Top

Health and Quality of Life Outcomes

Published in:

Open Access 01-12-2010 | Research

Vision-related quality of life in first stroke patients with homonymous visual field defects

Authors: Carolin Gall, Gabriele H Franke, Bernhard A Sabel

Published in: Health and Quality of Life Outcomes | Issue 1/2010

Abstract

Background

To evaluate vision-related and health-related quality of life (VRQoL, HRQoL) in first stroke patients with homonymous visual field defects (VFD) with respect to the extent of the lesion. Since VFD occur in approximately 10% of stroke patients the main purpose of the study was to investigate the additional impact of VFD in stroke patients hypothesizing that VFD causes diminished VRQoL.

Methods

In 177 first stroke patients with persisting VFD 2.5 years after posterior-parietal lesions VRQoL was assessed by the National-Eye-Institute-Visual-Functioning-Questionnaire (NEI-VFQ) and HRQoL by the Medical-Outcome-Study Short-Form-36 Health-Survey (SF-36). Questionnaire results of VFD-patients were compared with age- and sex-matched healthy controls and with general non-selected stroke samples as published elsewhere. VFD-type and visual acuity were partially correlated with questionnaire results.

Results

Compared to healthy controls VFD-patients had lower NEI-VFQ scores except ocular pain (Z-range -11.34 to -3.35) and lower SF-36 scores except emotional role limitations (Z-range -7.21 to -3.34). VFD-patients were less impaired in SF-36 scores than general stroke patients one month post lesion (6/8 subscales) but had lower SF-36 scores compared to stroke patients six months post lesion (5/8 subscales). Visual acuity significantly correlated with NEI-VFQ scores (r-range 0.27 to 0.48) and VFD-type with SF-36 mental subscales (r-range -0.26 to -0.36).

Conclusions

VFD-patients showed substantial reductions of VRQoL and HRQoL compared to healthy normals, but better HRQoL compared to stroke patients one month post lesion. VFD-patients (although their lesion age was four times higher) had significantly lower HRQoL than a general stroke population at six months post-stroke. This indicates that the stroke-related subjective level of HRQoL impairment is significantly exacerbated by VFD. While VRQoL was primarily influenced by visual acuity, mental components of HRQoL were influenced by VFD-type with larger VFD being associated with more distress.

Available only for authorised users

Papageorgiou E, Hardiess G, Schaeffel F, Wiethoelter H, Karnath HO, Mallot H, Schoenfisch B, Schiefer U: Assessment of vision-related quality of life in subjects with homonymous visual field defects. Graefes Arch Clin Exp Ophthalmol 2007, 245: 1749–1758. 10.1007/s00417-007-0644-zPubMedCrossRef

Gall C, Mueller I, Kaufmann C, Franke GH, Sabel BA: Visual field defects after cerebral lesions from the subject's perspective: Health- and vision-related quality of life assessed by SF-36 and NEI-VFQ. Nervenarzt 2008, 79: 185–194. 10.1007/s00115-007-2342-9PubMedCrossRef

Gall C, Lucklum J, Sabel BA, Franke GH: Vision- and health- related quality of life in subjects with visual field loss after postchiasmatic lesions. Invest Ophthalmol Vis Sci 2009, 50: 2765–2776. 10.1167/iovs.08-2519PubMedCrossRef

McKean-Cowdin R, Varma R, Wu J, Hays RD, Azen SP, Los Angeles Latino Eye Study Group: Severity of visual field loss and health-related quality of life. Am J Ophthalmol 2007, 143: 1013–1023. 10.1016/j.ajo.2007.02.022PubMedCentralPubMedCrossRef

Gutierrez P, Wilson MR, Johnson C, Gordon M, Cioffi GA, Ritch R, Sherwood M, Meng K, Mangione CM: Influence of glaucomatous visual field loss on health-related quality of life. Arch Ophthalmol 1997, 115: 777–784.PubMedCrossRef

Parrish RK, Gedde SJ, Scott IU, Feuer WJ, Schiffman JC, Mangione CM, Montenegro-Piniella A: Visual function and quality of life among patients with glaucoma. Arch Ophthalmol 1997, 115: 1447–1455.PubMedCrossRef

Carta A, Braccio L, Belpoliti M, Soliani L, Sartore F, Gandolfi SA, Maraini G: Selfassessment of the quality of vision: association of questionnaire score with objective clinical tests. Curr Eye Res 1998, 17: 506–511. 10.1076/ceyr.17.5.506.5191PubMedCrossRef

Jampel HD, Schwartz A, Pollack I, Abrams D, Weiss H, Miller R: Glaucoma patients' assessment of their visual function and quality of life. J Glaucoma 2002, 11: 154–163. 10.1097/00061198-200204000-00012PubMedCrossRef

Nelson P, Aspinall P, Papasouliotis O, Worton B, O'Brien C: Quality of life in glaucoma and its relationship with visual function. J Glaucoma 2003, 12: 139–150. 10.1097/00061198-200304000-00009PubMedCrossRef

10.

