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Multicenter Study
. 2020 Jul;40(7):1831-1839.
doi: 10.1007/s10792-020-01353-0. Epub 2020 Apr 5.

Correlation among Lens Opacities Classification System III grading, the 25-item National Eye Institute Visual Functioning Questionnaire, and Visual Function Index-14 for age-related cataract assessment

Yu Wan  1 , Yinhao Wang  1 , Liming Zhao  2 , Min Sun  3 , Li An  4 , Yang Yang  5 , Aimin Jiang  5 , Yanhui Xu  6 , Zhimin Chen  6 , Xuemin Li  7
Affiliations
Multicenter Study

Correlation among Lens Opacities Classification System III grading, the 25-item National Eye Institute Visual Functioning Questionnaire, and Visual Function Index-14 for age-related cataract assessment

Yu Wan et al. Int Ophthalmol. 2020 Jul.

Abstract

Purpose: To evaluate the relationship between cataract types and subjective visual function among patients with age-related cataract.

Methods: This was a prospective, multicenter, 831 Chinese patient-based, cross-sectional study. Patients were administered the Visual Function Index-14 (VF-14) and the 25-item National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) to evaluate their subjective visual function. Lens Opacities Classification System III (LOCS III) was used to evaluate the type of cataract. Relationships among these parameters were analyzed.

Results: LOCS III cortical (C) and posterior subcapsular scores are negatively associated with VF-14 (r = - 0.188, P < 0.01; r = - 0.146, P < 0.01) and total score of NEI-VFQ-25 (r = - 0.223, P < 0.01; r = - 0.160, P < 0.01), respectively; LOCS III nuclear opalescence (NO) score is positively associated with VF-14 (r = 0.087, P < 0.05) and total score of NEI-VFQ-25 (r = 0.097, P < 0.05). In multiple linear regression, a decrease in the LOCS III C score is a significant predictor for improvement of the total score of NEI-VFQ-25 (β = - 1.286, P < 0.05). In contrast, an increase in LOCS III NO score is a significant predictor for improvement of VF-14 (β = 3.826, P < 0.01) and total score of NEI-VFQ-25 (β = 4.618, P < 0.01). Patients with LOCS III C score ≤ 2 have higher VF-14 (49.38 versus 43.74, P < 0.01), total (80.73 versus 71.58, P < 0.01) and subscale scores of NEI-VFQ-25 than patients with LOCS III C score > 2.

Conclusion: Cortical cataract has adverse effects on subjective visual function, while mild-to-moderate nuclear cataract has positive effects. Furthermore, "LOCS III C score > 2" can be a potential cutoff as a reference for cataract surgery without self-assessing questionnaires.

Keywords: Age-related cataract; Cataract types; NEI-VFQ-25; Subjective visual function; VF-14.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Bar graph showing the distribution of vision impairment, LOCS III NO, C, and P scores among patients with age-related cataract. a The distribution of vision impairment. b The distribution of LOCS III NO, C, and P scores. LOCS Lens Opacities Classification System, NO nuclear opalescence, C cortical, P posterior subcapsular
Fig. 2
Fig. 2
Line graph showing the correlation among UDVA, the VF-14 score, the total score of NEI-VFQ-25, and LOCS III scores. a UDVA of the op-eye changing with LOCS III scores. b The VF-14 score changing with LOCS III scores. c The total score of NEI-VFQ-25 changing with LOCS III score. UDVA uncorrected distance visual acuity, op-eye operative eye, VF-14 the Visual Function Index-14, NEI-VFQ-25 the 25-item National Eye Institute Visual Functioning Questionnaire, LOCS Lens Opacities Classification System, NO nuclear opalescence, C cortical, P posterior subcapsular. Error bars indicate SEM
Fig. 3
Fig. 3
Bar graph showing the difference of UDVA, the VF-14 score, the total and subscale scores of NEI-VFQ-25 score between Group C1 (LOCS III C score ≤ 2) and Group C2 (LOCS III C score > 2). UDVA uncorrected distance visual acuity; VF-14 the Visual Function Index-14; NEI-VFQ-25 the 25-item National Eye Institute Visual Functioning Questionnaire. ***P < 0.001 analysis of variance. Error bars indicate SD
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