Vision-related Quality of Life Among Patients With Diabetes Attending the Medical and Retina Clinics in Kenyatta National Hospital

Abstract

Introduction: The quality of life among patients living with diabetes mellitus (DM) and diabetic retinopathy (DR) can be affected by visual impairment, patient‘s anxieties and lifestyle changes. Objective: We compared the vision-related quality of life (VRQoL) among diabetics with DR and those without DR, and assessed whether there was a trend of worsening VRQoL with increasing severity of DR. Design & Methods: Hospital-based analytical cross-sectional study conducted among patients with DM attending the medical and retina clinics in Kenyatta National Hospital in December 2020. Patients living with DM for at least five years and aged ≥18 years were studied. VRQoL was assessed using the World Health Organization / Prevention of Blindness and Deafness Vision Function-20 Questionnaire and the higher the mean score, the worse was the QoL. Diabetic retinopathy was graded using the Early Treatment of Diabetic Retinopathy Study. Student t-test and ANOVA were conducted using SPSS software. Results: We enrolled 100 participants; 50 without DR and 50 with DR. Patients with DR had a higher VRQoL mean score than those without DR in all domains; overall self-rating (2.6 vs 2.2, p<0.001), general functioning (18.0 vs 14.7, p=0.005), psychosocial (6.7 vs 5.3, p<0.001), and visual symptoms (6.1 vs 4.8, p<0.001). VRQoL was worse with increasing severity of DR in all domains. Overall self-rating (mild NPDR 2.2, moderate NPDR 2.5, severe NPDR 3.5 and PDR 3.3); visual symptoms (mild NPDR 5.6, moderate NPDR 5.6, severe NPDR 7.5 and PDR 7.4); psychosocial (mild NPDR 5.7, moderate NPDR 6.5, severe NPDR 6.0 and PDR 8.8); and general functioning (mild NPDR 15.7, moderate NPDR 16.9, severe NPDR 17.5 and PDR 23.6). Conclusion: Patients with DR had poorer VRQoL than those without DR. VRQoL reduced with increasing severity of retinopathy. These findings underscore the need for interventions for early detection and management of DR to prevent developing more advanced DR and its associated deterioration of VRQoL.