Singapore Eye Research Institute, Singapore.
Duke-NUS Medical School, Singapore.
Br J Ophthalmol. 2022 Aug;106(8):1063-1068. doi: 10.1136/bjophthalmol-2020-318269. Epub 2021 Feb 26.
We examined the associations between the 6-year incidence of age-related macular degeneration (AMD) and vision-related quality of life (VRQoL), and the contribution of presenting visual acuity (VA), in an Asian population.
Fundus images from the Singapore Chinese Eye Study, a population-based cohort study (baseline: 2009-2011; follow-up: 2015-2017), were graded using a modified Wisconsin age-related maculopathy grading system. Incident AMD was defined as no baseline AMD in both eyes and early/late AMD in the worse eye at follow-up. Presenting VA was assessed using the logarithm of the minimum angle of resolution chart at 4 m under standard lighting conditions with habitual correction. Multiple linear regression models determined the associations between AMD incidence with changes in the Rasch-transformed scores of the Reading, Mobility and Emotional VRQoL domains of the 32-item Impact of Visual Impairment (IVI-32) questionnaire, adjusted for traditional confounders. The contribution of presenting VA to changes in VRQoL was also estimated.
Of the 2251 participants without AMD at baseline (mean age (SD): 57.7 (9) years, 51.4% women), 101 (4.5%) and 11 (0.5%) developed incident early and late AMD at follow-up, respectively. Incident late AMD was associated with significant 30.3%, 32.5% and 30.9% decrements in Reading, Mobility and Emotional IVI scores, respectively. The contribution of presenting VA ranged between 1.62% and 4.35% of the observed decrements. No significant associations were noted with incident early AMD.
Incident late AMD had a substantial impact on all aspects of VRQoL, with presenting VA contributing only minimally to this longitudinal relationship.
我们研究了年龄相关性黄斑变性（AMD）发病 6 年后与视力相关的生活质量（VRQoL）之间的关联，以及在亚洲人群中，现有视力（VA）的表现对其的影响。
本研究使用改良的威斯康星年龄相关性黄斑变性分级系统对新加坡华人眼研究（基线：2009-2011 年；随访：2015-2017 年）的眼底图像进行分级。AMD 发病定义为双眼均无基线 AMD，且随访时一眼为早期/晚期 AMD。采用标准照明条件下的最小分辨角对数视力表，在常规矫正下评估现有的 VA。使用 Rasch 转化后的 32 项视觉障碍影响问卷（IVI-32）的阅读、移动和情感 VRQoL 领域得分的变化，通过多线性回归模型确定 AMD 发病与这些变化之间的关联，同时还调整了传统的混杂因素。还评估了现有 VA 对 VRQoL 变化的贡献。
在基线时无 AMD 的 2251 名参与者中（平均年龄（标准差）：57.7（9）岁，51.4%为女性），101 名（4.5%）和 11 名（0.5%）分别在随访时发生早期和晚期 AMD 发病。晚期 AMD 发病与阅读、移动和情感 IVI 得分分别显著下降 30.3%、32.5%和 30.9%相关。现有 VA 的贡献范围为观察到的下降幅度的 1.62%至 4.35%。早期 AMD 发病与 VRQoL 各方面均无显著关联。
晚期 AMD 发病对 VRQoL 的各个方面都有很大的影响，而现有 VA 对这一纵向关系的贡献很小。
