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The association between legal Japanese visual impairment grades and vision-related quality of life

  • Clinical Investigation
  • Published:
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Abstract

Purpose

This study examines the relationship between quality of life (QOL) and the legal Japanese grade of visual impairment as defined by the Physically Disabled Persons Welfare Act.

Methods

Participants of this cross-sectional study were 98 Japanese patients legally classified as visually impaired, from six ophthalmology departments. Vision-related QOL was evaluated using the 25-item National Eye Institute Visual Function Questionnaire (VFQ-25). The short Japanese version of this questionnaire (VFQ-J11) score was calculated from the VFQ-25 results for each participant. Health utility was measured using the EuroQoL Index (EQ-5D). Data were collected for age, gender, vision-disability level, the corrected visual acuity of each eye, and disease type.

Results

The mean age was 66.8 years (SD = 17.8). Visual impairment grade was significantly associated with VFQ-J11 score and the composite score developed from the VFQ-25 (p < 0.001), but not with the health utility score obtained from the EQ-5D.

Conclusions

In general, the Japanese legally designated grading system for visual impairment reflects the degree of vision-related QOL, but does not reflect general health utility as determined by the EQ-5D.

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References

  1. Yamada M, Hiratsuka Y, Roberts CB, Pezzullo ML, Yates K, Takano S, et al. Prevalence of visual impairment in the adult Japanese population by cause and severity and future projections. Ophthalmic Epidemiol. 2010;17:50–7.

    Article  PubMed  Google Scholar 

  2. Nakae K, Masuda K, Senoo T, Sawa M, Kanai A, Ishibashi T. Aging society and eye disease: a recent epidemiological study on underlying diseases responsible for visual impairment. Geriat Med. 2006;44:1221–4.

    Google Scholar 

  3. Broman AT, Munoz B, Rodriguez J, Sanchez R, Quigley HA, Klein R, et al. The impact of visual impairment and eye disease on vision-related quality of life in a Mexican–American population: proyecto VER. Invest Ophthalmol Vis Sci. 2002;43:3393–8.

    PubMed  Google Scholar 

  4. Swanson MW, McGwin G. Visual impairment and functional status from the 1995 National Health Interview Survey on Disability. Ophthalmic Epidemiol. 2004;11:227–39.

    Article  PubMed  Google Scholar 

  5. Mangione CM, Gutierrez PR, Lowe G, Orav EJ, Seddon JM. Influence of age-related maculopathy on visual functioning and health-related quality of life. Am J Ophthalmol. 1999;128:45–53.

    Article  CAS  PubMed  Google Scholar 

  6. West SK, Munoz B, Rubin GS, Schein OD, Bandeen-Roche K, Zeger S, et al. Function and visual impairment in a population-based study of older adults. The SEE project. Salisbury eye evaluation. Invest Ophthalmol Vis Sci. 1997;38:72–82.

    CAS  PubMed  Google Scholar 

  7. Steinberg EP, Tielsch JM, Schein OD, Javitt JC, Sharkey P, Cassard SD, et al. The VF-14. An index of functional impairment in patients with cataract. Arch Ophthalmol. 1994;112:630–8.

    Article  CAS  PubMed  Google Scholar 

  8. Scott IU, Smiddy WE, Schiffman J, Feuer WJ, Pappas CJ. Quality of life of low-vision patients and the impact of low-vision services. Am J Ophthalmol. 1999;128:54–62.

    Article  CAS  PubMed  Google Scholar 

  9. Wang JJ, Mitchell P, Smith W, Cumming RG, Attebo K. Impact of visual impairment on use of community support services by elderly persons: the Blue Mountains eye study. Invest Ophthalmol Vis Sci. 1999;40:12–9.

    CAS  PubMed  Google Scholar 

  10. Mangione CM, Berry S, Spritzer K, Janz NK, Klein R, Owsley C, et al. Identifying the content area for the 51-item National Eye Institute Visual Function Questionnaire: results from focus groups with visually impaired persons. Arch Ophthalmol. 1998;116:227–33.

    CAS  PubMed  Google Scholar 

  11. Mangione CM, Lee PP, Gutierrez PR, Spritzer K, Berry S, Hays RD. Development of the 25-item National Eye Institute Visual Function Questionnaire. Arch Ophthalmol. 2001;119:1050–8.

    Article  CAS  PubMed  Google Scholar 

  12. Suzukamo Y, Oshika T, Yuzawa M, Tokuda Y, Tomidokoro A, Oki K, et al. Psychometric properties of the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25), Japanese version. Health Qual Life Outcomes. 2005;3:65.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Brody BL, Gamst AC, Williams RA, Smith AR, Lau PW, Dolnak D, et al. Depression, visual acuity, comorbidity, and disability associated with age-related macular degeneration. Ophthalmology. 2001;108:1893–900 discussion 1900–1.

