Low vision status and declining vision decrease Health-Related Quality of Life: Results from a nationwide 11-year follow-up study

Abstract

PurposeThe impact of visual acuity (VA) on Health-Related Quality of Life (HRQoL) and the cross-sectional and longitudinal differences in HRQoL during the 11-year follow-up were investigated. The aim was to examine the impact declining vision has on HRQoL and to provide comparable data to facilitate the allocation of health-care resources.MethodsWe utilized nationwide health examination surveys carried out by the National Institute for Health and Welfare in 2000 and 2011, providing a representative sampling of the Finnish adult population aged 30 and older. VA was assessed through Snellen E test, and HRQoL scores were evaluated using EQ-5D and 15D questionnaires. Multiple imputations with Markov chain Monte Carlo method was used to utilize the data more effectively. Regression analyses were conducted to assess the impact of declining VA on HRQoL, adjusted for incident comorbidities.ResultsLower VA status was associated with significantly lower HRQoL at both time points, most clearly observable below the VA level of 0.5. Declining VA resulted in statistically significant decline in HRQoL during the follow-up, greater with distance than near VA. 15D impairment associated with decline in the distance VA was also clinically meaningful and greater than that associated with any of the examined comorbidities.ConclusionsHRQoL was significantly and meaningfully impaired even before the threshold of severe vision loss or blindness was reached. The results encourage the improvement of available treatment options aiming to postpone the onset of visual impairment or declining VA, to maintain better quality of life among the population.Electronic supplementary materialThe online version of this article (10.1007/s11136-019-02260-3) contains supplementary material, which is available to authorized users.

Prevalence and 11-year incidence of common eye diseases and their relation to health-related quality of life, mental health, and visual impairment

“…Low VA values outside the modified logMAR letter chart that could not be determined were reported as 0.01. The classified VA values were following: VA ≥ 1.0 (good vision), VA 0.63-0.8 (adequate vision), VA 0.32-0.5 (weak vision), VA 0.125-0.25 (impaired vision), and VA < 0.1 (severe vision loss or blindness) [8]. Habitual binocular distance VA ≤ 0.25 was considered as impaired vision.…”

“…Decreased VA can significantly affect the quality of life (QoL) of an individual even before the individual has become visually impaired (VA ≤ 0.25, Snellen decimal equivalent) [8] and, in fact, the awareness of an eye disease, such as glaucoma, is thought to reduce QoL through the fear of declining vision before the loss of VA affects the patient's life [7,[9][10][11]. However, a majority of the previously conducted research on the connection of QoL with VA and eye diseases has been based on relatively small study samples that may not be representative on larger populations [9,[12][13][14].…”

Trends in prevalence of blindness and distance and near vision impairment over 30 years: an analysis for the Global Burden of Disease Study

“… 10 Vision impairment and blindness are associated with reduced economic, educational, and employment opportunities, 11 , 12 , 13 , 14 and increased risk of death. 15 , 16 Furthermore, in older age, vision impairment not only significantly affects quality of life 17 (eg, the association between vision impairment and depression 18 , 19 , 20 ) but also amplifies comorbidities such as cognitive impairment 21 and risk of falls. 22 …”

Visual and Hormone Outcomes in Pituitary Apoplexy: Results of a Single Surgeon, Single Institution 15-Year Retrospective Review and Pooled Data Analysis

“…The 30% risk reduction of vision impairment we identified through pooled analysis advocates for early decompression in the setting of a visual or CN deficit, as loss of vision is associated with significant morbidity and decreased quality of life. [22][23][24][25] Moreover, our series suggests that many hormonal abnormalities normalize following surgery, although panhypopituitarism commonly arises. While the prevalence of hypothyroidism is estimated at 3.7% in the United States, 26 our data showed 41% of patients with thyroid dysfunction at presentation.…”