These incude ectopia lentis, high myopia, rhegmatogenous retinal detachment , open angle glaucoma etc. Ophthalmological examination plays vital role in early diagnosis and visual preservation. Case report: A 16 year old male presented with chief complaints of curtain like shadow in temporal visual field with present glasses for past 7 days. He had bilateral ectopia lentis with rhegmatogenous retinal detachment sparing the macula in the left eye. General examination of patient revealed physical features suggestive of Marfan’s syndrome. Although genetic testing was not possible, all features were suggestive of Marfan’s syndrome according to revised Ghent criteria. Pars plana vitrectomy with lens extraction with silicone oil injection was the treatment of choice. After an eventful post-operative period with silicone oil induced rise in intraocular pressure and 360 degrees peripheral anterior synechiae, early removal of silicone oil led to a good final visual outcome. Thus, with early detection and prompt treatment we were able to restore his visual quality of life. Conclusion: Although serious and vision threatening manifestations may occur in the eye in cases of Marfan’s syndrome, early diagnosis and prompt treatment may be able to salvage vision. It is necessary to keep patients on regular follow up and inform them of possible vision threatening ocular manifestations in the eye for early diagnosis and prompt management.

An Examination of Visual Quality of Life and Functional Vision Among Collision and Non-Collision Athletes Over a Competitive Season.

Repetitive head impacts (RHIs) experienced during sports are gaining attention due to potential long-term neurological dysfunction, absent of a diagnosed concussion. One area susceptible to dysfunction is vision. The goal of this study was to evaluate changes in visual quality of life (VQOL) and functional vision scores from pre- to post-season among collision and non-collision athletes. The Visual Functioning Questionnaire-25 and Neuro-Ophthalmic Supplement (NOS), as well as functional vision testing (Mobile Universal Lexicon Evaluation System - MULES) were completed pre- and post-season by three groups: collision athletes, non-collision athletes, and minimally active controls (MACs). There were 42 participants, with 41 (21 male, 20 female) completing both testing sessions, with a mean (standard deviation [SD]) age of 21 (2.46) years (collision group, n = 14; non-collision group, n = 13, MACs, n = 14). Baseline analyses revealed no significant differences between groups for VQOL or MULES scores. However, those with a family history of psychiatric disorder scored significantly worse on NOS. Post-season/follow-up testing revealed no significant differences between groups for VQOL scores. Non-collision athletes significantly improved on the MULES test by 2.46 ± 3.60 (SD) s (35.0 [95% confidence interval, 0.29-4.63]; p = .03). Change score results from pre- to post-season were not significant. Although the groups were not significantly different from one another, non-collision athletes significantly improved MULES scores, whereas collision athletes performed the worst, suggesting exposure to RHIs may impact functional vision. Thus, further evaluation of RHIs and their impact on vision is warranted.

Assessing machine independence of quantitative ultrasonography to evaluate vision degrading myodesopsia

Vision degrading myodesopsia (VDM) results from clinically significant vitreous opacities that reduce contrast sensitivity (CS) and visual quality of life (VQOL). Previous studies with a single clinical system for quantitative ultrasonography (QUS) found correlations with CS and VQOL as measured by the N.E.I. Visual Function Questionnaire (VFQ). Here, we evaluated a cohort of patients to determine if VDM as evaluated by QUS is machine independent. 28 eyes from 14 patients (age 56 ± 14 years) experiencing VDM were scanned with two different clinical ophthalmic ultrasound systems in succession: one with a 15-MHz single element transducer (23mm focal length, 7 mm aperture) and one with a 20 MHz annular array (five elements, 22 mm focal length, 9 mm total aperture). Images were acquired as a longitudinal plane through premacular vitreous in temporal gaze. Three QUS parameters and a composite score were computed from the vitreous region within each set of log-compressed envelope data and averaged over artifact-free frames. A linear regression comparing QUS parameters computed fromeach system showed statistically significant correlations (R ≥ 0.86, p < 0.001). Moreover, QUS parameters from both systems were correlated with CS and VFQ scores. The results from this study suggest the QUS parameters are independent of scanner and could be universally applied to assess VDM.