    Article  CAS  PubMed  Google Scholar 

  14. Jampel HD, Friedman DS, Quigley H, Miller R. Correlation of the binocular visual field with patient assessment of vision. Invest Ophthalmol Vis Sci. 2002;43:1059–67.

    PubMed  Google Scholar 

  15. Klein R, Moss SE, Klein BE, Gutierrez P, Mangione CM. The NEI-VFQ-25 in people with long-term type 1 diabetes mellitus: the Wisconsin epidemiologic study of diabetic retinopathy. Arch Ophthalmol. 2001;119:733–40.

    Article  CAS  PubMed  Google Scholar 

  16. Owen CG, Rudnicka AR, Smeeth L, Evans JR, Wormald RP, Fletcher AE. Is the NEI-VFQ-25 a useful tool in identifying visual impairment in an elderly population? BMC Ophthalmol. 2006;6:24.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Parrish RK 2nd. Visual impairment, visual functioning, and quality of life assessments in patients with glaucoma. Trans Am Ophthalmol Soc. 1996;94:919–1028.

    PubMed  PubMed Central  Google Scholar 

  18. Mangione CM, Lee PP, Pitts J, Gutierrez P, Berry S, Hays RD. Psychometric properties of the National Eye Institute Visual Function Questionnaire (NEI-VFQ). NEI-VFQ Field Test Investigators. Arch Ophthalmol. 1998;116:1496–504.

    Article  CAS  PubMed  Google Scholar 

  19. Congdon N, O’Colmain B, Klaver CC, Klein R, Muñoz B, Friedman DS, et al. Causes and prevalence of visual impairment among adults in the United States. Arch Ophthalmol. 2004;122:477–85.

    Article  PubMed  Google Scholar 

  20. Yanagisawa M, Kunimatsu S, Kato S, Sumi I, Kitazawa M, Tamura M, et al. Correlation between grading of visual impairment and quality of life in visually handicapped persons. Jpn J Clin Ophthalmol. 2008;62:259–63.

    Google Scholar 

  21. Kunimatsu S, Kato S, Sumi I, Kitazawa M, Tamura M, Mishima A, et al. Evaluation of quality of life characteristics and grade of legal visual impairment. Nippon Ganka Gakkai Zasshi. 2007;111:454–8 (In Japanese).

    PubMed  Google Scholar 

  22. Fukuhara S, Wakita T, Yamada M, Hiratsuka Y, Green J, Oki K. Development of a short version of the visual function questionnaire using item-response theory. PLoS One. 2013;8:e73084.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Hiratsuka Y, Yamada M, Akune Y, Murakami A, Okada AA, Yamashita H, et al. Assessment of vision-related quality of life among patients with cataract and the outcomes of cataract surgery using a newly developed visual function questionnaire; The VFQ-J11. Jpn J Ophthalmol. 2014;58:415–22.

    Article  PubMed  Google Scholar 

  24. Rabin R, de Charro F. EQ-5D: a measure of health status from the EuroQol Group. Ann Med. 2001;33:337–43.

    Article  CAS  PubMed  Google Scholar 

  25. Holladay JT. Proper method for calculating average visual acuity. J Refract Surg. 1997;13:388–91.

    CAS  PubMed  Google Scholar 

  26. Nakamura Y, Tomidokoro A, Sawaguchi S, Sakai H, Iwase A, Araie M. Prevalence and causes of low vision and blindness in a rural southwest island of Japan: the Kumejima study. Ophthalmology. 2010;117:2315–21.

    Article  PubMed  Google Scholar 

  27. Iwase A, Araie M, Tomidokoro A, Yamamoto T, Shimizu H, Kitazawa Y. Prevalence and causes of low vision and blindness in a Japanese adult population: the Tajimi study. Ophthalmology. 2006;113:1354–62.

    Article  PubMed  Google Scholar 

  28. Earnshaw J, Lewis G. NICE guide to the methods of technology appraisal: pharmaceutical industry perspective. Pharmacoeconomics. 2008;26:725–7.

    Article  PubMed  Google Scholar 

  29. Hiratsuka Y, Yamada M, Murakami A, Okada AA, Yamashita H, Ohashi Y, et al. Cost-effectiveness of cataract surgery in Japan. Jpn J Ophthalmol. 2011;55:333–42.

    Article  PubMed  Google Scholar 

  30. Eye Care Comparative Effectiveness Research Team (ECCERT), Hiratsuka Y, Yamada M, Akune Y, Murakami A, Okada AA, Yamashita H, et al. Cost-utility analysis of cataract surgery in Japan: a probabilistic Markov modeling study. Jpn J Ophthalmol. 2013;57:391–401.

