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Vision related quality of life in patients with type 2 diabetes in the EUROCONDOR trial

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Abstract

To evaluate vision related quality of life in the patients enrolled in The European Consortium for the Early Treatment of Diabetic Retinopathy, a clinical trial on prevention of diabetic retinopathy. Four-hundred-forty-nine patients, 153 women, with type 2 Diabetes and no or mild diabetic retinopathy were enrolled in a 2-year multicenter randomized controlled trial. The 25-item National Eye Institute Visual Functioning Questionnaire was used to explore 12 subscales of vision related quality of life. The patients were 62.8 ± 6.7 years old and had 11.1 ± 5.6 years known disease duration. Diabetic retinopathy was absent in 193 (43.0 %) and mild in 256 (57.0 %). Patients without diabetic retinopathy were older, had shorter diabetes duration and used less insulin and glucose-lowering agents but did not differ by gender, best corrected visual acuity or any subscale, except vision specific mental health and vision specific role difficulties. Patients with reduced retinal thickness at the ganglion cell layer (n = 36) did not differ for diabetic retinopathy but were older, had lower best corrected visual acuity and worse scores for ocular pain, color vision and peripheral vision. On multivariable analysis, worse scores for general vision remained associated with reduced retinal thickness, diabetes duration and best corrected visual acuity, and scores for visual specific mental health with diabetic retinopathy and lower best corrected visual acuity. Visual specific role difficulties were only associated with reduced best corrected visual acuity. Scores for driving decreased among females, with worsening of Hemoglobin A1c and best corrected visual acuity. Color vision depended only on reduced retinal thickness, and peripheral vision on both reduced thickness and best corrected visual acuity. The National Eye Institute Visual Functioning Questionnaire could detect subtle changes in patients’ perception of visual function, despite absent/minimal diabetic retinopathy.

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References

  1. E.L. Lamoureux, E.S. Tai, J. Thumboo et al., Impact of diabetic retinopathy on vision-specific function. Ophthalmology 117, 757–765 (2010)

    Article  Google Scholar 

  2. E.K. Fenwick, K. Pesudovs, G. Rees et al., The impact of diabetic retinopathy: understanding the patient’s perspective. Br. J. Ophthalmol. 95, 774–782 (2011)

    Article  CAS  Google Scholar 

  3. M. Finger, G. Fleckenstein, F. Holz et al., Quality of life in age-related macular degeneration: a review of available vision-specific psychometric tools. Qual. Life Res. 17, 559–574 (2008)

    Article  Google Scholar 

  4. G. Rees, M.B. Sasongko, E.K. Fenwick et al., Impact of diabetic retinopathy on patients’ beliefs about diabetes. Clin. Exp. Optom. 95, 371–376 (2012)

    Article  Google Scholar 

  5. R. Simó, C. Hernández, European Consortium for the Early Treatment of Diabetic Retinopathy (EUROCONDOR). Neurodegeneration is an early event in diabetic retinopathy: therapeutic implications. Br. J. Ophthalmol. 96, 1285–1290 (2012)

    Article  Google Scholar 

  6. K.J. Hellgren, E. Agardh, B. Bengtsson, Progression of early retinal dysfunction in diabetes over time: results of a long-term prospective clinical study. Diabetes 63, 3104–3111 (2014)

    Article  Google Scholar 

  7. C. Hernández, O. Simó-Servat, R. Simó, Somatostatin and diabetic retinopathy: current concepts and new therapeutic perspectives. Endocrine 46, 209–214 (2014)

    Article  Google Scholar 

  8. U. Frydkjaer-Olsen, R. Soegaard Hansen, R. Simó et al., Correlation between Retinal Vessel Calibre and Neurodegeneration in Patients with Type 2 Diabetes Mellitus in the European Consortium for the Early Treatment of Diabetic Retinopathy (EUROCONDOR). Ophth. Res. 56, 10–16 (2016)

    Article  Google Scholar 

  9. S.S. Feman, T.C. Leonard-Martin, J.S. Andrews et al., A quantitative system to evaluate diabetic retinopathy from fundus photographs. Invest. Ophthalmol. Vis. Sci. 36, 174–181 (1995)

    CAS  PubMed  Google Scholar 

  10. C.M. Mangione, P.P. Lee, P.R. Gutierrez et al., National Eye Institute Visual Function Questionnaire Field Test Investigators. Development of the 25-item national eye institute visual function questionnaire. Arch. Ophthalmol. 119, 1050–1058 (2001)

    Article  CAS  Google Scholar 

  11. A.T. Broman, B. Munoz, S.K. West et al., Psychometric properties of the 25-item NEI-VFQ in a Hispanic population: proyecto VER. Invest. Ophthalmol. Vis. Sci. 42, 606–613 (2001)

    CAS  PubMed  Google Scholar 

  12. G.C. Rossi, G. Milano, C. Tinelli, The Italian version of the 25-item National Eye Institute Visual Function Questionnaire: translation, validity and reliability. J. Glaucoma. 12, 213–220 (2003)

    Article  Google Scholar 

  13. G.H. Franke, J. Esser, J. Reimer, N. Maehner, Vision targeted QoL under different degrees of visual impairment. R. Portug. Psicos. 4, 39–49 (2002)

    Google Scholar 

  14. J.P. Nordmann, M. Viala, K. Sullivan, B. Arnould, G. Berdeaux, Psychometric Validation of the National Eye Institute Visual Function Questionnaire–25 (NEI VFQ-25) French version: in a population of patients treated for ocular hypertension and glaucoma. Pharmacoeconomics 22, 197–206 (2004)