Clinical performance of a smartphone-based low vision aid

Real-time digital image processing to optimally enhance low vision is now realizable with recent advances in personal computers. This study aimed to evaluate the efficacy of a wearable smartphone-based low vision aid (LVA) with customizable vision enhancement in patients with visual impairment. We recruited 35 subjects with visual impairment and who were literate and cognitively capable. The subjects completed a training session and were provided a smartphone-based LVA for a 4-week use. Visual functions including binocular best-corrected distance, intermediate, and near visual acuities; reading performance (reading speed and accuracy); and facial recognition performance were measured at baseline and after 4-weeks use. All subjects also completed the Low Vision Quality of Life (LVQOL) Questionnaire. Thirty-four subjects (mean age, 43.82 ± 15.06 years) completed the study. Significant improvements in binocular best-corrected distance, intermediate, and near visual acuities were observed after smartphone-based LVA use (all p < 0.001). Reading accuracy and facial recognition performance also improved significantly (p = 0.009 and p < 0.001, respectively), but reading speed did not. LVQOL scores significantly improved after 4 weeks of use in subjects aged < 40 years (p = 0.024), but not in subjects aged ≥ 40 years (p = 0.653). Ocular and non-ocular adverse events were infrequent and resolved when the device was removed. The smartphone-based LVA with customizable vision enhancement could provide clinically significant improvements in the visual function of patients with visual impairment and was generally well tolerated. This study suggests that the smartphone-based LVA would be beneficial for visual rehabilitation.

Leveraging Visual Outcome Measures to Advance Therapy Development in Neuroimmunologic Disorders.

The visual system offers unparalleled precision in the assessment of neuroaxonal damage. With the majority of patients with multiple sclerosis (MS) experiencing afferent and efferent visual dysfunction, outcome measures capturing these deficits provide insight into neuroaxonal injury, even in those with minimal disability. Ideal for use in clinical trials, visual measures are generally inexpensive, accessible, and reproducible. Quantification of visual acuity, visual fields, visual quality of life, and electrophysiologic parameters allows assessment of function, whereas optical coherence tomography (OCT) provides reliable measures of the structural integrity of the anterior afferent visual pathway. The technology of oculomotor biometrics continues to advance, and discrete measures of fixation, smooth pursuit, and saccadic eye movement abnormalities are ready for inclusion in future trials of MS progression. Visual outcomes allow tracking of neuroaxonal injury and aid in distinguishing MS from diseases such as neuromyelitis optica spectrum disorder (NMOSD) or myelin oligodendrocyte glycoprotein antibody–associated diseases (MOGAD). OCT has also provided unique insights into pathophysiology, including the identification of foveal pitting in NMOSD, possibly from damage to Müller cells, which carry an abundance of aquaporin-4 channels. For some study designs, the cost-benefit ratio favors visual outcomes over more expensive MRI outcomes. With the next frontier of therapeutics focused on remyelination and neuroprotection, visual outcomes are likely to take center stage. As an international community of collaborative, committed, vision scientists, this review by the International MS Visual System Consortium (IMSVISUAL) outlines the quality standards, informatics, and framework needed to routinely incorporate vision outcomes into MS and NMOSD trials.

Visual acuity, defocus curve and patient satisfaction of a new hybrid EDOF-multifocal diffractive intraocular lens.

