Department. of Ophthalmology, University of Bonn Ernst-Abbe-Str. 2, D-53127, Bonn, Germany.
Sci Rep. 2019 Oct 25;9(1):15326. doi: 10.1038/s41598-019-51769-7.
The purpose of this study was to assess which visual function measures are most strongly associated with vision-related quality of life (VRQoL) in age-related macular degeneration (AMD). A cross-sectional study of subjects with early AMD (n = 10), intermediate AMD (n = 42) and late AMD (n = 38) was conducted. Subjects were interviewed with the Impact of Vision Impairment (IVI) questionnaire. Functional tests performed included best-corrected visual acuity (BCVA), low luminance visual acuity (LLVA), visual acuity measured with the Moorfields Acuity Charts (MAC), contrast sensitivity, reading speed, mesopic and dark-adapted microperimetry. The relationship between VRQoL and visual function was assessed with multiple regressions controlling for confounders. Rasch analysis demonstrated the validity of the IVI to assess VRQoL through three subscales: reading and accessing information, mobility and independence, and emotional well-being. Subjects with late AMD had significant lower IVI scores on all subscales compared with intermediate and early AMD (p < 0.011). In the overall cohort, IVI subscales were associated with BCVA, LLVA, MAC-VA and contrast sensitivity (all p < 0.001). Among the subgroup of early and intermediate AMD subjects, reading and mobility subscales were significantly associated with MAC-VA (p < 0.013). These results suggest that MAC-VA is a useful, patient-relevant measure of visual impairment in AMD.
本研究旨在评估与年龄相关性黄斑变性（AMD）相关的视觉功能测量中哪些与视觉相关的生活质量（VRQoL）关系最密切。对早期 AMD（n=10）、中期 AMD（n=42）和晚期 AMD（n=38）患者进行了横断面研究。采用影响视力障碍问卷（IVI）对患者进行访谈。进行的功能测试包括最佳矫正视力（BCVA）、低亮度视力（LLVA）、用 Moorfields 视力图表（MAC）测量的视力、对比敏感度、阅读速度、中间和暗适应微视野。通过多元回归控制混杂因素，评估 VRQoL 与视觉功能之间的关系。Rasch 分析证明了 IVI 通过三个亚量表评估 VRQoL 的有效性：阅读和获取信息、移动和独立以及情绪健康。与中期和早期 AMD 相比，晚期 AMD 患者在所有亚量表上的 IVI 评分均显著降低（p<0.011）。在总体队列中，IVI 亚量表与 BCVA、LLVA、MAC-VA 和对比敏感度相关（均 p<0.001）。在早期和中期 AMD 患者亚组中，阅读和移动亚量表与 MAC-VA 显著相关（p<0.013）。这些结果表明，MAC-VA 是 AMD 患者视力障碍的一种有用的、与患者相关的测量方法。
