Knudtson Michael D, Klein Barbara E K, Klein Ronald, Cruickshanks Karen J, Lee Kristine E
Department of Ophthalmology and Visual Sciences, University of Wisconsin Medical School, Madison, USA.
Arch Ophthalmol. 2005 Jun;123(6):807-14. doi: 10.1001/archopht.123.6.807.
To examine the associations of measures of quality of life (Medical Outcomes Study Short Form Health Survey) and functional activities (activities of daily living, instrumental activities of daily living, and visual function) in persons with and without age-related eye diseases.
Two thousand, six hundred seventy persons participated in the 1998 through 2000 examinations of both the Beaver Dam Eye Study and the Epidemiology of Hearing Loss Study. Age-related eye disease (age-related maculopathy, cataract, diabetic retinopathy, glaucoma, macula edema, occlusions, amblyopia, and macular holes) were assessed by fundus, slitlamp, and retroilluminated photographs and self-reported ocular history. Also administered was a standard interview that included the Medical Outcomes Study Short Form Health Survey, activities of daily living, instrumental activities of daily living, and visual function questionnaires and information on other medical conditions.
After controlling for age and sex, we found that persons with an age-related eye disease had decreased scores in almost all the domains of the Medical Outcomes Study Short Form Health Survey, and persons with eye disease in both eyes had poorer scores than persons with eye disease in only 1 eye. Stratifying by age-related maculopathy and central cataract yielded similar results. Further adjustment for current visual acuity and the number of comorbid conditions explained most associations. Several of the mental scales were still marginally significantly lower (P<.10) in persons with age-related maculopathy after adjustment. Persons with an age-related eye disease were not more likely to have impaired activities of daily living or instrumental activities of daily living. After adjustment for current visual acuity and number of comorbidities, persons who had trouble reading small print or recognizing people across the street were more likely to have an age-related eye disease. Otherwise, there were no significant associations with the visual function questions and any of the specific ocular conditions.
Many measures of general quality of life and functional activities were related to age-related eye diseases, but few associations remained significant after adjustments for vision and other comorbidities. Our data are compatible with the notion that decreased visual function, irrespective of the pathologic reason for the decrease, is associated with diminished quality of life and functional activities of living.
研究患有和未患有年龄相关性眼病的人群中生活质量指标（医学结局研究简明健康调查）与功能活动（日常生活活动、工具性日常生活活动及视觉功能）之间的关联。
2670人参与了1998年至2000年比弗迪姆眼研究及听力损失流行病学研究的检查。通过眼底、裂隙灯及后照法摄影以及自我报告的眼部病史评估年龄相关性眼病（年龄相关性黄斑病变、白内障、糖尿病性视网膜病变、青光眼、黄斑水肿、阻塞、弱视及黄斑裂孔）。还进行了一项标准访谈，其中包括医学结局研究简明健康调查、日常生活活动、工具性日常生活活动及视觉功能问卷以及其他医疗状况的信息。
在控制年龄和性别后，我们发现患有年龄相关性眼病的人群在医学结局研究简明健康调查的几乎所有领域得分均降低，双眼患有眼病的人群得分比单眼患有眼病的人群更低。按年龄相关性黄斑病变和中心性白内障分层得出了类似结果。对当前视力和共病数量进行进一步调整后，解释了大多数关联。调整后，年龄相关性黄斑病变患者的几个心理量表得分仍略显著较低（P<0.10）。患有年龄相关性眼病的人群日常生活活动或工具性日常生活活动受损的可能性并不更高。在调整当前视力和共病数量后，阅读小字体或识别街道对面的人有困难的人群更有可能患有年龄相关性眼病。否则，视觉功能问题与任何特定眼部疾病之间均无显著关联。
许多一般生活质量和功能活动指标与年龄相关性眼病有关，但在对视力和其他共病进行调整后，几乎没有关联仍具有显著性。我们的数据与以下观点一致，即视觉功能下降，无论下降的病理原因如何，都与生活质量和生活功能活动的降低有关。
