Beyond visual acuity: Patient-relevant assessment measures of visual function in retinal diseases

Area of Science:

• Ophthalmology
• Clinical Research
• Patient-Reported Outcomes

Background:

• Age-related macular degeneration (AMD) and diabetic retinopathy (DR) significantly impact patients' visual function.
• Standardized and relevant outcome measures are crucial for evaluating treatment efficacy and guiding clinical practice in ophthalmology.
• Patient-reported outcomes (PROs) offer valuable insights into the patient's perspective on their condition and treatment.

Purpose of the Study:

• To identify and recommend patient-reported outcomes (PROs) and clinical outcome measures for age-related macular degeneration (AMD) and diabetic retinopathy (DR).
• To provide ophthalmologists with evidence-based guidance for selecting appropriate outcome measures in clinical practice.
• To promote the adoption of patient-centered care through the use of PROs.

Main Methods:

• The RAND/UCLA Appropriateness Method, incorporating evidence synthesis and a two-round Delphi expert panel, was employed.
• A systematic literature search identified outcome measures for AMD and DR published between 2005 and 2018.
• Fourteen Spanish ophthalmologists rated the relevance of identified outcome measures on a 1-9 scale.

Main Results:

• The search identified 33 PRO-specific questionnaires and 2 treatment satisfaction questionnaires.
• Methods for measuring contrast sensitivity (CS), low-luminance visual acuity (LLVA), and reading acuity/speed (RA-RS) were also cataloged.
• Eleven outcome measures for AMD and seven for DR were recommended based on expert panel consensus.

Conclusions:

• The recommended outcome measures will assist ophthalmologists in choosing the most suitable assessments for patients with AMD and DR.
• Integrating PROs into clinical practice supports a shift towards patient-centered medicine.
• Standardized outcome measurement enhances the evaluation of visual function in retinal diseases.