    Article  Google Scholar 

  31. Brown MM, Brown GC, Sharma S. Evidence-based to value-based medicine. Chicago: American Medical Association Press; 2005.

    Google Scholar 

  32. Kishimoto F, Naito T, Hasebe S, Ohtsuki H. Time trade-off utility analysis for surgical intervention in comitant strabismus, glaucoma, and cataract. Acta Med Okayama. 2012;66:191–201.

    PubMed  Google Scholar 

  33. Finger RP, Hoffmann AE, Fenwick EK, Wolf A, Kampik A, Kernt M, et al. Patients’ preferences in treatment for neovascular age-related macular degeneration in clinical routine. Br J Ophthalmol. 2012;96:997–1002.

    Article  PubMed  Google Scholar 

  34. Nishida T, Ando N, Sado K, Nakadomari S. Reconsideration of the most appropriate criterion in the lowest classification of vision disability in Japan. Jpn J Ophthalmol. 2011;55:651–9.

    Article  PubMed  Google Scholar 

  35. Yamagata Y, Terada Y, Suzuki A, Mimura O. Clinico-statistical study on availability of Esterman disability score for assessment of mobility difficulty in patients with visual field loss. Nippon Ganka Gakkai Zasshi. 2010;114:14–22 (In Japanese).

    PubMed  Google Scholar 

  36. Kamo J, Harada R, Matsumoto Y. Relationship between binocular Esterman score versus functional field score and the 25-item National Eye Institute visual function questionnaire. J Japn Soc Low Vis Res Rehabil. 2013;13:11–5 (In Japanese).

    Google Scholar 

  37. Minami T, Tonari M, Nakamura K, Hamamura M, Inaizumi R, Shimizu M, et al. Issues concerning guidelines for visual impairment certificate in Japan. Japn Orthoptic J. 2014;43:219–26 (In Japanese).

    Article  Google Scholar 

  38. Colenbrander A. Assessment of functional vision and its rehabilitation. Acta Ophthalmol. 2010;88:163–73.

    Article  PubMed  Google Scholar 

  39. Chin HS, Park SH, Park IK, Kwon JW, Lee SJ, Steering Committee of Korean Guides for Impairment Rating in Korean Academy of Medical Sciences. Guideline development for the evaluation of visual impairment in Korea. J Korean Med Sci. 2009;24(Suppl 2):S252–7.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgments

This work was supported by the Ministry of Health, Labour and Welfare of Japan. The authors thank Professor Shunichi Fukuhara, Department of Epidemiology and Healthcare Research, Kyoto University, for permission to use the VFQ-J11, and for helpful discussion. The authors thank Dr. Yoko Ozawa and Dr. Norihiro Nagai, Department of Ophthalmology, Keio University School of Medicine, for recruitment of participants.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 1608582, Japan

    Motoko Kawashima, Sachiko Inoue & Kazuo Tsubota

  2. Department of Health and Welfare Services, National Institute of Public Health, Wako, Japan

    Yoshimune Hiratsuka

  3. Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan

    Yoshimune Hiratsuka & Akira Murakami

  4. Department of Ophthalmology, Jikei University School of Medicine, Tokyo, Japan

    Tadashi Nakano

  5. Department of Ophthalmology & Visual Sciences, Kyoto University, Kyoto, Japan

    Hiroshi Tamura

  6. Division of Medical Information Technology & Administration Planning, Kyoto University Hospital, Kyoto, Japan

    Hiroshi Tamura

  7. Department of Ophthalmology, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan

    Koichi Ono

  8. National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan

    Masakazu Yamada

  9. Department of Ophthalmology, Kyorin University, Mitaka, Japan

    Masakazu Yamada

Authors
  1. Motoko Kawashima
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  2. Yoshimune Hiratsuka
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  3. Tadashi Nakano
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  4. Hiroshi Tamura
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  7. Sachiko Inoue
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  8. Kazuo Tsubota
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  9. Masakazu Yamada
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Corresponding author

Correspondence to Motoko Kawashima.

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Conflicts of interest

M. Kawashima, None; Y. Hiratsuka, None; T. Nakano, None; H. Tamura, None; K. Ono, None; A. Murakami, None; S. Inoue, None; K. Tsubota, None; M. Yamada, None.

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Kawashima, M., Hiratsuka, Y., Nakano, T. et al. The association between legal Japanese visual impairment grades and vision-related quality of life. Jpn J Ophthalmol 60, 219–225 (2016). https://doi.org/10.1007/s10384-016-0437-1

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  • DOI: https://doi.org/10.1007/s10384-016-0437-1

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