Vision- and health-related quality of life in patients with visual field loss after postchiasmatic lesions.

Purpose: The purpose of the study was to assess vision-related quality of life (QoL) in patients with visual field loss (VFL) after lesions of the postchiasmatic visual pathway and to investigate the influence of VFL and reduced visual acuity (VA) on vision-related QoL.

Methods: In 312 patients with postchiasmatic damage, VFL was measured by automated computer campimetry, and vision-related QoL was assessed by the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ). Health-related QoL was obtained by the SF-36 Health Survey in 272 patients. In addition, 90 degrees visual fields and VA data were obtained. NEI-VFQ and SF-36 scores were compared with those of healthy subjects and poststroke, brain-injured patients in general. Multiple analyses of covariance and multiple linear regression models for QoL results were performed with VA and VFL as independent variables.

Results: Patients with postchiasmatic lesions who had VFL had markedly lower NEI-VFQ scores than did healthy subjects and also lower SF-36 scores than did poststroke, brain-injured patients, particularly in the domain of role functioning. VFL and VA correlated significantly with vision-related but not with health-related QoL estimates when age was considered as confounding variable. Most scales of NEI-VFQ (9/12) were sensitive to differences in VFL.

Conclusions: VFL and VA had a coordinate influence on vision-related QoL in brain-injured patients with postchiasmatic lesions. Diminished health-related QoL was not associated with VFL and VA. Both VFL and VA should be considered when trying to explain variance of NEI-VFQ results in patients with postchiasmatic lesions of the visual pathway.