Nickels Stefan, Schuster Alexander K, Singer Susanne, Wild Philipp S, Laubert-Reh Dagmar, Schulz Andreas, Finger Robert P, Michal Matthias, Beutel Manfred E, Münzel Thomas, Lackner Karl J, Pfeiffer Norbert
Department of Ophthalmology, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany.
Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center Mainz, Mainz, Germany.
Health Qual Life Outcomes. 2017 Aug 8;15(1):156. doi: 10.1186/s12955-017-0732-7.
To estimate the burden of diseases, it is important to consider patient-reported outcomes including Quality of Life (QoL). The aim of this study is to provide population-based reference data for the National Eye Institute 25-Item Visual Function Questionnaire (NEI VFQ-25), stratified by sex and age.
The Gutenberg Health Study (GHS) is a population-based, prospective, observational cohort study in Germany, including 15,010 participants aged between 35 and 74. The baseline examination was conducted between 2007 and 2012. To overcome known shortcomings of the NEI VFQ-25, we calculated the previously proposed visual functioning scale and the socio-emotional scale based on Rasch-transformed person-level data. We present mean values, standard deviations and percentiles for age decades stratified by sex. We used a linear regression model to assess the influence of age, sex, socioeconomic status, distance-corrected visual acuity (better-seeing eye) and the absolute difference in distance-corrected visual acuity of both eyes on vision-related QoL.
NEI VFQ-25 data are available from 12,231 participants (82%). Both the long-form visual functioning scale (LFVFS) and the long-form socio-emotional scale (LFSES) showed a clear age dependency, with an average LFVFS score of 92.8 for men and 90.5 for women in the youngest age group and 85.7 and 83.4 in the oldest age group, and a LFSES score of 98.3 for men and 98.1 in women in the youngest and 94.7 and 94.5 in the oldest decade. The largest difference was observed between the youngest age group (35-44 years) and the 45-54 years group. Men tended to have slightly higher scores than women. In the multivariable linear regression analysis, age (per 5 years -0.42), female sex (-1.57), worse distance-corrected visual acuity of the better eye (per 0.1 increase in logMAR -2.92) and the difference between both eyes (per 0.1 increase in logMAR -0.87) were associated with a reduced LFVFS score (all p < 0.001). For the LFSES score, we showed that the influence of sex was minor, and that age (per 5 years -0.22), visual acuity of the better eye (-1.65), and the difference between both eyes (-0.56) were associated with a lower score (all p < 0.001).
We report age- and sex-specific reference data from a large population-based study of mainly Caucasian ethnicity of two unidimensional scores based on Rasch-transformed NEI VFQ-25 data. Vision-related QoL is lower in older and in female individuals. Our results support the association of vision-related QoL not only with the distance-corrected visual acuity of the better eye but also with the difference in visual acuity between each eye. Our findings could be used as a reference for comparison in future studies addressing the influence of eye diseases on vision-related QoL.
为了评估疾病负担，考虑患者报告的结果（包括生活质量（QoL））很重要。本研究的目的是提供按性别和年龄分层的美国国立眼科研究所25项视觉功能问卷（NEI VFQ - 25）的基于人群的参考数据。
古登堡健康研究（GHS）是一项在德国开展的基于人群的前瞻性观察队列研究，包括15010名年龄在35至74岁之间的参与者。基线检查在2007年至2012年期间进行。为克服NEI VFQ - 25已知的缺点，我们基于Rasch转换后的个体水平数据计算了先前提出的视觉功能量表和社会情感量表。我们呈现了按性别分层的各年龄十年的均值、标准差和百分位数。我们使用线性回归模型来评估年龄、性别、社会经济地位、距离矫正视力（较好眼）以及双眼距离矫正视力的绝对差值对视力相关生活质量的影响。
12231名参与者（82%）有NEI VFQ - 25数据。长形式视觉功能量表（LFVFS）和长形式社会情感量表（LFSES）均显示出明显的年龄依赖性，在最年轻年龄组中，男性的LFVFS平均得分为92.8，女性为90.5，在最年长年龄组中分别为85.7和83.4；在最年轻十年中，男性的LFSES得分为98.3，女性为98.1，在最年长十年中分别为94.7和94.5。在最年轻年龄组（35 - 44岁）和45 - 54岁组之间观察到最大差异。男性得分往往略高于女性。在多变量线性回归分析中，年龄（每5年 - 0.42）、女性性别（-1.57）、较好眼较差的距离矫正视力（logMAR每增加0.1 - 2.92）以及双眼之间的差异（logMAR每增加-0.87）与降低的LFVFS得分相关（所有p < 0.001）。对于LFSES得分，我们表明性别影响较小，年龄（每5年 - 0.22）、较好眼的视力（-1.65）以及双眼之间的差异（-0.56）与较低得分相关（所有p < 0.001）。
我们报告了一项主要基于白种人种族的大型人群研究中，基于Rasch转换后的NEI VFQ - 25数据得出的两个单维度得分的年龄和性别特异性参考数据。视力相关生活质量在老年人和女性个体中较低。我们的结果支持视力相关生活质量不仅与较好眼的距离矫正视力有关，还与每只眼睛之间的视力差异有关。我们的研究结果可作为未来研究中比较眼部疾病对视力相关生活质量影响的参考。
