Original article
Vision-Related Quality of Life and Visual Function Following Vitrectomy for Proliferative Diabetic Retinopathy

https://doi.org/10.1016/j.ajo.2008.02.006Get rights and content

Purpose

To evaluate the vision-related quality of life (VR-QOL) and visual function following vitrectomy for proliferative diabetic retinopathy (PDR).

Design

Prospective, interventional, consecutive, comparative case series.

Methods

The 25-Item National Eye Institute Visual Function Questionnaire (VFQ-25) was answered by 51 patients with PDR before and three months after 20-gauge pars plana vitrectomy. Among the patients with PDR, 30 underwent combined cataract surgery and vitrectomy. Clinical data were collected, including logarithm of minimal angle of resolution (logMAR) best-corrected visual acuity (BCVA), letter contrast sensitivity, and metamorphopsia. The VFQ-25 was also administered to 46 age-matched normal controls.

Results

The preoperative VFQ-25 composite score was significantly lower in the PDR patients (56.3 ± 18.8, mean ± standard deviation) than in the normal controls (85.2 ± 10.3; P < .0001). Vitrectomy significantly improved VFQ-25 composite score (P < .005) and eight of 12 subscales (P < .05). The preoperative VFQ-25 composite score significantly correlated with preoperative logMAR BCVA in the better-seeing eye (P < .001). The postoperative VFQ-25 composite score exhibited significant correlation with postoperative logMAR BCVA in the worse-seeing eye (P < .0001) as well as the better-seeing eye (P < .0001). Similar significant correlations were also observed between the VFQ-25 composite score and letter contrast sensitivity.

Conclusions

Vitrectomy for PDR significantly improves VR-QOL. The current study quantitatively indicates that VR-QOL in PDR patients depends on visual acuity and contrast sensitivity in the better-seeing eye preoperatively and in both the better-seeing and worse-seeing eyes postoperatively.

Section snippets

Methods

We analyzed 51 eyes of 51 patients with PDR who were scheduled to undergo pars plana vitrectomy. Their age averaged 55.8 ± 12.1 years (mean ± standard deviation), and there were 21 men and 30 women. Forty-six eyes of 46 age-matched subjects served as normal controls. Prior to inclusion in the study, all patients provided written informed consent after the nature of the study was explained to them.

The surgery was performed in our clinic by an experienced vitreoretinal surgeon from June 14, 2005

Results

The logMAR BCVA ranged from 2.30 to 0.00 preoperatively (mean, 1.24; median, 1.30) and from 2.60 to −0.08 postoperatively (mean, 0.46; median, 0.30). The vitrectomy significantly improved VA (P < .0001), with 39 patients (75.0%) gaining two or more Early Treatment Diabetic Retinopathy Study (ETDRS) lines. No change was observed in nine eyes (17.3%), and vision decreased by one or more lines in four patients (7.6%). The postoperative reduction in VA was attributed to neovascular glaucoma (two

Discussion

In the present study, VFQ-25 composite score and all subscale scores, except for color vision, were significantly reduced in patients with PDR, indicating that those patients were suffering from a wide range of functional vision difficulties as compared with the normal controls. The preoperative VFQ-25 composite score significantly correlated with VA and contrast sensitivity in the better-seeing eye. Postoperatively, VFQ-25 composite score significantly correlated with the condition of the

Fumiki Okamoto graduated from Tsukuba University School of Medicine, Ibaraki, Japan in 1994. He completed his ophthalmology residency and fellowship at University of Tsukuba Hospital. Dr Okamoto is currently the Assistant Professor in University of Tsukuba, Department of Ophthalmology. He specializes in vitreoretinal surgery.

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Fumiki Okamoto graduated from Tsukuba University School of Medicine, Ibaraki, Japan in 1994. He completed his ophthalmology residency and fellowship at University of Tsukuba Hospital. Dr Okamoto is currently the Assistant Professor in University of Tsukuba, Department of Ophthalmology. He specializes in vitreoretinal surgery.

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