Impact of Visual Field Loss on Vision-Specific Quality of Life in African Americans: The African American Eye Disease Study.

Abstract Purpose To elucidate how visual field loss (VFL) impacts self-reported vision-specific quality of life (VSQOL) in African Americans, who experience a disproportionate burden of visual impairment. Design Cross-sectional, population-based cohort Methods Eligible participants (n = 7,957) were recruited who self-identified as African American, were 40 years or older and resided in Inglewood, California. 6,347 participants (80.0%) completed clinical eye exams. Total mean deviation (MD) of VFL was measured bilaterally as decibels (dB) using the Humphrey SITA Standard 24-2 test. VSQOL was measured using the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) and scored using item response theory (IRT). Results Participants with reliable data (n = 5,121) had a mean age of 60.7 years (SD 11.0); those with worse VFL were older, had more comorbidities, lower income, less education, worse visual acuity, and were more likely to be unemployed and depressed. Using IRT analysis, a change in VF of 6.2 (95% CI: 5.3, 7.7) dB and 9.2 (95% CI: 7.5, 11.9) dB was necessary to observe a meaningful (5-point) difference in vision-related task and emotional well-being scores, respectively. VFL had the greatest impact on self-reported driving ability (6.0 dB [95% CI: 5.2, 7.1]), followed by satisfaction with general vision, near vision, vision-related mental health, and peripheral vision. Conclusions The strongest impact of VFL reported by African Americans was on their ability to complete visual tasks, especially for driving. An effect of VFL on emotional well-being also was observed, but the magnitude of association was about 50% lower for well-being compared to that of task.