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Quality of Life With Visual Acuity Loss From Diabetic Retinopathy and Age-Related Macular Degeneration
Arch Ophthalmol. 2002;120:481-484.
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.
Melissa M. Brown, MD, MN, MBA;
Gary C. Brown, MD, MBA;
Sanjay Sharma, MD, MSc, MBA;
Jennifer Landy, MD;
Jeff Bakal, MSc
From the Center for Evidence-Based Health Care Economics, Flourtown,
Pa (Drs M. M. Brown, G. C. Brown, Sharma, and Landy); the Cataract and Primary
Eye Care Service (Dr M. M. Brown) and the Retina Vascular Unit (Dr G. C. Brown),
Wills Eye Hospital, Jefferson Medical College, Philadelphia, Pa; and the Cost-Effective
Ocular Health Policy Unit, Queens University, Kingston, Ontario (Dr Sharma
and Mr Bakal).
Corresponding author and reprints: Melissa M. Brown, MD, MN, MBA,
Center for Evidence-Based Health Care Economics, Suite 210, 1107 Bethlehem
Pike, Flourtown, PA 19031(e-mail: lissa1011{at}aol.com).
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