Elsevier

Ophthalmology

Volume 111, Issue 6, June 2004, Pages 1141-1149
Ophthalmology

Original article
The impact of visual impairment on self-reported visual functioning in Latinos: The Los Angeles Latino Eye Study

https://doi.org/10.1016/j.ophtha.2004.02.003Get rights and content

Abstract

Objective

To assess the association between presenting binocular visual acuity (VA) and self-reported visual function as measured by the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25).

Design

A population-based, prevalence study of eye disease in Latinos 40 years and older residing in La Puente, California (Los Angeles Latino Eye Study [LALES]).

Participants

Six thousand three hundred fifty-seven Latinos 40 years and older from 6 census tracts in La Puente.

Methods

All participants completed a standardized interview, including the NEI-VFQ-25 to measure visual functioning, and a detailed eye examination. Two definitions of visual impairment were used: (1) presenting binocular distance VA of 20/40 or worse and (2) presenting binocular distance VA worse than 20/40. Analysis of variance was used to determine any systematic differences in mean NEI-VFQ-25 scores by visual impairment. Regression analyses were completed (1) to determine the association of age, gender, number of systemic comorbidities, depression, and VA with self-reported visual function and (2) to estimate a visual impairment–related difference for each subscale based on differences in VA.

Main outcome measures

The NEI-VFQ-25 scores in persons with visual impairment.

Results

Of the 5287 LALES participants with complete NEI-VFQ-25 data, 6.3% (including 20/40) and 4.2% (excluding 20/40) were visually impaired. In the visually impaired participants, the NEI-VFQ-25 subscale scores ranged from 46.2 (General Health) to 93.8 (Color Vision). In the regression model, only VA, depression, and number of comorbidities were significantly associated with all subscale scores (R2 ranged from 0.09 for Ocular Pain to 0.33 for the composite score). For 9 of 11 subscales, a 5-point change was equivalent to a 1- or 2-line difference in VA. Relationships were similar regardless of the definition of visual impairment.

Conclusion

In this population-based study of Latinos, the NEI-VFQ-25 was sensitive to differences in VA. A 5-point difference on the NEI-VFQ-25 seems to be a minimal criterion for a visual impairment–related difference. Self-reported visual function is essentially unchanged if the definition of visual impairment includes or excludes a VA of 20/40.

Section snippets

Study cohort

The study area comprised 6 census tracts in and around the city of La Puente in Los Angeles County, California. The study cohort consisted of self-identified Latinos, 40 years or older, living in La Puente. All study procedures adhere to the principles outlined in the Declaration of Helsinki for research involving human subjects.

Details of the study design, sampling plan, and baseline data are reported elsewhere.14 Institutional review board/ethics committee approval was obtained from the Los

Description of study cohort

Of the 7789 individuals in these 6 census tracts who were eligible for LALES, 6357 completed an ophthalmic examination, resulting in a participation rate of 82%.14 Complete data on both the NEI-VFQ-25 and a home interview were available for 5386 of the 6357 participants in the 6 census tracts, and these participants were included in this analysis. Details regarding the study participants have been presented elsewhere.14

A comparison of demographic and clinical characteristics between the study

Discussion

The LALES is the largest epidemiologic study of eye disease in the US, in the largest group of Latinos. Because it is a population-based study, there are fewer biases in sample selection relative to quality-of-life studies in convenience samples (presenting for treatment at clinical sites) and clinical trials. The strength of the LALES sample is enhanced by the high participation rate and the use of objective measures of VA. In this study, the NEI-VFQ-25 was found to be a valid measure to

References (32)

  • C.M Mangione et al.

    Identifying the content area for the 51-item National Eye Institute Visual Function Questionnaireresults from focus groups with visually impaired persons

    Arch Ophthalmol

    (1998)
  • B.K Lee et al.

    The Glaucoma Symptom Scale. A brief index of glaucoma-specific symptoms

    Arch Ophthalmol

    (1998)
  • A.T Broman et al.

    The impact of visual impairment and eye disease on vision-related quality of life in a Mexican-American populationProyecto VER

    Invest Ophathalmol Vis Sci

    (2002)
  • R Klein et al.

    The NEI-VFQ-25 in people with long-term type 1 diabetes mellitusthe Wisconsin Epidemiologic Study of Diabetic Retinopathy

    Arch Ophthalmol

    (2001)
  • Varma R, Paz SH, Azen SP, et al. The Los Angeles Latino Eye Study. Design, methods, and baseline data. Ophthalmology...
  • D.R Globe et al.

    Using focus groups to develop a culturally sensitive methodology for epidemiological surveys in a Latino populationfindings from the Los Angeles Latino Eye Study (LALES)

    Ethn Dis

    (2002)
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    This work was supported by the National Eye Institute and the National Center on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland (grant nos.: EY11753, EY03040); Research to Prevent Blindness, New York, New York; and a Pharma Foundation Faculty Development Award. Dr Varma is a Research to Prevent Blindness Sybil B. Harrington Scholar.

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