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. 2021 Aug;30(8):2311-2327.
doi: 10.1007/s11136-021-02817-1. Epub 2021 Mar 23.

Prevalence and 11-year incidence of common eye diseases and their relation to health-related quality of life, mental health, and visual impairment

Petri K M Purola  1   2 , Janika E Nättinen  3 , Matti U I Ojamo  4   5 , Seppo V P Koskinen  5 , Harri A Rissanen  5 , Päivi R J Sainio  5 , Hannu M T Uusitalo  3   4   6
Affiliations

Prevalence and 11-year incidence of common eye diseases and their relation to health-related quality of life, mental health, and visual impairment

Petri K M Purola et al. Qual Life Res. 2021 Aug.

Abstract

Purpose: To study the prevalence and incidence of the most common eye diseases and their relation to health-related quality of life (HRQoL), depression, psychological distress, and visual impairment in the aging population of Finland.

Methods: Our study was based on two nationwide health surveys conducted in 2000 and 2011. Eye disease status data were obtained from 7379 and 5710 individuals aged 30 + years, of whom 4620 partook in both time points. Both surveys included identical indicators of HRQoL (EuroQol-5 Dimension [EQ-5D], 15D), depression (Beck Depression Inventory [BDI]), psychological distress (General Health Questionnaire-12 [GHQ-12]), visual acuity, and self-reported eye diseases. We assessed the impact of known eye diseases on these factors, adjusted for age, gender, and co-morbidities.

Results: Prevalence of self-reported eye diseases was 3.1/2.7% for glaucoma, 8.1/11.4% for cataract, and 3.4/3.8% for retinal degeneration in 2000 and 2011, and the average incidence between 2000 and 2011 was 22, 109, and 35 /year/10,000 individuals, respectively. These eye diseases were associated with a significant decrease in EQ-5D and 15D index scores in both time points. BDI and GHQ-12 scores were also worsened, with some variation between different eye diseases. Impaired vision was, however, the strongest determinant of declined HRQoL. During the 11-year follow-up the effect of eye diseases on HRQoL and mental health diminished.

Conclusion: Declined HRQoL associated with eye diseases is more related to impaired vision than the awareness of the disease itself, and this declining effect diminished during the follow-up. Therefore, information directed to the public on the risks and prevention of blindness can and should be strengthened to prevent the deleterious effects of visual impairment.

Keywords: Eye disease; Health-related quality of life; Incidence; Mental health; Prevalence; Visual impairment.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Flow chart of glaucoma, unoperated cataract, and retinal degeneration (RD) status. NA not applicable
Fig. 2
Fig. 2
Prevalence of glaucoma, cataract, retinal degeneration (RD), and impaired distance visual acuity (VA; ≤ 0.25) in 2000 and 2011, and their incidence 2000–2011 (with 95% confidence intervals) in the Finnish population aged 30 years or over by gender and age. Prevalence of glaucoma in 2000 (a) and 2011 (b), and incidence 2000–2011 (c); prevalence of cataract in 2000 (d) and 2011 (e), and incidence 2000–2011 (f); prevalence of RD in 2000 (g) and 2011 (h), and incidence 2000–2011 (i); prevalence of visual impairment in 2000 (j) and 2011 (k), and incidence 2000–2011 (l)
Fig. 3
Fig. 3
Mean values (with standard error bars) of health-related quality of life index scores (a, b), mental health total scores (c–e), and distance visual acuity (VA; f) in both time points. When calculating statistical significance (Mann–Whitney U test), eye disease groups were tested against individuals with no eye diseases, and individuals with impaired distance VA were tested against those with good distance VA within the same year. In addition, mean values were compared between time points in each group. RD retinal degeneration. *Denotes statistical significance with p < 0.05. **Denotes statistical significance with p < 0.01. ***Denotes statistical significance with p < 0.0001
Fig. 4
Fig. 4
Change in health-related quality of life (a, b), psychological distress (c), and distance visual acuity (VA; d) in individuals with same eye status in both time points. Low scores for EQ-5D and 15D indicate worse quality of life and high score for GHQ-12 worse mental health. For reference, a group of individuals with no eye diseases and same distance VA in both time points was included. RD retinal degeneration
Fig. 5
Fig. 5
Relation of age to health-related quality of life (a, b), psychological distress (c), and distance visual acuity (VA; d) in individuals who had participated in both time points by age and 2011 eye status. Low scores for EQ-5D and 15D indicate worse quality of life and high score for GHQ-12 worse mental health. Few data points for young individuals with impaired VA are missing as the number of these individuals was low. RD retinal degeneration
Fig. 6
Fig. 6
Mean values of health-related quality of life (a, b) and mental health (c, d) compared to distance visual acuity (VA) in 2000. RD retinal degeneration
Fig. 7
Fig. 7
Mean values of health-related quality of life (a, b) and mental health (c, d) compared to distance visual acuity (VA) in 2011. RD retinal degeneration
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