[The neuroophthalmic supplement to the NEI-VFQ: test statistics and validation with a cohort of patients with pre- and postchiasmatic damage]. / Das neuroophthalmologische Supplement des NEI-VFQ: Teststatistische Überprüfung und Validierung an einer Stichprobe prä- und postchiasmatisch geschädigter Patienten.

BACKGROUND: The National Eye Institute Visual Function Questionnaire (NEI-VFQ) is not sufficient to assess vision-related quality of life in patients with vision impairments caused by neuroophthalmic deficits. The neuroophthalmic supplement to the NEI-VFQ is currently only available in an English version. The supplement was translated into German and three items concerning visual field loss were added. MATERIAL AND METHODS: NEI-VFQ and supplement data were collected from 62 pre- and postchiasmatic patients with visual field defects and from 245 healthy reference persons. NEI-VFQ and supplement were psychometrically tested and validated. Relations between visual field variables and vision-related quality of life were assessed. RESULTS: The patient group showed diminished quality of life in 10 NEI-VFQ subscales and in eight supplement items when compared to age-matched healthy controls. Correlations between supplement and visual field diagnostic variables demonstrate moderate relations between visual field loss and deterioration of vision-related quality of life. A Cronbach's α of 0.81 for the supplement can be increased to 0.92 in combination with the NEI-VFQ, the sole application of the NEI-VFQ generates an alpha of 0.93 in this sample. A factor analysis reveals four factors that cover the 13 items capturing the following issues: 'severity/problems due to the visual field defect", "unusual eyelid appearances", "blurry vision/double vision" and "diverse vision of both eyes"; 72 % of the variance can be explained by these four factors. CONCLUSION: The German translation of the neuroophthalmic supplement to the NEI-VFQ captures additional vision-specific problems beyond the sole NEI-VFQ that are often reported by patients with vision impairments after brain damage. Although the relevance of some items can be questioned, nevertheless the supplement qualifies for an enhanced outline of subjective vision impairments that are not included in the previous NEI-VFQ.

[Impairments of vision- and health-related quality of life in stroke patients with homonymous visual field defects depend on severity of visual function loss]. / Beeinträchtigung der seh- und gesundheitsbezogenen Lebensqualität bei Schlaganfallpatienten mit homonymen Gesichtsfelddefekten in Abhängigkeit von der Schwere des visuellen Funktionsverlustes.

BACKGROUND AND PURPOSE: Little is known about whether and to what extent health- and vision-related quality of life in stroke patients with visual field defects is influenced by the severity of visual function loss and which quality of life is achieved compared to healthy control persons. PATIENTS/MATERIALS AND METHODS: Results of the National Eye Institute-Visual Functioning Questionnaire (NEI-VFQ) and the Medical Outcome Study Short-Form 36 Health Survey (SF-36) of 177 first stroke patients with visual field defects were compared with scores of age- and sex-matched healthy reference persons. The influence of visual field loss, perimetric data, reduced visual acuity and demographic variables on NEI-VFQ and SF-36 scores were estimated by analyses of variance. RESULTS: First stroke patients showed worse results in 11/12 NEI-VFQ and in 6/8 SF-36 subscales when compared to healthy controls. The factor "intact central visual field" influenced 9/12 NEI-VFQ subscales (F-range 3.16 - 14.11; all p < 0.05), but only one SF-36 scale (F = 3.15; p < 0.05). Patients with larger intact visual fields, shorter reaction times in the visual field test and better visual acuity reached higher NEI-VFQ and SF-36 scores. Male patients reported worse scores for SF-36 subscale General Health Perceptions than female patients (F = 8.61; p = 0.004), but no differences in vision-related quality of life due to the factor gender could be detected. CONCLUSIONS: Patients with visual field defects showed considerable reductions in vision- and health-related quality of life compared to healthy control persons. These were mainly influenced by variables of visual functioning such as size of intact visual field, reaction times or visual acuity. The size of the intact central visual field influenced vision-related quality of life rather than health-related quality of life.