年龄相关性黄斑变性患者视觉相关生存质量变化及相关因素分析

Vision-related quality of life and related factors in patients with age-related macular degeneration

目的调查年龄相关性黄斑变性(AMD)患者视觉相关生存质量(VRQoL)的变化,并分析相关的影响因素。方法收集上海交通大学附属第一人民医院眼科门诊就诊的AMD患者(AMD组)和非AMD患者(对照组)各88例,采用中文版低视力者生存质量量表(CLVQOL)评估两组患者的VRQoL。计算两组患者CLVQOL总得分以及各维度(远视力、移动和光感维度、调节能力维度、读和精细工作维度、日常生活能力维度)得分,分析其与单眼logMAR视力和双眼平均视力(WMAR)的相关性。结果 AMD组CLVQOL总得分均值为(96.18±20.35)分,显著低于对照组的(106.53±12.75)分,两组间比较差异有统计学意义(P<0.01)。除日常生活能力维度外,AMD组其他维度的CLVQOL得分均显著低于对照组,差异有统计学意义(P<0.01)。AMD组CLVQOL总得分和各维度得分与较佳眼远视力和WMAR相关性均较高,两者相关系数相近。除读和精细工作维度外,较佳眼远视力是影响AMD患者CLVQOL各维度得分和总得分的首要独立因素;WMAR是影响读和精细工作维度得分的首要独立因素。结论 AMD患者VRQoL较低,保存较佳眼视力可能是减少AMD患者VRQoL下降的途径之一。

Objective To investigate the vision-related quality of life（VRQoL） and related factors in patients with age-related macular degeneration（AMD）.Methods Eighty-eight patients with AMD（AMD group） and 88 patients with non-AMD diseases（control group） diagnosed at Department of Ophthalmology,the First People＇s Hospital affiliated to Shanghai Jiaotong University were selected,and Chinese version Low Vision Quality of Life Questionnaire（CLVQOL） was employed to evaluate VRQoL in both groups.The total score of CLVQOL and scores of each scale of CLVQOL（scale of distant visual acuity,motion and light perception,scale of adjustment ability,scale of reading and fine work and scale of daily living） were calculated,and their correlations with monocular logMAR visual acuity and weighted average logMAR visual acuity（WMAR） were explored.Results The average total score of CLVQOL in AMD group was（96.18±20.35） points,which was significantly lower than that in control group [（106.53±12.75） points]（P0.01）.Except the scale of daily living,the scores of the other scales of CLVQOL in AMD group were significantly lower than that in control group（P0.01）.The total score and scores of each scale of CLVQOL in AMD group well correlated with logMAR visual acuity in the better-seeing eye and WMAR,with similar correlation coefficients.WMAR was confirmed as the chief independent risk factor of the score of the scale of reading and fine work,and the visual acuity in the better-seeing eye was determined as the chief independent risk factor of the total score and scores of the other scales of CLVQOL.Conclusion VRQoL in patients with AMD is relatively lower,and avoiding the visual acuity decrease in the better-seeing eye may be a way to maintain VRQoL.