Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States of America.
Division of Aging, Brigham and Women's Hospital, Department of Medicine, VA Boston Health care system, Harvard Medical School, Boston, Massachusetts, United States of America.
PLoS One. 2018 May 10;13(5):e0196481. doi: 10.1371/journal.pone.0196481. eCollection 2018.
Vision loss from age-related macular degeneration (AMD) has a profound effect on vision-related quality of life (VRQoL). The pupose of this study is to identify clinical factors associated with VRQoL using the Rasch- calibrated NEI VFQ-25 scales in bilateral advanced AMD patients.
We retrospectively reviewed 47 patients (mean age 83.2 years) with bilateral advanced AMD. Clinical assessment included age, gender, type of AMD, high contrast visual acuity (VA), history of medical conditions, contrast sensitivity (CS), central visual field loss, report of Charles Bonnet Syndrome, current treatment for AMD and Rasch-calibrated NEI VFQ-25 visual function and socioemotional function scales. The NEI VFQ visual function scale includes items of general vision, peripheral vision, distance vision and near vision-related activity while the socioemotional function scale includes items of vision related-social functioning, role difficulties, dependency, and mental health. Multiple regression analysis (structural regression model) was performed using fixed item parameters obtained from the one-parameter item response theory model.
Multivariate analysis showed that high contrast VA and CS were two factors influencing VRQoL visual function scale (β = -0.25, 95% CI-0.37 to -0.12, p<0.001 and β = 0.35, 95% CI 0.25 to 0.46, p<0.001) and socioemontional functioning scale (β = -0.2, 95% CI -0.37 to -0.03, p = 0.023, and β = 0.3, 95% CI 0.18 to 0.43, p = 0.001). Central visual field loss was not assoicated with either VRQoL visual or socioemontional functioning scale (β = -0.08, 95% CI-0.28 to 0.12,p = 0.44 and β = -0.09, 95% CI -0.03 to 0.16, p = 0.50, respectively).
In patients with vision impairment secondary to bilateral advanced AMD, high contrast VA and CS are two important factors affecting VRQoL.
年龄相关性黄斑变性（AMD）导致的视力丧失对与视力相关的生活质量（VRQoL）有深远影响。本研究的目的是使用经 Rasch 校准的 NEI VFQ-25 量表，确定双侧晚期 AMD 患者与 VRQoL 相关的临床因素。
我们回顾性分析了 47 例双侧晚期 AMD 患者（平均年龄 83.2 岁）。临床评估包括年龄、性别、AMD 类型、高对比度视力（VA）、既往病史、对比敏感度（CS）、中心视野丧失、Charles Bonnet 综合征的报告、AMD 的当前治疗方法以及经 Rasch 校准的 NEI VFQ-25 视觉功能和社会情感功能量表。NEI VFQ 视觉功能量表包括一般视力、周边视力、远距离视力和近距离视力相关活动的项目，而社会情感功能量表包括与视力相关的社会功能、角色困难、依赖性和心理健康的项目。使用来自单参数项目反应理论模型的固定项目参数进行多元回归分析（结构回归模型）。
多变量分析显示，高对比度 VA 和 CS 是影响 VRQoL 视觉功能量表（β=-0.25，95%CI-0.37 至-0.12，p<0.001 和β=0.35，95%CI 0.25 至 0.46，p<0.001）和社会情感功能量表（β=-0.2，95%CI-0.37 至-0.03，p=0.023，β=0.3，95%CI 0.18 至 0.43，p=0.001）的两个因素。中心视野丧失与 VRQoL 视觉或社会情感功能量表均无相关性（β=-0.08，95%CI-0.28 至 0.12，p=0.44 和β=-0.09，95%CI-0.03 至 0.16，p=0.50）。
在双侧晚期 AMD 导致视力损害的患者中，高对比度 VA 和 CS 是影响 VRQoL 的两个重要因素。