Purpose: To evaluate the visual acuity, defocus curve and visual quality of life following bilateral implantation of a new hybrid extended depth of focus (EDOF)-multifocal diffractive intraocular lens (IOL). Methods: Patients who underwent cataract surgery with bilateral implantation of Tecnis Synergy IOL were enrolled in this study. The main outcomes were defined as uncorrected distant, intermediate and near visual acuities (UDVA, UIVA and UNVA, respectively), defocus curve and VF-14 questionnaire aimed for visual performance. Results: The mean ± SD values for binocular UDVA, UIVA and UNVA were -0.01 ± 0.04, 0.05 ± 0.03 and 0.03 ± 0.05 logMAR, respectively. Defocus curve showed a continuous vision above 0.16 logMAR between +0.50 D and -2.50 D. Patients had good visual performance with mean VF-14 scores above 3 points. Driving at night (3.47 ± 0.64) was found to be the most difficult task to perform. Spectacle independence was 100% for both distant and near vision. Conclusion: Bilateral implantation of Tecnis Synergy IOL in cataract patients shows good visual acuity and performance, covering a good visual range without any need of spectacles.

Quality of Life in Patients with Chronic Thyroid Eye Disease in the United States.

IntroductionThyroid eye disease (TED) is an autoimmune condition producing ocular pain, dysmotility, and ocular structure and function changes. As disease activity changes, redness, swelling, and pain can improve, but eye comfort, appearance, and motility alterations often persist. There are limited data on chronic TED patient-reported outcomes. This study examined chronic US TED patient-reported symptoms and quality of life (QOL).MethodsExisting data from an online survey regarding chronic TED signs/symptoms and patient QOL were retrospectively examined. The Graves’ Ophthalmopathy QOL instrument (GO-QOL; 0–100, 100 = highest QOL) evaluated overall, appearance, and vision-related QOL. Influencing factors were examined by stratifying patients into low (overall QOL ≤ 50), moderate (> 50 and < 75), and high (≥ 75) QOL categories.ResultsOne hundred patients (47 women, 81 Caucasian, 45.2 ± 7.6 years) were included. The duration of inactive TED was 3.0 ± 4.6 years and total duration of TED was 5.8 ± 5.9 years. Patients reported an average of 20 doctor visits/year and high prevalence of anxiety (34%) and depression (28%). Prior TED treatments for the polled population included systemic corticosteroids during active TED (25%), orbital radiation (5%), and surgery (25%). The overall GO-QOL score was 60.5 ± 21.8 (vision-related: 58.6 ± 24.0, appearance-related: 62.3 ± 25.1). Patients with low QOL more frequently reported hypothyroidism, anxiety, and a larger number of chronic TED signs/symptoms (average: 4.2). Compared to high QOL patients, low QOL patients had more pain (39% vs. 13%), blurry vision (30% vs. 17%), and diplopia (27% vs. 3%, all p ≤ 0.025). Additionally, the low QOL group more often had TED-specific surgical history (45% vs. 10%, p = 0.002), more often reported disability/unemployment (21% vs. 3%, p = 0.055), and had a higher number of doctor visits (40 vs. 5 visits/person/year, p < 0.001).ConclusionTED severely impacts patient QOL, despite becoming stable and chronic. Patients reported vision and appearance impairment and psychosocial impact long after acute TED had subsided.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40123-021-00385-8.

Correlation between Visual Quality of Life and Visual Function in Mild Glaucoma Patients

Correlation between Visual Quality of Life and Visual Function in Mild Glaucoma Patients

Vision-Related Quality of Life After Vitrectomy: Cross-Sectional Study from Jordan.

