Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Dec 5;8(12):e81042.
doi: 10.1371/journal.pone.0081042. eCollection 2013.

Visual impairment as a function of visual acuity in both eyes and its impact on patient reported preferences

Robert P Finger  1 , Eva Fenwick, Christoph W Hirneiss, Arthur Hsueh, Robyn H Guymer, Ecosse L Lamoureux, Jill E Keeffe
Affiliations

Visual impairment as a function of visual acuity in both eyes and its impact on patient reported preferences

Robert P Finger et al. PLoS One. .

Abstract

Purpose: To assess the impact of VA loss on patient reported utilities taking both eyes into account compared to taking only the better or the worse eye into account.

Methods: In this cross-sectional study 1085 patients and 254 controls rated preferences with the generic health-related (EQ-5D; n = 868) and vision-specific (Vision and Quality of Life Index (VisQoL); n = 837) multi-attribute utility instruments (MAUIs). Utilities were calculated for three levels of VA in the better and worse eyes, as well as for 6 different vision states based on combinations of the better and worse eye VA.

Results: Using the VisQoL, utility scores decreased significantly with deteriorating vision in both the better and worse eyes when analysed separately. When stratified by the 6 vision states, VisQoL utilities decreased as VA declined in the worse eye despite stable VA in the better eye. Differences in VisQoL scores were statistically significant for cases where the better eye had no vision impairment and the worse seeing fellow eye had mild, moderate or severe vision impairment. In contrast, the EQ-5D failed to capture changes in better or worse eye VA, or any of the six vision states.

Conclusions: Calculating utilities based only on better eye VA or using a generic MAUI is likely to underestimate the impact of vision impairment, particularly when the better eye has no or little VA loss and the worse eye is moderately to severely visually impaired. These findings have considerable implications for the assessment of overall visual impairment as well as economic evaluations within eye health.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors received funding from Novartis Pharma Germany for a part of this study as acknowledged in the financial disclosure section. However, this does not alter the authors’ adherence to all the PLOS ONE policies on sharing data and materials.

Figures

Figure 1
Figure 1. Utility across all six vision states (VS), for the VisQoL and the EQ-5D utility instruments, demonstrating a reduction of visual acuity with worsening vision states for the VisQoL but not the EQ-5D.
See this image and copyright information in PMC

References

    1. Hurley SF, Matthews JP, Guymer RH (2008) Cost-effectiveness of ranibizumab for neovascular age-related macular degeneration. Cost Eff Resour Alloc 6: 12. - PMC - PubMed
    1. Mitchell P, Annemans L, White R, Gallagher M, Thomas S (2011) Cost effectiveness of treatments for wet age-related macular degeneration. Pharmacoeconomics 29: 107–131. - PubMed
    1. Bourne R, Price H, Stevens G (2012) Global burden of visual impairment and blindness. Archives of ophthalmology 130: 645–647. - PubMed
    1. Sharma S, Brown GC, Brown MM, Shah GK, Snow K, et al. (2000) Converting visual acuity to utilities. Canadian journal of ophthalmology Journal canadien d’ophtalmologie 35: 267–272. - PubMed
    1. Vu HT, Keeffe JE, McCarty CA, Taylor HR (2005) Impact of unilateral and bilateral vision loss on quality of life. Br J Ophthalmol 89: 360–363. - PMC - PubMed

Publication types