Shah Vinay A, Gupta Shailesh K, Shah Kanan V, Vinjamaram Sanjay, Chalam K V
Department of Ophthalmology, University of Florida/College of Medicine, Jacksonville, Florida 32209, USA.
Ophthalmic Epidemiol. 2004 Feb;11(1):43-51. doi: 10.1076/opep.11.1.43.26436.
To evaluate the utility scores in patients with varying degrees of visual morbidity due to diabetic retinopathy or ARMD.
Patients with vision < or =20/40 in one eye due to diabetic retinopathy or ARMD were enrolled. Utility scores were measured by the time trade-off (TTO) method after stratifying the patient population with visual impairment in the better eye (group 1, 20/20 to 20/40; group 2, 20/50 to 20/100; group 3, 20/200 to no light perception).
Sub-group analysis revealed that subjects in group 1 were willing to give up a median of 1 year as compared to 3 years by the subjects in group 3 for perfect bilateral visual acuity (P<0.05). The median utility score was 0.94 for group 1, 0.96 for group 2 and 0.80 for group 3. While the utility scores for groups 1 and 2 were comparable (P>0.05), there was a significant difference in the utility scores between groups 1 and 3 and between groups 2 and 3 (P<0.05). There was no significant effect on the utility scores of age, educational level or prior ocular surgery.
Substantial visual loss secondary to diabetic retinopathy or ARMD is associated with a significant decrease in utility scores. However, TTO scores were not sensitive enough to demonstrate a difference between subjects with mild (group 1) and moderate (group 2) visual loss in the better eye secondary to diabetic retinopathy or ARMD.
评估因糖尿病视网膜病变或年龄相关性黄斑变性导致不同程度视力损害患者的效用评分。
纳入因糖尿病视网膜病变或年龄相关性黄斑变性导致一只眼视力≤20/40的患者。在根据较好眼的视力损害情况将患者人群分层后(第1组,20/20至20/40;第2组,20/50至20/100;第3组,20/200至无光感),采用时间权衡(TTO)方法测量效用评分。
亚组分析显示,与第3组患者为获得双眼完美视力愿意放弃3年相比,第1组患者愿意放弃的时间中位数为1年(P<0.05)。第1组的效用评分中位数为0.94,第2组为0.96,第3组为0.80。虽然第1组和第2组的效用评分具有可比性(P>0.05),但第1组和第3组之间以及第2组和第3组之间的效用评分存在显著差异(P<0.05)。年龄、教育水平或既往眼部手术对效用评分无显著影响。
糖尿病视网膜病变或年龄相关性黄斑变性继发的严重视力丧失与效用评分显著降低相关。然而,TTO评分对因糖尿病视网膜病变或年龄相关性黄斑变性导致较好眼轻度(第1组)和中度(第2组)视力丧失的患者之间的差异不够敏感,无法显示出来。