BackgroundIn the era of patient-centered medical care, using objective clinical measures to assess patient-centered outcomes in all aspects became a necessity, and pars plana vitrectomy (PPV) is a major ophthalmic surgical procedure used for the treatment of vitreoretinal disorders aiming to improve their vision-related quality of life.PurposeTo study the impact of PPV on visual quality of life by assessing its effect on common daily activities, to assess its association with various factors, and to explore the relations between these factors and postoperative visual function.MethodsVision-related quality of life for 87 patients who underwent PPV was assessed using the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) by phone call interviews. Variables assessed include age, gender, indication of surgery, duration since surgery, preoperative best-corrected visual acuity (BCVA), postoperative BCVA, fellow eye BCVA, medical history and lens status.ResultsThe factors significantly affecting the total score were postoperative visual acuity and fellow eye VA. Upon analyzing the effect of the indication on total score, a significant difference was found with the highest being for those who had dropped lens as the indication for surgery and the lowest was for those with tractional retinal detachment (TRDs) and inflammatory indications. Subscale analysis and visual acuity improvement were also varying between indications.ConclusionVRQOL significantly improves after PPV, the improvement is variable with different indications, being the greatest for those with dropped lens and the least for TRDs and endophthalmitis, with postoperative VA being the most important factor affecting the VRQOL score.

Correlation of macular sensitivity measures and visual acuity to vision-related quality of life in patients with age-related macular degeneration

BackgroundVisual acuity is commonly used as a functional outcome measure in patients with age-related macular degeneration (AMD), despite having a weak correlation with self-perceived visual quality of life. Microperimetry is a useful method of detecting loss of macular function. We wanted to investigate the relationship between these two objective visual outcome measures and subjective vision-related quality of life, finding out which objective measure is more patient-relevant.MethodsFifty-one consecutive patients with AMD were recruited to the study. Participants were required to complete the Visual Function Questionnaire 39, the Early Treatment Diabetic Retinopathy Study visual acuity examination and a microperimetry assessment using the Micro Perimeter 3. One patient withdrew consent and seven patients dropped out due to cooperation difficulties under microperimetry. Forty-three patients with AMD were included in the study: twenty-eight patients with late AMD (exudative AMD) and fifteen patients with early (non-exudative) AMD. The right eye was included as standard, as was the eye with the best-corrected visual acuity.ResultsThere was a higher correlation between vision-related quality of life and macular sensitivity (r = 0.458; p = 0.014) than between vision-related quality of life and visual acuity (r = 0.446; p = 0.018) in patients with late AMD. There was a positive correlation between vision-related quality of life and macular sensitivity in patients with early AMD (r = 0.542; p = 0.037) while the correlation between vision-related quality of life and visual acuity in these patients was not statistically significant. Composite score (r = 0.469; p = 0.012) correlated highest with the nasal outer macular sub-region and near-distance activities score (r = 0.652; p < 0.001) correlated highest with the nasal inner macular sub-region in patients with late AMD. Correlations between composite score and macular sub-regions in patients with early AMD were not significant, but near-distance activities score correlated with the nasal outer macular sub-region in these patients (r = 0.469; p = 0.012).ConclusionsMacular sensitivity as measured using microperimetry correlates with vision-related quality of life in early AMD and in late AMD, showing it to be a patient-relevant outcome measure. Furthermore, the nasal sub-regions of the macula appear to be preferred retinal loci in patients with AMD.(338 words)

Validation of Computer-Adaptive Contrast Sensitivity as a Tool to Assess Visual Impairment in Multiple Sclerosis Patients.

