Vision-related quality of life declines with presence, severity of diabetic retinopathy
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Key takeaways:
- Compared with those without DR, VFQ-25 subscales progressively worsened with disease severity.
- Reduced visual acuity, older age, male sex, type 2 diabetes and disease duration correlated with lower scores.
Vision-related quality of life declined with the presence and severity of diabetic retinopathy, highlighting the importance of interventions to reduce disease progression, according to a study published in JAMA Ophthalmology.
With limited data available on the association between quality of life (QoL) and diabetic retinopathy (DR), researchers in the United Kingdom conducted a systematic review and meta-analysis to investigate the effect of DR on both vision-related QoL (VRQoL) and health-related QoL (HRQoL).
After searching MEDLINE, EBSCO, Embase and Web of Science databases, they identified 93 articles, conducted between 2001 and 2022 in 24 countries, that included adults with DR and a reported measure of QoL using validated scales. The most commonly used scales were National Eye Institute 25-item Visual Function Questionnaire (VFQ-25) for VRQoL Short Form Health Survey for HRQoL.
Of 79 studies meeting inclusion criteria, VRQoL was recorded in 54, HRQoL in 26 and both in 13. he The first analysis included eight studies, in which 1,138 participants with DR were compared with 347 who did not have DR. The second analysis included 35 studies of 6,351 participants with DR.
According to results of the first analysis, most VFQ-25 subscales progressively worsened with DR severity. Compared with participants without DR, the composite VFQ-25 score was 3.8 points lower among those with non-vision-threatening DR and 25.1 points lower in vision-threatening DR (P < .001) Among those with vision-threatening DR, the greatest effect was on mental health and near vision, while the least effect was on ocular pain.
In the second analysis, the mean VFQ-25 composite score for participants with non-vision threatening DR was 91.8, which dropped to 73.2 for those with vision-threatening DR (P < .001). A univariate meta-regression model demonstrated that reduced visual acuity, older age, male sex, type 2 diabetes and longer disease duration were associated with lower VFQ-25 composite scores.
Researchers further reported that HRQoL scores had no or weak associations with non-vision-threatening DR and strong associations with vision-related DR.
“This analysis found that VRQoL declines with the presence and increasing severity of DR,” researchers wrote. “This decline is not fully explained by the impact of DR on VA. Therapies that prevent the development or progression of DR, even before advanced stages, may improve VRQoL.”
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