The impact of bilateral vision status on vision-related quality of life in people with diabetes mellitus

Abstract

Purpose: To assess the impact of bilateral vision status on vision-related quality of life (VR-QOL) in patients with type 2 diabetes in a Chinese cohort. Methods: Patients with presenting visual acuity (PVA) and VR-QOL data from the Fushun Diabetic Retinopathy Cohort Study were included. VR-QOL was assessed using the National Eye Institute Visual Function Questionnaire-25 (VFQ-25). Monocular PVA (Snellen) was categorized into 3 levels for both the better-seeing eye (BSE) and worse-seeing eye (WSE): 1) High PVA (H, > 6/18); 2) Moderate PVA (M, 6/18–6/60); and 3) Low PVA (L, < 6/60). Based on the monocular PVAs, 6 categories of bilateral vision status were defined (H-H, H-M, H-L, M-M, M-L, L-L). The parameters of VR-QOL were analyzed between the groups. Results: A total of 1717 patients were enrolled. For BSEs in the same PVA level, the VFQ-25 composite score decreased significantly with declining PVA in the WSE (H-M vs H-L: 80.5±17.9 vs. 73.6±22.5, P=0.01; M-M vs M-L: 78.7±19.6 vs. 69.1±26.4, P=0.01). Conversely, for WSEs in the same PVA level, there was no significant difference in the VFQ-25 composite score as PVA changed in the BSE (H-M vs M-M, 80.5±17.9 vs. 78.7±19.6, P=0.30; H-L vs. M-L: 73.6±22.5 vs. 69.1±26.4, P=0.25). Conclusion: The PVA of the WSE in bilateral vision has a greater impact on VR-QOL in diabetic patients. Priority treatment may be considered for the WSE for diabetic patients with different bilateral vision statuses, to better improve VR-QOL.