title: Longitudinal changes in visual acuity and health-related quality of life: the Los Angeles Latino Eye study.
abstract: OBJECTIVE
  To examine the association between longitudinal changes in visual acuity (VA) and health-related quality of life (HRQOL) in a population-based sample of adult Latinos.
  
  
  METHODS
  A population-based cohort study of eye disease in Latinos.
  
  
  METHODS
  We included 3169 adult Latino participants who live in the city of La Puente, California.
  
  
  METHODS
  Data for these analyses were collected for the Los Angeles Latino Eye Study (LALES). Distance VA was measured during a detailed ophthalmologic examination using the standard Early Treatment Diabetic Retinopathy Study protocol at baseline and a 4-year follow-up examination. We assessed HRQOL by the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) and the Medical Outcomes Study 12-Item Short-Form Health Survey version 1 (SF-12).
  
  
  METHODS
  Mean differences in HRQOL composite and subscale scores between baseline and follow-up were calculated for 3169 participants with complete clinical examination and HRQOL data at both time points. Mean differences and effect sizes (ES) for NEI-VFQ and SF-12 scores were calculated for 3 categories of VA change over the 4-year follow-up period (VA improved ≥ 2 lines, no change in VA or -2 < VA < 2, VA loss ≥ 2 lines).
  
  
  RESULTS
  For participants with a 2-line loss in VA, we noted an approximate 5-point loss in the NEI-VFQ-25 composite score, with the greatest score changes found for the driving difficulties, vision-related mental health, and vision-related dependency subscales (-12.7, -11.5, and -11.3, respectively). For participants with a 2-line improvement in VA, we also noted an approximate 5-point gain in the NEI-VFQ-25 composite score. The greatest change (ES = 0.80) was observed for the driving difficulties subscale. No measurable differences in HRQOL were observed for individuals without change in VA from baseline to follow-up.
  
  
  CONCLUSIONS
  Clinically important, longitudinal changes in VA (≥ 2-line changes) were associated with significant changes in self-reported visual function and well-being. Both the size and direction of VA change influenced change in HRQOL scores.
authors.affiliation: Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
authors.forename: Roberta
authors.initials: R
authors.lastname: McKean-Cowdin
authors.forename: Rohit
authors.initials: R
authors.lastname: Varma
authors.forename: Ron D
authors.initials: RD
authors.lastname: Hays
authors.forename: Joanne
authors.initials: J
authors.lastname: Wu
authors.forename: Farzana
authors.initials: F
authors.lastname: Choudhury
authors.forename: Stanley P
authors.initials: SP
authors.lastname: Azen
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006630:Hispanic or Latino; D006801:Humans; D015141:Los Angeles; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D014792:Visual Acuity / Q000502:physiology*