title: Impact of diabetic retinopathy on vision-specific function.
abstract: OBJECTIVE
  To assess the influence of the spectrum of diabetic retinopathy (DR) on vision-specific function in an Asian population.
  
  
  METHODS
  Population-based cross-sectional study.
  
  
  METHODS
  Persons aged 40 to 80 years of Malay ethnicity in Singapore.
  
  
  METHODS
  The Singapore Malay Eye Study was a population-based, cross-sectional study of 3280 Asian Malays (78.7% response rate). Five end points were considered: (1) any DR, (2) macular edema (ME), (3) clinically significant macular edema (CSME), (4) vision-threatening DR (VTDR), and (5) DR severity levels ranging from none to proliferative diabetic retinopathy (PDR). Vision function was assessed using the Vision-Specific Functioning Scale validated using Rasch analysis.
  
  
  METHODS
  Vision-specific functioning score.
  
  
  RESULTS
  Of 357 diabetic participants in the study, 23.2% had any DR, 5.6% had ME, 5.0% had CSME, 10.6% had VTDR, and 6.2% had PDR. In linear regression models adjusting for age, gender, stroke, diabetic risk factors, and socioeconomic factors, poorer vision-specific function was associated independently with any DR (beta, -0.21; P<0.05), ME (beta, -0.48; P<0.05), CSME (beta, -0.42; P<0.05), VTDR (beta, -0.64; P<0.05), and PDR (beta, -0.92; P<0.001). When controlling further for presenting visual acuity, VTDR (beta, -0.37; P = 0.01) and PDR (beta, -0.61; P = 0.002) were the only 2 DR categories independently associated with poorer vision-specific function and PDR. Persons with VTDR and PDR were 6 to 12 times more likely to report lower participation in daily living activities than those without these DR levels.
  
  
  CONCLUSIONS
  People with VTDR and PDR have substantial difficulty undertaking vision-specific daily activities. These findings reinforce the importance of preventative efforts targeted at the earliest DR stages to prevent progression to later stages of DR.
  
  
  BACKGROUND
  Proprietary or commercial disclosure may be found after the references.
authors.affiliation: Centre for Eye Research Australia, the Royal Victorian Eye and Ear Hospital, University of Melbourne, Melbourne, Victoria, Australia. ecosse@unimelb.edu.au
authors.forename: Ecosse L
authors.initials: EL
authors.lastname: Lamoureux
authors.forename: E Shyong
authors.initials: ES
authors.lastname: Tai
authors.forename: Julian
authors.initials: J
authors.lastname: Thumboo
authors.forename: Ryo
authors.initials: R
authors.lastname: Kawasaki
authors.forename: Seang-Mei
authors.initials: SM
authors.lastname: Saw
authors.forename: Paul
authors.initials: P
authors.lastname: Mitchell
authors.forename: Tien Y
authors.initials: TY
authors.lastname: Wong
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000208:ethnology; D003430:Cross-Sectional Studies; D003930:Diabetic Retinopathy / Q000208:ethnology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008269:Macular Edema / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D011788:Quality of Life; D012307:Risk Factors; D018434:Sickness Impact Profile; D012846:Singapore / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014785:Vision, Ocular / Q000502:physiology*; D014792:Visual Acuity / Q000502:physiology*