Vision-related quality of life in first stroke patients with homonymous visual field defects
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RESEARCH
Open Access
Vision-related quality of life in first stroke patients with homonymous visual field defects Carolin Gall1*, Gabriele H Franke2, Bernhard A Sabel1
Abstract Background: To evaluate vision-related and health-related quality of life (VRQoL, HRQoL) in first stroke patients with homonymous visual field defects (VFD) with respect to the extent of the lesion. Since VFD occur in approximately 10% of stroke patients the main purpose of the study was to investigate the additional impact of VFD in stroke patients hypothesizing that VFD causes diminished VRQoL. Methods: In 177 first stroke patients with persisting VFD 2.5 years after posterior-parietal lesions VRQoL was assessed by the National-Eye-Institute-Visual-Functioning-Questionnaire (NEI-VFQ) and HRQoL by the MedicalOutcome-Study Short-Form-36 Health-Survey (SF-36). Questionnaire results of VFD-patients were compared with age- and sex-matched healthy controls and with general non-selected stroke samples as published elsewhere. VFDtype and visual acuity were partially correlated with questionnaire results. Results: Compared to healthy controls VFD-patients had lower NEI-VFQ scores except ocular pain (Z-range -11.34 to -3.35) and lower SF-36 scores except emotional role limitations (Z-range -7.21 to -3.34). VFD-patients were less impaired in SF-36 scores than general stroke patients one month post lesion (6/8 subscales) but had lower SF-36 scores compared to stroke patients six months post lesion (5/8 subscales). Visual acuity significantly correlated with NEI-VFQ scores (r-range 0.27 to 0.48) and VFD-type with SF-36 mental subscales (r-range -0.26 to -0.36). Conclusions: VFD-patients showed substantial reductions of VRQoL and HRQoL compared to healthy normals, but better HRQoL compared to stroke patients one month post lesion. VFD-patients (although their lesion age was four times higher) had significantly lower HRQoL than a general stroke population at six months post-stroke. This indicates that the stroke-related subjective level of HRQoL impairment is significantly exacerbated by VFD. While VRQoL was primarily influenced by visual acuity, mental components of HRQoL were influenced by VFD-type with larger VFD being associated with more distress.
Background Homonymous visual field defects (VFD) are among the most common disorders after posterior-parietal strokes and can severely reduce vision-related quality of life (VRQoL) [1-3]. It is known that diminished VRQoL is correlated with the extent of visual field loss after cerebral injury [1-3]. A correlation between visual field loss and quality of life was also shown in a large populationbased cross-sectional study [4] and for different ophthalmologic diseases resulting in VFD such as glaucoma [5-11], retinal lesions [12,13] or optic neuropathy [14] (An overview of these studies which investigated the
* Correspondence: [email protected] 1 Otto-von-Guericke University of Magdeburg, Medical Faculty, Institute of Medical Psychology, Leipziger Str. 44, 39120 Magdeburg, Germany
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