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Assessing disutility associated with diabetic retinopathy, diabetic macular oedema and associated visual impairment using the Vision and Quality of Life Index.

Abstract Use of generic multi-attribute utility instruments (MAUI) to assess the impact of diabetic retinopathy (DR) on health-related quality of life (HRQoL) has produced inconsistent findings. Therefore, we assessed the impact of DR, diabetic macular oedema (DME) and associated visual impairment on vision-related QoL (VRQoL) using a vision-specific MAUI.
PMID
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Authors

Mayor MeshTerms

Quality of Life

Keywords
Journal Title clinical & experimental optometry
Publication Year Start




PMID- 22537275
OWN - NLM
STAT- MEDLINE
DA  - 20120518
DCOM- 20120914
LR  - 20150623
IS  - 1444-0938 (Electronic)
IS  - 0816-4622 (Linking)
VI  - 95
IP  - 3
DP  - 2012 May
TI  - Assessing disutility associated with diabetic retinopathy, diabetic macular
      oedema and associated visual impairment using the Vision and Quality of Life
      Index.
PG  - 362-70
LID - 10.1111/j.1444-0938.2012.00742.x [doi]
AB  - BACKGROUND: Use of generic multi-attribute utility instruments (MAUI) to assess
      the impact of diabetic retinopathy (DR) on health-related quality of life (HRQoL)
      has produced inconsistent findings. Therefore, we assessed the impact of DR,
      diabetic macular oedema (DME) and associated visual impairment on vision-related 
      QoL (VRQoL) using a vision-specific MAUI. METHODS: In this cross-sectional study,
      203 diabetic patients were recruited from specialised eye clinics in a Melbourne 
      tertiary eye hospital. Severity of combined DR/DME was categorised as: no DR/no
      DME, mild non-proliferative DR (NPDR) and/or mild DME; moderate NPDR and/or
      moderate DME and vision-threatening DR (severe NPDR or proliferative DR (PDR)
      and/or severe DME) in the worse eye. Visual impairment was categorised as: none
      (up to 0.18 logMAR); mild (from 0.18 to 0.3 logMAR); moderate (from 0.3 to 0.48
      logMAR); severe (from 0.48 to 0.78 logMAR); and profound (worse than 0.78
      logMAR). The Vision and Quality of Life Index (VisQoL) vision-specific MAUI was
      the main outcome measure. As the distribution of the utilities was skewed,
      independent associations with covariates were explored using multivariable
      quantile regression models (five groups: 15(th) , 30(th) , 45(th) , 60(th) and
      75(th) percentiles) ranging from poorest to highest VRQoL. RESULTS: Participants'
      median age was 65 years (range: 27 to 90 years). Of the 203 participants, 50
      (24.6 per cent) had no DR/DME, 24 (11.8 per cent) had mild NPDR/DME, 47 (23.2 per
      cent) had moderate NPDR/DME and 82 (40.4 per cent) had vision-threatening DR.
      After adjusting for relevant covariables, only profound visual impairment was
      independently associated with VisQoL utilities (beta= -0.297 +/- 0.098 p < 0.01).
      Severity of DR/DME was not significantly associated with any group of VisQoL
      utilities. CONCLUSION: The variation in VisQoL utilities was attributed to
      profound visual impairment but not mild, moderate or severe visual impairment or 
      DR/DME severity. These findings support the use of vision-specific MAUI to
      capture the impact of profound visual impairment associated with DR and DME. A
      DR-specific MAUI might be required to assess the specific utility deficits
      associated with DR/DME across the spectrum of the condition.
CI  - (c) 2012 The Authors. Clinical and Experimental Optometry (c) 2012 Optometrists
      Association Australia.
FAU - Fenwick, Eva K
AU  - Fenwick EK
AD  - Centre for Eye Research Australia, The University of Melbourne, The Royal
      Victorian Eye and Ear Hospital, Australia.
FAU - Xie, Jing
AU  - Xie J
FAU - Pesudovs, Konrad
AU  - Pesudovs K
FAU - Ratcliffe, Julie
AU  - Ratcliffe J
FAU - Chiang, Peggy P C
AU  - Chiang PP
FAU - Finger, Robert P
AU  - Finger RP
FAU - Lamoureux, Ecosse L
AU  - Lamoureux EL
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20120427
PL  - Australia
TA  - Clin Exp Optom
JT  - Clinical & experimental optometry
JID - 8703442
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Cross-Sectional Studies
MH  - Diabetes Complications/*psychology
MH  - Diabetic Retinopathy/*psychology
MH  - Female
MH  - Humans
MH  - Macular Edema/etiology/*psychology
MH  - Male
MH  - Middle Aged
MH  - *Quality of Life
MH  - Vision Disorders/etiology/*psychology
MH  - Visual Acuity
EDAT- 2012/04/28 06:00
MHDA- 2012/09/15 06:00
CRDT- 2012/04/28 06:00
AID - 10.1111/j.1444-0938.2012.00742.x [doi]
PST - ppublish
SO  - Clin Exp Optom. 2012 May;95(3):362-70. doi: 10.1111/j.1444-0938.2012.00742.x.
      Epub 2012 Apr 27.