Top

Graefe's Archive for Clinical and Experimental Ophthalmology

Published in:

01-02-2009 | Medical Ophthalmology

Diabetic retinopathy and health-related quality of life

Authors: Eldad Davidov, Lusine Breitscheidel, Johannes Clouth, Marion Reips, Michael Happich

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 2/2009

Abstract

Objective

To describe the impact of co-morbidities, visual acuity, diabetic retinopathy (DR) grade, and macular edema (ME) on the health-related quality of life (HRQOL) among patients with diabetic retinopathy.

Methods

Analysis of data of 207 patients with diabetic retinopathy from Germany in 2003. HRQOL assessment was done using the generic (SF-12) questionnaire. It was hypothesized that exogenous variables (co-morbidities, visual acuity impairment, DR, and ME) would have an impact on HRQOL. Using a structural equation modelling procedure, the effects of exogenous variables on endogenous variables physical component summaries (PSC) and mental component summaries (MCS) reflecting HRQOL were tested.

Results

The number of co-morbidities had a negative effect on visual acuity (b = −0.26, standardized) and a similar negative effect on PCS (b = −0.27). DR grade had a negative effect on visual acuity (b = −0.19) and a positive effect on the variable ME (b = 0.44). ME displayed a negative effect on visual acuity (b = −0.58) and also on MCS (b = −0.29). Visual acuity had a positive effect (b = 0.48) on PCS.

Conclusions

Presence of DR and ME, visual acuity impairment and patient co-morbidities lead to significant impairment of both the physical and mental components of HRQOL.

Horle S, Gruner F, Kroll P (2002) Epidemiology of diabetes-induced blindness: a review. Klin Monatsbl Augenheilkd 219:777–784 doi:10.1055/s-2002-36318 PubMedCrossRef

Knudsen S, Bek T, Poulsen P, Hove M, Rehling M, Mogensen C (2002) Macular edema reflects generalized vascular hyperpermeability in type 2 diabetic patients with retinopathy. Diabetes Care 25:2328–2334 doi:10.2337/diacare.25.12.2328 PubMedCrossRef

Funatsu H, Yamashita H, Ikeda T, Nakanishi Y, Kitano S, Hori S (2002) Angiotensin II and vascular endothelial growth factor in the vitreous fluid of patients with diabetic macular edema and other retinal disorders. Am J Ophthalmol 133:537–543 doi:10.1016/S0002-9394(02)01323-5 PubMedCrossRef

Javitt J, Aiello L (1996) Cost-effectiveness of detecting and treating diabetic retinopathy. Ann Intern Med 124:164–169PubMed

World Health Organisation (2002) Diabetes mellitus. Fact sheet No 138. Retrieved January 12, 2006, from http://www.who.int/mediacentre/factsheets/fs138/en/print.html

Lamoureux E, Hassell J, Keeffe J (2004) The impact of diabetic retinopathy on participation in daily living. Arch Ophthalmol 122:84–88 doi:10.1001/archopht.122.1.84 PubMedCrossRef

Klein BE, Klein R, McBride PE, Cruickshanks KJ, Palta M, Knudtson MD, Moss SE, Reinke JO (2004) Cardiovascular disease, mortality, and retinal microvascular characteristics in type 1 diabetes: Wisconsin epidemiologic study of diabetic retinopathy. Arch Intern Med 164:1917–1924 doi:10.1001/archinte.164.17.1917 PubMedCrossRef

Wilkinson CP, Ferris FL, Klein RE, Lee PP, Agardh CD, Davis M, Dills D, Kampik A, Pararajasegaram R, Verdaguer JT (2003) Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales. Ophthalmology 110:1677–1682 doi:10.1016/S0161-6420(03)00475-5 PubMedCrossRef

Happich M, Reitberger U, Breitscheidel L, Ulbig M, Watkins J (2008) The economic burden of diabetic retinopathy in Germany in 2002. Graefes Arch Clin Exp Ophthalmol 246:151–159 doi:10.1007/s00417-007-0573-x PubMedCrossRef

10.

Ware J, Kosinski M, Keller S (1996) A 12-Item Short-Form Health Survey. Med Care 34:220–233 doi:10.1097/00005650-199603000-00003 PubMedCrossRef

11.

Ware J, Sherbourne C (1992) The MOS 36-item short-form health survey (SF-36). Conceptual framework and item selection. Med Care 30:473–483 doi:10.1097/00005650-199206000-00002 PubMedCrossRef

12.

Woodcock A, Bradley C, Plowright R, Ffytche T, Kennedy-Martin T, Hirsch A (2004) The influence of diabetic retinopathy on quality of life: interviews to guide the design of a condition-specific, individualised questionnaire: the RetDQoL. Patient Educ Couns 53:365–383 doi:10.1016/j.pec.2003.10.007 PubMedCrossRef

13.

