Impact of Diabetic Retinopathy Treatment Modalities on Vision-Related Quality of Life: A Comparative Study Using NEI VFQ-25

Background: Diabetic retinopathy (DR) is a leading cause of visual impairment and affects patients' quality of life. Understanding the impact of different treatments on vision-related quality of life (VR-QOL) is essential for optimizing care. Objective: To assess the effect of different lines of diabetic retinopathy treatment on patients’ (VR-QOL) using the National Eye Institute Visual Function Questionnaire (NEI VFQ-25).
Patients and Methods: This prospective quasi-experimental study was conducted in Mansoura Ophthalmology Center over 6 months on 200 diabetic retinopathy patients, in which 50 patients received laser photocoagulation, 50 patients received anti-VEGF treatment, 50 received intravitreal steroids, and vitrectomy was planned for 50 patients. The NEI VFQ-25 was fulfilled by all patients before treatment and 1 month and 6 months after treatment. The results were compared to the baseline in each group.
Results: Themean age of the included patients was 57.58±7.38 years with female predominance (54.5%). Patients who underwent vitrectomy had significantly higher mean age compared to patients who received laser or anti-VEGF therapy and most of them came from rural areas. Most of the subscales and total score showed significant improvement from baseline to 1- month and 6- month post treatment in total cohort. The most significant improvement was noted in the vitrectomy group followed by the anti-VEGF group.
Conclusion: All treatment modalities led to significant improvements in VR-QOL with varying degrees. Vitrectomy demonstrated the most substantial effect, particularly in advanced DR, followed by intravitreal anti-VEGF. The study highlights the importance of tailored interventions based on disease severity.