For a study, researchers sought to determine the effect of visual field loss (VFL) on vision-specific quality of life (VSQOL) based on race, ethnicity, and age. The participants in the Multiethnic Ophthalmology Cohorts of California Study (MOCCaS) were 6,142 Latinos, 4,582 Chinese Americans, and 6,347 Black Americans from Los Angeles County. From 2000 to 2018, 17,071 people aged 40 and above had full interviews and ocular examinations. VFL was assessed as decibels (dB) of mean deviation using the Humphrey Swedish Interactive Threshold Algorithm Standard 24-2 test (MD). Adjusting for sociodemographic and clinical covariables, multivariable linear regression was performed to assess the influence of VFL in the better-seeing eye on self-reported VSQOL levels. After analyzing the main effects and interactions by race, ethnicity, and age, hierarchical modeling was used to select the best-fit model. The 25-item National Eye Institute Visual Function Questionnaire was used to assess VSQOL (NEI-VFQ-25). Item response theory was utilized to compute 11 vision subscales, and classical test theory was used to construct vision-related task and well-being composite scores.
The effect of VFL on VSQOL differed according to race and ethnicity. Mild-to-moderate VFL resulted in five-point decreases in task and well-being scores for Latinos (6.7 dB and 7.5 dB), mild-to-moderate VFL for Chinese Americans (7.0 dB and 8.7 dB), and moderate-to-severe VFL for Black Americans (10.1 dB and 12.9 dB), respectively. The differences were statistically significant when comparing Latinos and Black Americans (P<0.001). Among all individuals, visual field reduction had the greatest impact on driving. Driving difficulties were the only VSQOL outcome that differed by age; individuals 65 and older scored 0.487 points less per MD of VFL (P<0.001). VFL had the greatest impact on the subscales of role function, mental health, and reliance.
Even after controlling for sociodemographic factors, race and ethnicity altered the influence of VFL on VSQOL. For the same level of VFL, Latinos and Chinese Americans reported a higher change in VSQOL than Black Americans in MOCCaS. Future research should determine if the findings were attributable to socioeconomic or cultural disparities in visual function perception.