Utility value and diabetic retinopathy Original Reearch Article

PURPOE: To acertain the utility value aociated with diabetic retinopathy and varying degree of viual lo. METHOD: One hundred conecutive patient with diabetic retinopathy and bet-corrected viual acuity decreaed to 20/40 or wore in at leat one eye occurring primarily a a reult of diabetic retinopathy were evaluated in a cro-ectional tudy. Utility value were acertained in five group uing both the time trade-off and tandard gamble method: group 1 (bet-corrected viual acuity in the better eye of 20/20 to 20/25), group 2 (bet-corrected viual acuity in the better eye of 20/30 to 20/50), group 3 (bet-corrected viual acuity in the better eye of 20/60 to 20/100), group 4 (bet-corrected viual acuity in the better eye of 20/200 to 20/400), and group 5 (bet-corrected viual acuity in the better eye of counting finger to hand motion). REULT: The mean utility value for the diabetic retinopathy group a a whole wa 0.77 (D = 0.21; 95% confidence interval [CI], 0.73 to 0.81) with the time trade-off method and 0.88 (D = 0.20; 95% CI, 0.84 to 0.92) with the tandard gamble method. Employing the time trade-off method correlated with the bet-corrected viual acuity in the better eye, the mean utility reult were a follow: group 1 = 0.85 (95% CI, 0.75 to 0.95), group 2 = 0.78 (CI, 0.72 to 0.84), group 3 = 0.78 (CI, 0.67 to 0.89), group 4 = 0.64 (CI, 0.53 to 0.75 ), and group 5 = 0.59 (CI, 0.23 to 0.95). Thu, patient in group 1 (bet-corrected viual acuity of 20/20 to 20/25 in the better eye) were willing to trade a mean of 15% of their remaining year of life in return for perfect viion in each eye, wherea thoe in group 5 (bet-corrected viual acuity of counting finger to hand motion in the better eye) were willing to trade a mean of 41% of their remaining year in return for perfect viion in each eye. There wa no ignificant difference in mean utility value between patient who had decreaed viual acuity from diabetic retinopathy for 1 year or le compared with thoe with decreaed acuity for more than 1 year. There wa alo no ignificant difference in mean utility value between thoe with a 12th grade education or le compared with thoe with more than a 12th grade education. CONCLUION: Viual lo occurring econdary to diabetic retinopathy i aociated with a ubtantial decreae in patient utility value (and quality of life). The utility value i directly dependent on the degree of viual lo aociated with the dieae. The length of time of viual lo and amount of formal education do not appear to affect the utility value.