Ringsdorf L, McGwin G Jr, Owsley C: Visual field defects and vision-specific healthrelated quality of life in African Americans and whites with glaucoma. J Glaucoma 2006, 15: 414–418. 10.1097/01.ijg.0000212252.72207.c2PubMedCrossRef

11.

McKean-Cowdin R, Wang Y, Wu J, Azen SP, Varma R, Los Angeles Latino Eye Study Group: Impact of Visual Field Loss on Health-Related Quality of Life in Glaucoma The Los Angeles Latino Eye Study. Ophthalmology 2008, 115: 941–948. 10.1016/j.ophtha.2007.08.037PubMedCrossRef

12.

Szlyk JP, Fishman GA, Grover S, Revelins BI, Derlacki DJ: Difficulty in performing everyday activities in patients with juvenile macular dystrophies: comparison with patients with retinitis pigmentosa. Br J Ophthalmol 1998, 82: 1372–1376. 10.1136/bjo.82.12.1372PubMedCentralPubMedCrossRef

13.

Deramo VA, Cox TA, Syed AB, Lee PP, Fekrat S: Vision-related quality of life in people with central retinal vein occlusion using the 25-item National Eye Institute Visual Function Questionnaire. Arch Ophthalmol 2003, 121: 1297–1302. 10.1001/archopht.121.9.1297PubMedCrossRef

14.

Noble J, Forooghian F, Sproule M, Westall C, O'Connor P: Utility of the National Eye Institute VFQ-25 questionnaire in a heterogeneous group of multiple sclerosis patients. Am J Ophthalmol 2006, 142: 464–468. 10.1016/j.ajo.2006.04.051PubMedCrossRef

15.

Naess H, Waje-Andreassen U, Thomassen L, Nyland H, Myhr KM: Health- related quality of life among young adults with ischemic stroke on long-term follow-up. Stroke 2006, 37: 1232–1236. 10.1161/01.STR.0000217652.42273.02PubMedCrossRef

16.

Madden S, Hopman WM, Bagg S, Verner J, O'Callaghan CJ: Functional Status and health-related quality of life during inpatient stroke rehabilitation. Med Rehabil 2006, 85: 831–838. 10.1097/01.phm.0000240666.24142.f7CrossRef

17.

Rønning OM, Stavem K: Determinants of change in quality of life from 1 to 6 months following acute stroke. Cerebrovasc Dis 2007, 25: 67–73.PubMed

18.

Hopman WM, Verner J: Quality of life during and following in-patient stroke rehabilitation. Stroke 2003, 34: 801–805. 10.1161/01.STR.0000057978.15397.6FPubMedCrossRef

19.

Anderson C, Laubscher S, Burns R: Validation of the Short Form 36 (SF-36) health survey questionnaire among stroke patients. Stroke 1996, 27: 1812–1816.PubMedCrossRef

20.

Warlow CP, Dennis MS, van Gijn J: Stroke. A practical guide to management. Oxford: Blackwell Scientific; 2001.

21.

Duncan PW, Samsa GP, Weinberger M, Goldstein LB, Bonito A, Witter DM, Enarson C, Mtachar D: Health status of individuals with mild stroke. Stroke 1997, 28: 740–745.PubMedCrossRef

22.

Wade DT, Collins C: The Barthel ADL index: a standard measure of physical disability. Int Disabil Stud 1988, 10: 64–67.PubMedCrossRef

23.

Bagg S, Paris Pombo A, Hopman WM: Effect of age on functional outcomes after stroke rehabilitation. Stroke 2002, 33: 179–185. 10.1161/hs0102.101224PubMedCrossRef

24.

Mangione CM, Berry S, Spritzer K, Janz NK, Klein R, Owsley C, Lee PP: Identifying the content area for the 51-item National Eye Institute Visual Function Questionnaire: results from focus groups with visually impaired persons. Arch Ophthalmol 1998, 116: 227–233.PubMed

25.

Mangione CM, Lee PP, Pitts J, Gutierrez P, Berry S, Hays RD: Psychometric properties of the National Eye Institute Visual Function Questionnaire (NEI-VFQ). NEI-VFQ Field Test Investigators. Arch Ophthalmol 1998, 116: 1496–1504.PubMedCrossRef

26.

Wolffsohn JS, Cochrane AL, Watt NA: Implementation methods for vision related quality of life questionnaires. Br J Ophthalmol 2000, 84: 1035–1040. 10.1136/bjo.84.9.1035PubMedCentralPubMedCrossRef

27.

Mangione CM, Lee PP, Gutierrez PR, Spritzer K, Berry S, Hays RD: Development of the 25-item National Eye Institute-Visual Function Questionnaire. Arch Ophthalmol 2001, 119: 1050–1058.PubMedCrossRef

28.

Franke GH, Esser J, Voigtländer A, Mähner N: Der National Eye Institute-Visual Function Questionnaire (NEI-VFQ) - Erste Ergebnisse zur psychometrischen Überprüfung eines Verfahrens zur Erfassung der Lebensqualität bei Sehbeeinträchtigten. Zeitschrift für Medizinische Psychologie 1998, 7: 178–184.

29.

