Validation and test characteristics of a 10-item neuro-ophthalmic supplement to the NEI-VFQ-25.
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.
Raphael
Brian A
BA
Department of Neurology, Division of Neuro-Ophthalmology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.
Galetta
Kristin M
KM
Jacobs
Dina A
DA
Markowitz
Clyde E
CE
Liu
Grant T
GT
Nano-Schiavi
M Ligia
ML
Galetta
Steven L
SL
Maguire
Maureen G
MG
Mangione
Carol M
CM
Globe
Denise R
DR
Balcer
Laura J
LJ
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*