Original article
Utility of the National Eye Institute VFQ-25 Questionnaire in a Heterogeneous Group of Multiple Sclerosis Patients

https://doi.org/10.1016/j.ajo.2006.04.051Get rights and content

Purpose

To investigate the utility of the 25-Item National Eye Institute Visual Function Questionnaire (VFQ-25) in assessing visual function in a heterogeneous group of multiple sclerosis (MS) patients and to identify correlations of VFQ-25 scores with clinically relevant objective visual parameters.

Design

Comparative cohort study.

Methods

The VFQ-25 was distributed to 34 patients with clinically definite MS. Patients underwent a comprehensive ophthalmic examination, including Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity (VA), Pelli-Robson contrast sensitivity (CS), Humphrey visual field 30 to 2 (HVF), and Farnsworth-Munsell 100-Hue color vision (100-Hue). Expanded Disability Status Scores (EDSS) were recorded for each patient. Comparative analyses using χ2 tests and t tests were performed. Spearman rank correlation coefficients were computed to identify relationships between VFQ-25 scores and the aforementioned visual parameters.

Results

In comparison with a published reference group without ocular disease, MS patients had considerably worse VFQ-25 composite scores (P < .01), being similar to published cohorts of glaucoma and cataract patients. VFQ-25 composite scores were found to be modestly and significantly correlated with several clinical parameters, including: VA (r = −0.63, P < .001), CS (r = 0.60, P < .001), HVF (r = 0.53, P = .003), and 100-Hue (r = −0.48, P = .01). EDSS scores, the use of disease modifying agents, and having a history of previous optic neuritis did not correlate significantly with VFQ-25 composite scores.

Conclusions

The VFQ-25 questionnaire is a sensitive and useful tool in assessing visual function in MS patients. Such patients have quality of life indices similar to glaucoma and cataract patients, underscoring the significance of visual symptoms in MS.

Section snippets

Methods

Patients with clinically definite MS (CDMS, as defined by the Poser criteria)9 visiting the MS clinic at St Michael’s Hospital in Toronto, Canada, were invited to participate in the study during new or routine clinical encounters. The study was approved by the research ethics board of St Michael’s Hospital, and signed informed consent was obtained from all patients. Patients with a history of ocular disease not associated with MS (glaucoma, cataract, retinal disease) were excluded. Consenting

Results

In total, there were 34 participants in the study, 28 (82%) of whom were female. The mean age was 42 years (range, 22 to 63). The mean binocular visual acuity was logMAR 0.08 ± 0.21 (range −0.18 to 0.58); the mean log CS was 1.51 ± 0.16 logMAR units (range, 0.90 to 1.75 logMAR units); the mean 100-Hue score was 178 ± 112 (range, 34 to 740); and the average HVF mean deviation scores (MD) were −3.37 ± 3.3 (−13.9 to 0.47, see Table 1). Twenty-one participants (62%) had relapse remitting MS; 10

Discussion

In the present study of a clinically heterogeneous group of MS patients, including patients on and off DMDT and those with and without previous ON, the VFQ-25 correlated significantly with a variety of clinically relevant parameters including ETDRS VA, Pelli-Robson CS, HVF, and Farnsworth-Munsell 100-(100-Hue).

The findings of the current study suggest that impairments of the tested visual parameters can predict impaired HRQOL in MS patients and, conversely, that reduced VFQ-25 scores are

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Supported by the Multiple Sclerosis Society, Toronto, Ontario, Canada.

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