Quality of life with visual acuity loss from diabetic retinopathy and age-related macular degeneration

Abstract

Objective: To compare the quality of life in patients with visual acuity loss occurring secondary to diabetic retinopathy with visual acuity loss occurring secondary to age-related macular degeneration (ARMD). Methods: Consecutive patients with diabetic retinopathy and ARMD were evaluated using the time trade-off method of utility value analysis. Both groups were stratified according to the degree of visual acuity loss in the better-seeing eye (group 1: 20/20-20/25, group 2: 20/30-20/40, group 3: 20/50-20/100, group 4: ≤20/200). Utility values obtained from the patients, once stratified for visual acuity group, were compared with use of the t test and the Mann-Whitney U test. In addition, a 2-way analysis of variance was performed to control for potential confounding variables. Results: No difference was found between the utility value means of the diabetic retinopathy (n=333) and ARMD (n=246) subgroups stratified according to visual acuity levels: group 1, P=.54; group 2, P=.96; group 3, P=.09; and group 4, P=.32. A 2-way analysis of variance demonstrated that, among the variables of ocular disease, sex, age, and visual acuity in the better-seeing eye, only visual acuity was significantly associated with utility values (P=.003). Conclusions: At similar levels of visual acuity loss, that associated with diabetic retinopathy causes a similar reduction in quality of life to that associated with ARMD. This information has important implications for use in cost-utility analyses of ophthalmic interventions.