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Abstract #100410 Published in IGR 23-1
Quality of life associated with no light perception vision
Brown GC; Brown MM; Stein JD; Sharma SCanadian Journal of Ophthalmology 2023; 58: 361-368
OBJECTIVE: Time trade-off (TTO) utility analysis quantifies the quality of life associated with best-seeing-eye (BSE) vision. We compared the patient quality of life associated with unilateral and bilateral no light perception (NLP) with that of a control cohort without NLP. DESIGN: Cross-sectional interviews using a validated, reliable TTO vision utility analysis instrument. PARTICIPANTS: A total of 1598 consecutive ophthalmology patients from the authors' practices. METHODS: Patient records were reviewed in a case-control fashion The utilities of participants with unilateral or bilateral NLP vision were compared with those from patients without NLP vision. RESULTS: Among 99 NLP patients, 93 (94%) had unilateral NLP and 6 (6%) had bilateral NLP, for a total of 105 NLP eyes. Multiple regression analysis demonstrated the highest correlation between utility and BSE acuity (p = 0.001), with no correlation with age, ophthalmic disease, time of vision loss, race, or education. Mean unilateral NLP utility ranged from 0.55 in the counting fingers to light perception subcohort to 0.80 in the 20/20-20/25 subcohort. The 6-person bilateral NLP subcohort had a 0.54 utility. The 99-patient NLP cohort mean utility was 0.69, a 55% quality-of-life decrease versus a BSE vision-matched 0.80 in 1499 non-NLP patients (p < 0.001). CONCLUSIONS: TTO utility in unilateral NLP patients correlated with BSE vision at a lower utility than in patients with matched BSE vision without fellow-eye NLP. Decreased unilateral NLP patient quality of life should be considered in cost-utility analysis and clinical management. Bilateral NLP patient utility (0.54) was slightly less than that (0.55) in blind unilateral NLP patients with fellow-eye counting fingers to light perception vision, suggesting that more study is needed.
Center for Value-Based Medicine, Hilton Head, SC; Wills Eye Hospital, Jefferson Medical University, Philadelphia, Pa; Department of Ophthalmology, Emory University School of Medicine, Atlanta, Ga. Electronic address: gary0514@gmail.com.
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