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The aim of the study is to test if EQ-5D, a more generic instrument, and Activity Inventory, a more specific instrument to the visual condition, produce consistent results when considering the different levels of visual impairment. By assessing how these instruments reflect visual status in a sample of patients with visual impairment, we will help to understand how they can work in cultural context and population in which they were never tested before.Method is based on Multivariate Analysis of Variance, in which the levels of visual impairment (slightly, moderate, severe/blindness) are defined through the visual acuity values, and the utility values derived from EQ-5D and the Activity Inventory.Participants were recruited in 3 public hospitals as a part of an ongoing study of prevalence and costs of visual impairment in Portugal. Patients attending outpatient appointments in these hospitals with acuity in the better eye of 0,30logMAR or worse and/or visual field in the better eye <20 degrees were invited to take part in face-to-face interviews. Additional visual measures, as acuity was collected using standardize methods. Visual acuity was assessed using an internally illuminated ETDRS chart at 4 m with room lights extinguished.The results show that both instruments have a good explanatory power. However when considering different clinical conditions, the AI presents better results. The EQ-5D due its low sensitivity/adaptability does not capture differences in health status in patients with slightly and moderate visual impairment.Since EQ-5D is the instrument most used in the evaluation of public health programs performance, the results suggest that its use should be more cautious in a situation of different difficulty levels. The results indicate that in these cases the EQ-5D should be used with a complementary instrument more specific to the clinical condition. Key messages The results suggest that with different difficulty levels the EQ-5D should be used with, Poster presentation

Purpose: Vision loss can have a substantial human and economic impact on individuals and society that include disability, loss of productivity and reduction in quality of life. The purpose of this study was to estimate economic burden of visual impairment in Portugal. Methods: A prevalence-based cost of illness approach was adopted to estimate costs of vision impairment. We estimated direct medical costs and indirect economic costs. Direct medical hospital costs were determined using a bottom up approach. For those meeting the inclusion criteria (visual acuity of 20/40 or 0.5decimal or worse in the better eye and/or visual field of less than 20deg) we estimated direct costs by collecting information from administrative records that included: physician’s office visits, emergency and outpatient visits. We developed a survey based in parts of the annotated cost questionnaire-HERU Discussion Paper N.03/01 (UK Working Party on Patient Costs) and the Service Receipt Inventory-European Version. Using the questionnaire that we developed, in face-to-face interviews, we collect direct medical expenditures supported by patients that included: costs with medical prescriptions, low vision aids and devices. With the same questionnaire we collected information for indirect costs calculations. Indirect costs were calculated by estimating the value of productivity losses including employment participation, absenteeism and caregiver costs. Results: Results presented here correspond to 442 patients that met the inclusion criteria. The four main causes of visual impairment in this sample were Diabetic Retinopathy, Cataract, Glaucoma and Age-related macular degeneration. Direct medical hospital costs were accountable for 12% of total costs calculated. Patient expenditures represented 25% of expenses with visual impairment and indirect costs corresponded to 63% of the total. From this data we estimated that the average annual direct cost per patient with VI was 958 euro and average annua

Purpose: To characterize interventions needed by the population with visual impairment or to assess interventions in vision rehabilitation validated and standardized instruments used in different cultural contexts are necessary. The aim of this work was to characterize the functional status of a sample of people with visual impairment with the Portuguese version of the activity inventory (AI) Methods: A group of participants in the study Prevalence and Costs of Visual Impairment in Portugal (PC-VIP) was recruit to face-to-face interviews and the activity inventory was administered. The AI examines 50 goals split between three objectives: social functioning, recreation and daily living. Goals rated ‘not important’ were skipped, but for all other goals the participant was asked to rate its difficulty on a five point scale ranging from ‘not difficult’ to ‘impossible without help’. The difficulty responses were Rasch analysed (Winsteps v3.81.0) to produce a continuous measure of visual ability (AI score). Additional information about distance and near visual acuity (ETDRS scale), contrast sensitivity (MARS test) and critical print size (MNREAD test) was collected. Results: A total of 94 persons participated in this study. Some participants were not able to read or recognize letters due to their poor vision or poor literacy and were excluded from further analysis. Data reported here are from 62 participants, median age 63y (range=12-85) and the most common cause of visual impairment were retinal diseases. Mean presenting acuity in the better eye was 0.93logMAR (SD=0.5). The mean difficulty (item measure) in the AI was -0.33 logits (SD=0.96). The most difficult items were "sew or do needlework", "read the newspaper", "drive" and the easiest items were "provide care for a pet", "eat your meals", "use the restroom in a public place". The mean ability score (person measures) was 1.11 logits (SD=2.04). The ability measures in the AI were correlated with distance visual acuity