    Article  Google Scholar 

  15. M.S. Soresen, S. Andersen, G.O. Henningsen, T.L. Sørensen, Danish version of Visual Function Questionnaire-25 and its use in age-related macular degeneration. Danish medical bulletin 58, A4290 (2011)

    Google Scholar 

  16. C. Hirneiss, C. Schmid-Tannwald, M. Kernt, A. Kampik, A.S. Neubauer, The NEI VFQ-25 vision-related quality of life and prevalence of eye disease in a working population. Graefes Arch. Clin. Exp. Ophthalmol. 248, 85–92 (2010)

    Article  Google Scholar 

  17. A.E. Hipwell, J. Sturt, A. Lindenmeyer, I. Stratton, R. Gadsby, P. O’Hare, P.H. Scanlon, Attitudes, access and anguish: a qualitative interview study of staff and patients’ experiences of diabetic retinopathy screening. BMJ Open 4, e005498 (2014)

    Article  CAS  Google Scholar 

  18. B.E. Wolff, M.A. Bearse Jr, M.E. Schneck et al., Color vision and neuroretinal function in diabetes. Doc. Ophthalmol. 130, 131–139 (2015)

    Article  CAS  Google Scholar 

  19. M. Trento, L. Charrier, M. Salassa et al., Depression, anxiety and cognitive function in patients with type 2 diabetes: an 8-year prospective observational study. Acta Diabetol. 52, 1157–1166 (2015)

    Article  CAS  Google Scholar 

  20. M. Trento, P. Passera, M. Trevisan et al., Quality of life, impaired vision and social role in people with diabetes: a multicenter observational study. Acta Diabetol. 50, 873–877 (2013)

    Article  Google Scholar 

  21. L. Dandona, Dandona. Socioeconomic status and blindness. Br. J.Ophthalmol. 85, 1484–1488 (2001)

    Article  CAS  Google Scholar 

  22. M. Marmot, Social determinants of health inequalities. Lancet 365, 1099–1104 (2005)

    Article  Google Scholar 

  23. E.L. Lamoureux, E. Fenwick, J. Xie et al., Methodology and early findings of the Diabetes Management Project: a cohort study investigating the barriers to optimal diabetes care in diabetic patients with and without diabetic retinopathy. Clin. Experiment.Ophthalmol. 40, 73–82 (2012)

    Article  Google Scholar 

  24. R.L. Thomas, F.D. Dunstan, S.D. Luzio et al., Prevalence of diabetic retinopathy within a national diabetic retinopathy screening service. Br. J. Ophthalmol. 99, 64–68 (2015)

    Article  Google Scholar 

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Acknowledgments

This project has received funding from the European Union’s Seventh Framework Program for research, technological development and demonstration under grant agreement no 278040.

MT, OD, SL, MAC, CH and RS collected and analyzed the data and revised the manuscript. LC and FC did the statistical analysisand revised the manuscript. MT and MP drafted and finalized the manuscript.

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Authors and Affiliations

  1. Laboratory of Clinical Pedagogy, Department of Medical Sciences, University of Turin, Turin, Italy

    Marina Trento, Olga Durando, Sonia Lavecchia & Massimo Porta

  2. Department of Public Health and Paediatrics, University of Turin, Turin, Italy

    Lorena Charrier & Franco Cavallo

  3. Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal

    Miguel Angelo Costa

  4. Diabetic Retinopathy Centre, Department of Medical Sciences, University of Turin, Turin, Italy

    Miguel Angelo Costa

  5. Vall d’ Hebron Research Institute and CIBERDEM (ISCIII), Barcelona, Spain

    Cristina Hernández & Rafael Simó

Authors
  1. Marina Trento
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  2. Olga Durando
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  3. Sonia Lavecchia
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  4. Lorena Charrier
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  5. Franco Cavallo
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  6. Miguel Angelo Costa
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  7. Cristina Hernández
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  8. Rafael Simó
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  9. Massimo Porta
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for the EUROCONDOR trial investigators

Corresponding author

Correspondence to Marina Trento.

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Conflict of interest

The authors declare that they have no competing interests.

Members of EUROCONDOR, who have contributed to this paper

F. Bandello and R. Lattanzio (Scientific Institute San Raffaele, Italy), J. Cunha-Vaz and M.A. Costa (Association for Innovation and Biomedical Research on Light and Image, Portugal), C. Egan (Moorfields Eye Hospital, UK), J. García-Arumí (Valld’Hebron University Hospital, Spain), J. Gibson (University of Aston, UK), S. Harding (University of Liverpool, UK), S. Karadeniz (International Diabetes Federation, Europe Region, IDF Europe), G. Lang (University of Ulm, Germany), P. Massin (HôpitalLariboisière-APHP, France), E. Midena (University of Padova, Italy), B. Ponsati (BCN Peptides, Spain), M. Porta (University of Turin, Italy), P. H. Scanlon and S. J. Aldington (Cheltenham General Hospital, UK), R. Simó and C. Hernández (Valld’Hebron Research Institute and CIBERDEM, Spain), J. Grauslund (Odense University Hospital, Denmark).

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Trento, M., Durando, O., Lavecchia, S. et al. Vision related quality of life in patients with type 2 diabetes in the EUROCONDOR trial. Endocrine 57, 83–88 (2017). https://doi.org/10.1007/s12020-016-1097-0

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  • DOI: https://doi.org/10.1007/s12020-016-1097-0

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