title: Validation and test characteristics of a 10-item neuro-ophthalmic supplement to the NEI-VFQ-25.
abstract: OBJECTIVE
  To determine whether a 10-Item Neuro-Ophthalmic Supplement increases the capacity of the 25-Item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) to capture self-reported visual dysfunction in patients with neuro-ophthalmologic disorders.
  
  
  METHODS
  A cross-sectional survey to examine the characteristics of a 10-Item Neuro-Ophthalmic Supplement to the 25-Item NEI-VFQ-25 in a cohort of patients with neuro-ophthalmologic disorders.
  
  
  METHODS
  The 10-Item Neuro-Ophthalmic Supplement was designed previously by our research group by survey and focus-group methods. In the present study, the NEI-VFQ-25 and 10-Item Supplement were administered concurrently to patients and disease-free control subjects. High-contrast visual acuities with patient usual distance correction were measured with the use of Early Treatment Diabetic Retinopathy Study (ETDRS) charts.
  
  
  RESULTS
  Diagnoses for patients (n = 215) included optic neuritis, multiple sclerosis, idiopathic intracranial hypertension, ischemic optic neuropathy, stroke, ocular myasthenia gravis, ocular motor palsies, and thyroid eye disease. Scores for the 10-Item Supplement had a significant capacity to distinguish patients vs disease-free control subjects that was independent of the NEI-VFQ-25 composite score (odds ratio in favor of patient vs control status for 10-point worsening in Supplement scores: 2.7 [95% confidence interval [CI], 1.6, 4.6]; P < .001, logistic regression models that account for NEI-VFQ-25 composite score, age, and gender). Patients with visual dysfunction (binocular Snellen equivalents worse than 20/20) had significantly lower mean scores (9-21 points lower); these differences remained significant after accounting for age and gender (P >or= .001, linear regression). Supplement items and composite scores demonstrated appropriate degrees of internal consistency reliability.
  
  
  CONCLUSIONS
  The 10-Item Neuro-Ophthalmic Supplement demonstrates a capacity to capture self-reported visual dysfunction beyond that of the NEI-VFQ-25 alone, which supports validity for this new scale. The use of the 10-Item Supplement in clinical trials and epidemiologic studies will examine its capacity to demonstrate treatment effects in longitudinal cohorts.
authors.affiliation: Department of Neurology, Division of Neuro-Ophthalmology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.
authors.forename: Brian A
authors.initials: BA
authors.lastname: Raphael
authors.forename: Kristin M
authors.initials: KM
authors.lastname: Galetta
authors.forename: Dina A
authors.initials: DA
authors.lastname: Jacobs
authors.forename: Clyde E
authors.initials: CE
authors.lastname: Markowitz
authors.forename: Grant T
authors.initials: GT
authors.lastname: Liu
authors.forename: M Ligia
authors.initials: ML
authors.lastname: Nano-Schiavi
authors.forename: Steven L
authors.initials: SL
authors.lastname: Galetta
authors.forename: Maureen G
authors.initials: MG
authors.lastname: Maguire
authors.forename: Carol M
authors.initials: CM
authors.lastname: Mangione
authors.forename: Denise R
authors.initials: DR
authors.lastname: Globe
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Balcer
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005128:Eye Diseases / Q000175:diagnosis*; D005260:Female; D049970:Graves Ophthalmopathy / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis; D009157:Myasthenia Gravis / Q000175:diagnosis; D009886:Ophthalmoplegia / Q000175:diagnosis*; D009901:Optic Nerve Diseases / Q000175:diagnosis*; D011559:Pseudotumor Cerebri / Q000175:diagnosis; D011594:Psychometrics; D018434:Sickness Impact Profile; D020521:Stroke / Q000175:diagnosis; D011795:Surveys and Questionnaires; D014786:Vision Disorders / Q000175:diagnosis*