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Does Functional Vision Behave Differently in Low-Vision Patients with Diabetic Retinopathy?—A Case-Matched Study

From the Lions Vision Research and Rehabilitation Center, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.

PURPOSE. A retrospective case-matched study designed to compare patients with diabetic retinopathy (DR) and other ocular diseases, managed in a low-vision clinic, in four different types of functional vision.

METHODS. Reading, mobility, visual motor, and visual information processing were measured in the patients (n = 114) and compared with those in patients with other ocular diseases (n = 114) matched in sex, visual acuity (VA), general health status, and age, using the Activity Inventory as a Rasch-scaled measurement tool. Binocular distance visual acuity was categorized as normal (20/12.5–20/25), near normal (20/32–20/63), moderate (20/80–20/160), severe (20/200–20/400), profound (20/500–20/1000), and total blindness (20/1250 to no light perception). Both Wilcoxon matched pairs signed rank test and the sign test of matched pairs were used to compare estimated functional vision measures between DR cases and controls.

RESULTS. Cases ranged in age from 19 to 90 years (mean age, 67.5), and 59% were women. The mean visual acuity (logMar scale) was 0.7. Based on the Wilcoxon signed rank test analyses and after adjusting the probability for multiple comparisons, there was no statistically significant difference (P > 0.05) between patients with DR and control subjects in any of four functional visions. Furthermore, diabetic retinopathy patients did not differ (P > 0.05) from their matched counterparts in goal-level vision-related functional ability and total visual ability.

CONCLUSIONS. Visual impairment in patients with DR appears to be a generic and non–disease-specific outcome that can be explained mainly by the end impact of the disease in the patients’ daily lives and not by the unique disease process that results in the visual impairment.