Background/aims To assess the independent impact of diabetic retinopathy (DR) on three domains of vision-related quality of life (VRQoL) in a Chinese Singapore population.
Methods The Singapore Chinese Eye Study (n=3353; 2009–2011) was a population-based, prospective, cross-sectional study conducted at the Singapore Eye Research Institute. The study population included 292 adults with diabetes, with and without DR. DR (better eye) was categorised as presence and absence of any DR; severity of DR (no vision-threatening DR (VTDR); severe non-proliferative DR (NPDR); PDR and/or clinically significant macular oedema and VTDR). Our main outcome was VRQoL which was measured using Rasch-calibrated scores from the ‘Reading’, ‘Mobility’ and ‘Emotional’ domains of the Impact of Vision Impairment questionnaire. The relationship between DR and VRQoL was assessed using multiple linear regression models.
Results Of the 292 individuals (mean age 61.35 ± 9.66 years; 55.8% male), 201 (68.8%), 49 (16.8%), 20 (6.8%), 22 (7.5%) and 27 (9.2%) had no DR, minimal-mild NPDR, moderate-severe NPDR, PDR and VTDR, respectively. Any DR and VTDR were independently associated with 6% and 12% worse Reading scores and 7% and 18% poorer Emotional well-being, respectively, compared with those without DR. These associations persisted after separate adjustment for visual impairment and presenting visual acuity. No significant difference was found in the Mobility domain between persons with and without DR.
Conclusions We documented that DR, particularly VTDR, was independently associated with restrictions in Reading and Emotional well-being. Understanding factors underlying the detrimental DR-VRQoL relationship may optimise rehabilitation outcomes for individuals with DR.
- diabetic retinopathy
- quality of life
- emotional well-being
- vision-specific functioning
- vision impairment
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Contributors EKF and REKM contributed to the conception of the work, interpretation of the data and drafting of the manuscript. EKF and ATLG conducted the data analysis, assisted with interpretation of results and drafted sections of the paper. NK, CW, AA, PG, JJW, PM, TYW and C-YC revised the manuscript critically for important intellectual content. ELL contributed to the conception of the work, interpretation of the data and revised the manuscript critically for important intellectual content.
Funding This study was supported by grants from the National Medical Research Council (STaR/0003/2008), the Singapore Bio Imaging Consortium (C-011/2006) and the Biomedical Research Council (08/1/35/19/550).
Disclaimer None of funding organisations had any role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; or in the decision to submit the manuscript for publication.
Competing interests None declared.
Patient consent Obtained.
Ethics approval Ethics approval was obtained from the Singapore Eye Research Institutional Review Board.
Provenance and peer review Not commissioned; externally peer reviewed.