Wagenbreth C, Franke GH, Sabel BA, Gall C: Beeinträchtigung der seh- und gesundheitsbezogenen Lebensqualität bei Schlaganfallpatienten mit homonymen Gesichtsfelddefekten in Abhängigkeit von der Schwere des visuellen Funktionsverlustes. Klin Monatsbl Augenheilkd 2009, in press.

30.

Bullinger M, Kirchberger I: Der SF-36 Fragebogen zum Gesundheitszustand- Handbuch für die deutschsprachige Fragebogen-Version. Göttingen: Hogrefe Verlag; 1998.

31.

Mueller I, Mast H, Sabel BA: Recovery of visual field defects: A large clinical observational study using vision restoration therapy. Restor Neurol Neurosci 2007, 25: 563–572.PubMed

32.

Radner W, Willinger U, Obermayer W, Mudrich C, Velikay-Parel M, Eisenwort B: Eine neue Lesetafel zur gleichzeitigen Bestimmung von Lesevisus und Lesegeschwindigkeit. Klin Monatsbl Augenheilkd 1998, 213: 174–181. 10.1055/s-2008-1034969PubMedCrossRef

33.

Bailey IL, Lovie JE: New design principles for visual acuity letter charts. Am J Optom Physiol Opt 1976, 53: 740–745.PubMedCrossRef

34.

Scott IU, Schein OD, West S, Bandeen-Roche K, Enger C, Folstein MF: Functional status and quality of life measurement among ophthalmic patients. Arch Ophthalmol 1994, 112: 329–335.PubMedCrossRef

35.

Suenkeler ICH, Nowak M, Misselwitz B, Kugler C, Schreiber W, Oertel WH, Back T: Timecourse of health-related quality of life as determined 3, 6 and 12 months after stroke. Relationship to neurological deficit, disability and depression. J Neurol 2002, 249: 1160–1167. 10.1007/s00415-002-0792-3PubMedCrossRef

36.

Jobke S, Kasten E, Sabel BA: Do patients undergo changes of their personality due to visual field defects? Klin Monatsbl Augenheilkd 2008, 225: 570–576. 10.1055/s-2008-1027417PubMedCrossRef

37.

Duncan PW, Goldstein LB, Matchar D, Divine GW, Feussner J: Measurement of motor recovery after stroke. Outcome assessment and sample size requirements. Stroke 1992, 23: 1084–1089.PubMedCrossRef

38.

Pedersen PM, Jørgensen HS, Nakayama H, Raaschou HO, Olsen TS: Aphasia in acute stroke: incidence, determinants and recovery. Ann Neurol 1995, 38: 659–666. 10.1002/ana.410380416PubMedCrossRef

39.

Demeurisse G, Demol O, Derouck M, de Beuckelaer R, Coekaerts MJ, Capon A: Quantitative study of the rate of recovery from aphasia due to ischemic stroke. Stroke 1980, 11: 455–458.PubMedCrossRef

40.

Zhang X, Kedar S, Lynn MJ, Newman NJ, Biousse V: Natural history of homonymous hemianopia. Neurology 2006, 66: 901–905. 10.1212/01.wnl.0000203338.54323.22PubMedCrossRef

41.

Christensen MC, Mayer SA, Ferran JM, Kissela B: Depressed mood after intracerebral hemorrhage: The FAST Trial. Cerebrovasc Dis 2009, 27: 353–360. 10.1159/000202012PubMedCrossRef

42.

van Nispen RM, de Boer MR, Hoeijmakers JG, Ringens PJ, van Rens GH: Co-morbidity and visual acuity are risk factors for health-related quality of life decline: five-month follow-up EQ-5D data of visually impaired older patients. Health Qual Life Outcomes 2009, 25: 18. 10.1186/1477-7525-7-18CrossRef

43.

Sprangers MA, de Regt EB, Andries F, van Agt HM, Bijl RV, de Boer JB, Foets M, Hoeymans N, Jacobs AE, Kempen GI, Miedema HS, Tijhuis MA, de Haes HC: Which chronic conditions are associated with better or poorer quality of life? J Clin Epidemiol 2000, 53: 895–907. 10.1016/S0895-4356(00)00204-3PubMedCrossRef

Title: Vision-related quality of life in first stroke patients with homonymous visual field defects
Authors: Carolin Gall
Gabriele H Franke
Bernhard A Sabel
Publication date: 01-12-2010
Publisher: BioMed Central
Published in: Health and Quality of Life Outcomes / Issue 1/2010
Electronic ISSN: 1477-7525
DOI: https://doi.org/10.1186/1477-7525-8-33

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Vision-related quality of life in first stroke patients with homonymous visual field defects

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2010

How do existing HIV-specific instruments measure up? Evaluating the ability of instruments to describe disability experienced by adults living with HIV

Development of the Japanese version of the Pediatric Quality of Life Inventory™ Brain Tumor Module

Patient-reported outcomes as predictors of 10-year survival in women after acute myocardial infarction

Content comparison of haemophilia specific patient-rated outcome measures with the international classification of functioning, disability and health (ICF, ICF-CY)

TMD pain: the effect on health related quality of life and the influence of pain duration

The effect of peer-led education on the life quality of mastectomy patients referred to breast cancer-clinics in Shiraz, Iran 2009