Abstract:Objective: To investigate the effect of diabetic macular edema (DME) on vision-related quality of life (VRQoL) in patients with type 2 diabetes. Methods: In this cross-sectional study, 187 patients with type 2 diabetes diagnosed with DME were included from June 2017 to May 2019. Questionnaires were completed to collect information about their sociodemographic and healthcare characteristics. VRQoL was assessed using the 25-Item National Eye Institute Visual Questionnaire (NEI-VFQ-25). NEI-VFQ-25 scores that were compared between groups using the Wilcoxon rank-sum test. The severity of DME in each eye was graded as mild, moderate, or severe. A generalized estimating equation model was used to assess the relationship between NEI-VFQ-25 scores and DME severity. Results: A total of 159 patients were recruited for the study eventually. Compared with patients without visual impairment (decimal visual acuity >0.3), those with visual impairment showed statistically significant compromises in terms of general vision, near activities, distance activities, social functioning, dependency, mental health, role difficulties, color vision, peripheral vision, and NEI-VFQ-25 composite scores (P<0.001). Compared with unilateral DME, bilateral DME was associated with greater dependency and role difficulties, compromised near and distance activities, and poorer general health, general vision, color vision, peripheral vision, mental health, and NEIVFQ- 25 composite scores (P<0.05). Scores for NEI-VFQ-25 on general health (Ptrend=0.013), general vision (Ptrend<0.001), near activities (Ptrend=0.001), distance activities (Ptrend=0.002), mental health (Ptrend=0.001), role difficulties (Ptrend=0.022), dependency (Ptrend=0.023), peripheral vision (Ptrend=0.041) and NEI-VFQ-25 composite (Ptrend=0.001) decreased gradually as DME severity increased. β coefficients were the largest for mental health (β=-15.01, 95%CI: -26.73- -3.30, P=0.012) and general vision (β=-13.66, 95%CI: -19.86- -7.47, P<0.001). Conclusions: DME severity significantly affects patients' VRQoL, particularly their general vision and mental health. NEI-VFQ-25 should be widely used to assess overall health in patients.
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