Woodcock A, Bradley C, Plowright R, Kennedy-Martin T, Hirsch A, Ffytche T (2005) Development of the new retinopathy treatment satisfaction questionnaire (ReTSQ). Int Congr Ser 1282:342–346 doi:10.1016/j.ics.2005.04.011 CrossRef

14.

Bollen K (1989) Structural equations with latent variables. Wiley, New York

15.

Byrne B (2001) Structural equation modeling with AMOS. Lawrence Erlbaum Associates, Rahwah, NJ

16.

Muthén L, Muthén B (2007) Mplus user’s guide. Muthén & Muthén, Los Angeles, CA

17.

Flora D, Curran P (2004) An empirical evaluation of alternative methods of estimation for confirmatory factor analysis with ordinal data. Psychol Methods 9:466–491 doi:10.1037/1082-989X.9.4.466 PubMedCrossRef

18.

Schafer J, Graham J (2002) Missing data: our view of the state of the art. Psychol Methods 7:147–177 doi:10.1037/1082-989X.7.2.147 PubMedCrossRef

19.

Hu L, Bentler P (1999) Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Modeling 6:1–55CrossRef

20.

Marsh H, Hau K, Wen Z (2004) In search of golden rules: comment on hypothesis-testing approaches to setting cutoff values for fit indexes and dangers in overgeneralizing Hu and Bentler’s (1999) findings. Struct Equ Modeling 11:320–341 doi:10.1207/s15328007sem1103_2 CrossRef

21.

Hahl J, Hamalainen H, Sintonen H, Simell T, Arinen S, Simell O (2002) Health-related quality of life in type 1 diabetes without or with symptoms of long-term complications. Qual Life Res 11:427–436 doi:10.1023/A:1015684100227 PubMedCrossRef

22.

Maddigan S, Feeny D, Johnson J (2005) Health-related quality of life deficits associated with diabetes and comorbidities in a Canadian National Population Health Survey. Qual Life Res 14:1311–1320 doi:10.1007/s11136-004-6640-4 PubMedCrossRef

23.

Lloyd C, Matthews K, Wing R, Orchard T (1992) Psychosocial factors and complications of IDDM. The Pittsburgh Epidemiology of Diabetes Complications Study. Diabetes Care 15:166–172 doi:10.2337/diacare.15.2.166 PubMedCrossRef

24.

Muñoz B, West S, Rubin G, Schein O, Quigley H, Bressler S, Bandeen-Roche K (2000) Causes of blindness and visual impairment in a population of older Americans: The Salisbury Eye Evaluation Study. Arch Ophthalmol 118:819–825PubMed

25.

Tielsch J, Javitt J, Coleman A, Katz J, Sommer A (1995) The prevalence of blindness and visual impairment among nursing home residents in Baltimore. N Engl J Med 332:1205–1209 doi:10.1056/NEJM199505043321806 PubMedCrossRef

26.

Schotliff K, Duncan G (2005) Diabetes: chronic complications. In: Shaw KM, Cummings MH (Eds) Wiley, New York

27.

Chia E, Mitchell P, Rochtchina E, Foran S, Wang J (2003) Unilateral visual impairment and health related quality of life: the Blue Mountains Eye Study. Br J Ophthalmol 87:392–395 doi:10.1136/bjo.87.4.392 PubMedCrossRef

28.

Unruh M, Yan G, Radeva M, Hays R, Benz R, Athienites N, Kusek J, Levey A, Meyer K (2003) Bias in assessment of health-related quality of life in a hemodialysis population: a comparison of self-administered and interviewer-administered surveys in the HEMO study. J Am Soc Nephrol 14:2132–2141 doi:10.1097/01.ASN.0000076076.88336.B1 PubMedCrossRef

Title: Diabetic retinopathy and health-related quality of life
Authors: Eldad Davidov
Lusine Breitscheidel
Johannes Clouth
Marion Reips
Michael Happich
Publication date: 01-02-2009
Publisher: Springer-Verlag
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 2/2009
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-008-0960-y

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Diabetic retinopathy and health-related quality of life

Abstract

Objective

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 2/2009

Are intravitreal bevacizumab and ranibizumab effective in a rat model of choroidal neovascularization?

Quantitative analysis of central visual field defects in macular edema using three-dimensional computer-automated threshold Amsler grid testing

Acanthamoeba sclerokeratitis

Jonathan D. Trobe: Neuro-Ophthalmology (Rapid Diagnosis in Ophthalmology Series)

Intravitreal administration of the anti-TNF monoclonal antibody Infliximab in the rabbit

Improved reproducibility of retinal nerve fiber layer thickness measurements with the repeat-scan protocol using the Stratus OCT in normal and glaucomatous eyes