Functional Vision Impairments in Diabetic Retinal Diseases Captured by In-Depth Interviews for the Development of a Novel Patient-Reported Outcomes Measure

Authors

Timothy Mayotte
Rafid Farjo
Alex Z. Zmejkoski
Gabrielle Lacy
Dana Chung
Mahsaw Mansoor
Krystal Kao
Jessica Stout
Chris A. Andrews
Fernanda Abalem
Joshua Grant, Corewell Health East
Julie M. Rosenthal
Anjali R. Shah
Mark W. Johnson
Amy D. Zhang
Thomas J. Wubben
Shilpa Kodati
Brett Malbin
Thiran Jayasundera

Document Type

Conference Proceeding

Publication Date

6-2025

Publication Title

Investigative Ophthalmology and Visual Science

Abstract

Purpose : A validated instrument to measure patients’ functional vision impairments in accordance with visual physiology in diabetic retinal disease (DRD) is lacking. During the development of a novel patient-reported outcome measure (PRO), we performed a cross-sectional study to examine the differences in patient-reported functional vision impairments across disease severity and treatment history.

Methods : Semi-structured in-depth interviews (IDIs) were conducted for 77 adult patients with DRD to elicit visual complaints and symptoms. Interviews were transcribed and coded within Atlas.ti software (version 9.5.4) for thematic analysis using principles of grounded theory in selective coding. Proportions of respondents with code occurrence were compared across DRD stage, center-involving diabetic macular edema (CIDME) status, and history of pan-retinal photocoagulation (PRP). Proportions were compared using chi-square tests to determine significance.

Results : DRD patients with a history of PRP reported significantly higher frequency of impairment with contrast sensitivity, color vision, dark adaptation, and photosensitivity than those without a history of PRP. Patients with proliferative DRD reported significantly higher frequency of impairment with color vision, contrast sensitivity and photosensitivity than those with non-proliferative DRD when controlled for CIDME. Patients with CIDME reported significantly higher frequency of metamorphopsia than those without CIDME.

Conclusions : The data from these IDIs suggest certain impairments in functional vision are more frequently self-reported in DRD throughout disease progression and treatment. These may help to establish a conceptual model for DRD. They also suggest that certain retinal treatments such as PRP may be associated with dark adaptation difficulty among other visual symptoms. Furthermore, the data validate a need for a PRO divided into domains that assess patient difficulties and limitations in accordance with visual physiology.

Volume

66

Issue

8

First Page

1114

Comments

Association for Research in Vision and Ophthalmology ARVO Annual Meeting, May 4-8, 2025, Salt Lake City, UT

Last Page

1114

Recommended Citation

Mayotte T, Farjo R, Zmejkoski AZ, Lacy G, Chung D, Mansoor M, et al. [Grant J]. Functional vision impairments in diabetic retinal diseases captured by in-depth interviews for the development of a novel patient-reported outcomes measure. Invest Ophthal Vis Sci. 2025 Jun;66(8):1114.