Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Ophthalmology. 2011 Apr;118(4):649-55. doi: 10.1016/j.ophtha.2010.08.003. Epub 2010 Oct 29.
To assess the impact of diabetic retinopathy (DR) and its severity on health-related quality of life (HRQOL) in a population-based sample of Latinos with type 2 diabetes mellitus (DM).
Cross-sectional population-based study, the Los Angeles Latino Eye Study (LALES).
We included 1064 LALES participants with DM.
We measured HRQOL by the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) and the Medical Outcomes Study 12-item Short Form Health Survey (SF-12). We assessed DR by masked standardized grading of stereoscopic photographs from 7 standard fields. Severity of DR in eyes was graded using a modified Airlie House classification. The severity scores from each eye were then concatenated to create a single per person grade ranging from 1 (no DR in either eye) to 15 (bilateral PDR). Multiple linear regression analyses were performed to determine the independent relationship between severity of DR and HRQOL after adjusting for covariates.
Scores on the NEI-VFQ-25 and SF-12.
More severe DR was associated with worse HRQOL scores on all of the NEI-VFQ-25 and SF-12 subscales (P<0.05). Individuals with DR from grade 2 (minimum nonproliferative diabetic retinopathy [NPDR]) through grade 8 (unilateral moderate NPDR) show a modest decline in HRQOL. However, the decline becomes significantly steeper between steps 8 (unilateral moderate NPDR) and 9-15 (bilateral moderate NPDR to bilateral PDR). The domains with the most significant impact were for vision-related daily activities, dependency, and mental health.
Greater severity of DR was associated with lower general and vision-specific HRQOL. Persons with bilateral moderate NPDR had the most substantial decrease in quality of life compared with those with less severe DR. The prevention of incident DR and, more important, its progression from unilateral to bilateral NPDR is likely to have a positive impact on a person's HRQOL and should be considered an important goal in management of individuals with DM.
在 2 型糖尿病（DM）的拉丁裔人群中，评估糖尿病视网膜病变（DR）及其严重程度对健康相关生活质量（HRQOL）的影响。
基于人群的横断面研究，洛杉矶拉丁裔眼病研究（LALES）。
我们纳入了 1064 名 LALES 参与者，其中患有 DM。
我们使用 25 项国家眼科研究所视觉功能问卷（NEI-VFQ-25）和医疗结果研究 12 项短格式健康调查（SF-12）来测量 HRQOL。我们通过对 7 个标准区域的立体照片进行盲法标准化分级来评估 DR。DR 的严重程度使用改良的 Airlie House 分类进行分级。然后将每只眼的严重程度评分串联起来，创建一个从 1（双眼均无 DR）到 15（双眼 PDR）的个人分级。进行多元线性回归分析，以确定在调整协变量后，DR 严重程度与 HRQOL 之间的独立关系。
NEI-VFQ-25 和 SF-12 的得分。
更严重的 DR 与所有 NEI-VFQ-25 和 SF-12 子量表的 HRQOL 评分较差相关（P<0.05）。从 2 级（最低非增殖性糖尿病视网膜病变[NPDR]）到 8 级（单侧中度 NPDR）的 DR 患者的 HRQOL 略有下降。然而，在 8 级（单侧中度 NPDR）和 9-15 级（双侧中度 NPDR 至双侧 PDR）之间，下降变得显著陡峭。影响最大的领域是与视力相关的日常生活活动、依赖性和心理健康。
DR 的严重程度与一般和视力特异性 HRQOL 呈负相关。与轻度 DR 患者相比，双侧中度 NPDR 患者的生活质量下降幅度最大。预防 DR 的发生，更重要的是，预防其从单侧到双侧 NPDR 的进展，可能对一个人的 HRQOL 产生积极影响，因此应将其视为 DM 患者管理的重要目标。