BackgroundImpairment of visual function is one of the major symptoms of people with multiple sclerosis (pwMS). A multitude of disease effects including inflammation and neurodegeneration lead to structural impairment in the visual system. However, the gold standard of disability quantification, the expanded disability status scale (EDSS), relies on visual assessment charts. A more comprehensive assessment of visual function is the full contrast sensitivity function (CSF), but most tools are time consuming and not feasible in clinical routine. The quantitative CSF (qCSF) test is a computerized test to assess the full CSF. We have already shown a better correlation with visual quality of life (QoL) than for classical high and low contrast charts in multiple sclerosis (MS).ObjectiveTo study the precision, test duration, and repeatability of the qCSF in pwMS. In order to evaluate the discrimination ability, we compared the data of pwMS to healthy controls.MethodsWe recruited two independent cohorts of MS patients. Within the precision cohort (n = 54), we analyzed the benefit of running 50 instead of 25 qCSF trials. The repeatability cohort (n = 44) was assessed by high contrast vision charts and qCSF assessments twice and we computed repeatability metrics. For the discrimination ability we used the data from all pwMS without any previous optic neuritis and compared the area under the log CSF (AULCSF) to an age-matched healthy control data set.ResultsWe identified 25 trials of the qCSF algorithm as a sufficient amount for a precise estimate of the CSF. The median test duration for one eye was 185 s (range 129–373 s). The AULCSF had better test–retest repeatability (Mean Average Precision, MAP) than visual acuity measured by standard high contrast visual acuity charts or CSF acuity measured with the qCSF (0.18 vs. 0.11 and 0.17, respectively). Even better repeatability (MAP = 0.19) was demonstrated by a CSF-derived feature that was inspired by low-contrast acuity charts, i.e., the highest spatial frequency at 25% contrast. When compared to healthy controls, the MS patients showed reduced CSF (average AULCSF 1.21 vs. 1.42, p < 0.01).ConclusionHigh precision, usability, repeatability, and discrimination support the qCSF as a tool to assess contrast vision in pwMS.

Predicting quality of life in AMD patients-insights on the new NICE classification and on a bolt-on vision dimension for the EQ-5D.

Health-related quality of life (HRQoL) in age-related macular degeneration (AMD) is difficult to estimate as most generic tools underestimate vision. Our aim was to measure the effect of AMD on generic and visual quality of life and how it relates to handicap. We also aimed to validate the NG82 NICE AMD classification. Finally, we studied if a bolt-on visual domain increased the EQ-5D sensitivity to AMD. Ninety-six patients with AMD participated in this observational cross-sectional study. Visual (VF-14) and generic questionnaires (EQ-5D) with VIS, and the London handicap scale (LHS) was used to quantify HRQoL and handicap. ANOVA and regression analysis were used to identify significant associations. Visual dysfunction in AMD has a significant effect in VF-14 (P < 0.001), LHS (p < 0.001), and EQ-5D (p = 0.015). The EQ-5D was less sensitive than the VF-14 and LHS and was not significantly correlated with the VIS bolt-on domain (p = 0.608). On the other hand, VIS was significantly associated with visual acuity (p < 0.001), AMD diagnosis (p = 0.005), VF-14 (p < 0.001), and LHS (p < 0.001). The new AMD classification was a good predictor of visual HRQoL and had an excellent association with visual acuity in the best eye. This article shows that visual impairment is associated with lower HRQoL and with an increased handicap. It also suggests that a visual dimension may increase the EQ-5D sensitivity in AMD. There was a relationship between visual impairment and handicap with the items of the new NICE AMD classification, which supports its use.

Macular pigment optical density and visual quality of life

PurposeThere is robust evidence that higher macular pigment concentrations help reduce both veiling and discomfort glare in patients with or without ocular disease. We investigated whether there was also a relationship between macular pigment optical density (MPOD) and patient surveys about glare or ocular discomfort. MethodsWe measured MPOD psychophysically in 23 healthy subjects and administered the National Eye Institute Visual Functioning Questionnaire (VFQ-25). Responses for each survey question were sorted from low (no limitation) to high (very severe limitation). The median response for each question was determined, and independent t-tests were performed on the mean MPOD values for survey responses above and below the median. We also performed a non-parametric correlation analysis between MPOD and survey responses. ResultsWhile the median response was “no limitation” for most (22 of 25) survey questions, responses were slightly higher for two questions concerning ocular discomfort and one question related to driving at night. MPOD levels were significantly higher in subjects that reported no discomfort in or around their eyes than in those that reported mild discomfort. There was also a trend toward higher MPOD levels in subjects who reported that pain in or around their eyes never limited their activity as well as in subjects who reported no difficulty driving at night. ConclusionThese preliminary findings are consistent with the well-established discomfort and glare hypotheses for MPOD. The current findings on subjective ocular discomfort in the absence of glare deserve further study.