Beyond vision loss: the independent impact of diabetic retinopathy on vision-related quality of life in a Chinese Singaporean population
Abstract
BACKGROUND/AIMS: To assess the independent impact of diabetic retinopathy (DR) on three domains of vision-related quality of life (VRQoL) in a Chinese Singapore population. METHODS: The Singapore Chinese Eye Study (n=3353; 2009-2011) was a population-based, prospective, cross-sectional study conducted at the Singapore Eye Research Institute. The study population included 292 adults with diabetes, with and without DR. DR (better eye) was categorised as presence and absence of any DR; severity of DR (no vision-threatening DR (VTDR); severe non-proliferative DR (NPDR); PDR and/or clinically significant macular oedema and VTDR). Our main outcome was VRQoL which was measured using Rasch-calibrated scores from the 'Reading', 'Mobility' and 'Emotional' domains of the Impact of Vision Impairment questionnaire. The relationship between DR and VRQoL was assessed using multiple linear regression models. RESULTS: Of the 292 individuals (mean age 61.35 ± 9.66 years; 55.8% male), 201 (68.8%), 49 (16.8%), 20 (6.8%), 22 (7.5%) and 27 (9.2%) had no DR, minimal-mild NPDR, moderate-severe NPDR, PDR and VTDR, respectively. Any DR and VTDR were independently associated with 6% and 12% worse Reading scores and 7% and 18% poorer Emotional well-being, respectively, compared with those without DR. These associations persisted after separate adjustment for visual impairment and presenting visual acuity. No significant difference was found in the Mobility domain between persons with and without DR. CONCLUSIONS: We documented that DR, particularly VTDR, was independently associated with restrictions in Reading and Emotional well-being. Understanding factors underlying the detrimental DR-VRQoL relationship may optimise rehabilitation outcomes for individuals with DR.
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Anxiety and depression in DR patients reduce their quality of life.
“It not only threatens the physical and mental health of DR patients, but also reduces the quality of life of patients.[9–12]”
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- Authors
- Fenwick, E. K., Man, R. E. K., Gan, A. T. L., Kumari, N., Wong, C., Aravindhan, A., Gupta, P., Wang, J. J., Mitchell, P., Wong, T. Y., Cheng, C.-Y., & Lamoureux, E. L.
- Affiliations
- National University of Singapore (SG)
- Singapore Eye Research Institute (SG)
- The University of Sydney (AU)
- Corresponding author
- Lamoureux, Ecosse Luc
- ORCID
- Venue
- British Journal of Ophthalmology
- Publisher
- BMJ
- Published
- 2018-10-25
- Volume
- 103
- Issue
- 9
- Pages
- 1314-1319
- ISSN
- 0007-1161 (ISSN-L)
- 1468-2079
- OpenAlex
- W2898374891
- Cited by
- 16
- References
- 30
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 2 · 2023: 2 · 2022: 4 · 2021: 2 · 2020: 1
- FWCI
- 0.76
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- British Journal of Ophthalmology (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- The Singapore Bio Imaging Consortium (C-011/2006)
- National Medical Research Council (STaR/0003/2008)
- Biomedical Research Council (08/1/35/19/550)
- Topics
- Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
- Health Sciences › Medicine › Epidemiology › Ophthalmology and Visual Impairment Studies
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Retinal Imaging and Analysis
- Keywords
- diabetic retinopathy, vision-related quality of life, visual impairment, reading disorders, emotional well-being, proliferative diabetic retinopathy, clinically significant macular edema, diabetes mellitus, Singapore Chinese, visual rehabilitation
- MeSH terms
- Adult, Aged, Cross-Sectional Studies, Diabetic Retinopathy, Female, Humans, Male, Middle Aged, Prospective Studies, Quality of Life, Reading, Regression Analysis, Risk Factors, Singapore, Vision Disorders
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