1. Relationship between Human Immunodeficiency Virus Neuroretinal Disorder and Vision-Specific Quality of Life among People with AIDS.
- Author
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Ashraf DC, May KP, Holland GN, Van Natta ML, Wu AW, Thorne JE, and Jabs DA
- Subjects
- Acquired Immunodeficiency Syndrome virology, Adult, Contrast Sensitivity physiology, Cross-Sectional Studies, Eye Infections, Viral virology, Female, HIV-1 pathogenicity, Humans, Male, Middle Aged, Optic Nerve Diseases virology, Prospective Studies, Retinal Diseases virology, Sickness Impact Profile, Surveys and Questionnaires, Visual Acuity physiology, Acquired Immunodeficiency Syndrome psychology, Eye Infections, Viral psychology, Optic Nerve Diseases psychology, Quality of Life psychology, Retinal Diseases psychology, Vision Disorders psychology
- Abstract
Purpose: Some human immunodeficiency virus (HIV)-infected individuals have evidence of optic nerve or retinal dysfunction that manifests as decreased contrast sensitivity, even with good best-corrected visual acuity (BCVA). This condition, termed HIV-related neuroretinal disorder (HIV-NRD), is a risk factor for vision impairment (BCVA <20/40), blindness (BCVA ≤20/200), and increased mortality. We investigated the effect of HIV-NRD on vision-specific quality of life (QOL)., Design: Cross-sectional analysis of data from a prospective, observational study., Participants: Individuals from the Longitudinal Study of the Ocular Complications of AIDS cohort who completed the National Eye Institute 25-item Visual Function Questionnaire (VFQ-25), had BCVA of 20/40 or better, and had no evidence of ocular opportunistic infection or cataract., Methods: We compared QOL by HIV-NRD status, adjusting for potential confounding variables, using multiple linear regression. Among those with HIV-NRD, we assessed the relationship between VFQ-25 and the logarithm of contrast sensitivity (logCS), using Spearman correlation. We defined a minimum clinically important difference (MCID) as 1 standard error of measurement from a well-characterized, historical population of individuals with a variety of ophthalmic disorders., Main Outcome Measures: Subscales and composite VFQ-25 scores (0 = worst, 100 = best)., Results: A total of 813 individuals met study criteria. Those with HIV-NRD (n = 39 [4.8%]) had a lower mean composite score than those without HIV-NRD (81 vs. 89; P = 0.0002) and lower mean scores in the following subscales: near activities (77 vs. 86; P = 0.004), distance activities (85 vs. 91; P = 0.01), social functioning (89 vs. 96; P = 0.0005), mental health (75 vs. 87; P = 0.0001), dependency (81 vs. 94; P < 0.0001), driving (75 vs. 85; P = 0.02), color vision (90 vs. 97; P < 0.0001), and peripheral vision (85 vs. 91; P = 0.0496). Score differences for each of these subscales met criteria for MCID. Among those with HIV-NRD, there was a positive correlation between logCS and composite score (r = 0.36; 95% confidence interval, 0.04-0.60)., Conclusions: HIV-NRD has a statistically significant and clinically meaningful association with decreased vision-specific QOL among people with AIDS and good BCVA., (Published by Elsevier Inc.)
- Published
- 2015
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