Impact of Visual Field Loss on Vision-Specific Quality of Life in African Americans: The African American Eye Disease Study

Am J Ophthalmol. 2021 Sep:229:52-62. doi: 10.1016/j.ajo.2021.02.008. Epub 2021 Feb 8.

Abstract

Purpose: To elucidate how visual field loss (VFL) impacts self-reported vision-specific quality of life (VSQOL) in African Americans, who experience a disproportionate burden of visual impairment.

Design: Cross-sectional, population-based cohort.

Methods: Eligible participants (n = 7,957) were recruited who self-identified as African American, were aged 40 years or older, and resided in Inglewood, California, USA. A total of 6,347 participants (80.0%) completed clinical eye examinations. Total mean deviation (MD) of VFL was measured bilaterally as decibels (dB) using the Humphrey SITA Standard 24-2 test. VSQOL was measured using the National Eye Institute Visual Function Questionnaire (NEI-VFQ 25) and scored using item response theory (IRT).

Results: Participants with reliable data (n = 5,121) had a mean age of 60.7 years (standard deviation 11.0); those with worse VFL were older; had more comorbidities, lower income, less education, and worse visual acuity; and were more likely to be unemployed and depressed. Using IRT analysis, a change in VF of 6.2 (95% confidence interval [CI]: 5.3, 7.7) dB and 9.2 (95% CI: 7.5, 11.9) dB was necessary to observe a meaningful (5-point) difference in vision-related task and emotional well-being scores, respectively. VFL had the greatest impact on self-reported driving ability (6.0 dB [95% CI: 5.2, 7.1]), followed by satisfaction with general vision, near vision, vision-related mental health, and peripheral vision.

Conclusions: The strongest impact of VFL reported by African Americans was on their ability to complete visual tasks, especially for driving. An effect of VFL on emotional well-being also was observed, but the magnitude of association was about 50% lower for well-being compared to that of task.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Black or African American*
  • Cross-Sectional Studies
  • Humans
  • Middle Aged
  • Quality of Life*
  • Sickness Impact Profile
  • Surveys and Questionnaires
  • Vision Disorders
  • Visual Fields