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To evaluate the possible correlation between quality of life (QOL) characteristics and grades of legal visual impairment.Quality of life characteristics associated with various causes of visual loss were investigated in 237 Japanese patients in the low-vision care clinic at Tokyo University Hospital, who had been issued the official ID and handbook for the physically handicapped. The main causes of vision loss were glaucoma (87 patients), macular degeneration (35) and diabetic retinopathy (34). Using a previously developed questionnaire, we assessed the correlation between the disability index (DI) as a quality of life characteristic, and the grade of legal visual impairment.Total DI was 1.24 +/- 0.43, showing a very significant correlation with Handicapped Handbook grades (r = -0.44, p.0001). The correlation coefficients were -0.63 (p0.0001) for diabetic retinopathy, -0.50 (p = 0.002) for macular degeneration, and -0.16 (p = 0.14) for glaucoma patients.The needs of low-vision patients correlate with the grade of legal visual impairment and it is important to understand that the needs of low vision patients differ for each disease.

To evaluate the relationship between visual disability and visual scores in patients with retinitis pigmentosa.The relationship between visual disability and visual scores (visual acuity and visual field) was investigated in 93 patients with retinitis pigmentosa. The visual disability of each patient was evaluated using a questionnaire (a total of 35 questions, in 7 sections, regarding daily life). The reproducibility and validity of the data obtained by the questionnaire had been established by a similar investigation in glaucoma patients. Mean (+/-SD) age of patients was 52.6 +/- 15.1 years, the mean visual acuity of the logarithm of the minimum angle of resolution (log10MAR) was 0.5 +/- 0.4, and the mean deviation of visual field with the Humphrey Field Analyzer program 30-2 was -22.0 +/- 10.9 dB.The visual acuity of log10MAR in the better eye (r = 0.66 to 0.81) and the mean sensitivity within the central 10 degrees of the visual field (r = -0.76 to -0.62) had a definite relationship to the visual disability index of each section and their sum (P.0001). This relationship was also confirmed in multiple regression analysis, which showed a high correlation coefficient (R2 = 0.57 to 0.77, P.0001).The retinal sensitivity within the central 10 degrees and the visual acuity of log10MAR in the better eye had a significant influence on a patient's daily life. We suggest that in patients with retinitis pigmentosa, visual disability in daily life can be precisely evaluated with the retinal sensitivity within the central 10 degrees and the visual acuity in the logarithm of the minimum angle of resolution in the better eye.

To evaluate the relationship between visual disability and the remaining visual field in glaucoma patients.Prospective noncomparative survey.One hundred forty-seven Japanese patients with glaucoma were examined.Using a previously developed questionnaire, we assessed the relationship between visual disability indices and both the visual field examined using program 30-2 of the Humphrey Field Analyzer and visual acuity.Pearson's correlation coefficients between visual disability indices and the 22 visual field and 2 visual acuity measurements were calculated. Multiple regression analysis with stepwise variable selection identified factors significantly contributing to visual disability.We identified a significant correlation between visual disability and both the visual field and visual acuity measurements collected. Of the factors examined, retinal sensitivity in the lower hemifield within 5 degrees of the fixation and visual acuity in the better eye significantly contributed to all the item and total disability indices (DIs), measurements of the degree of visual disability as evaluated by the questionnaire; visual acuity in the worse eye contributed to two of the seven item DIs, as well as the total DI. The R value for total DI (R = 0.87, P0.0001) indicated that approximately 76% of the visual disability could be explained by these factors.The Japanese glaucoma patients' visual disability is explained primarily by retinal sensitivity in the lower hemifield within 5 degrees of the fixation and visual acuity in the better eye and secondarily by visual acuity in the worse eye.

Background The influence of retinal artery circulation on central retinal vein occlusion (CRVO) is not well known. Case A 73-year-old man with hypertension complained of transient visual loss in his left eye. At initial examination, ophthalmoscopy of his left eye showed mild dilatation and tortuosity of the retinal vein and a few dot hemorrhages. Fluorescein angiography disclosed normal arm-to-retina circulation time and no leakage of dye, but delayed retinal circulation time. These findings indicated venous stasis retinopathy of CRVO. In spite of intravenous infusion of prostaglandin E1 and vasodilative treatment, four days after initial examination, the patient's left eyeground showed complication of branch retinal artery occlusion (BRAO). A fibrinolytic agent was given intravenously, but four weeks later, his left eyeground developed typical hemorrhagic retinopathy. The hemodynamics of retrobulbar arterial circulation were investigated by color Doppler imaging. Conclusion We report a case of venous stasis retinopathy of CRVO associated with BRAO, that developed hemorrhagic retinopathy despite treatment with prostaglandin E1 and other vasodilative agents. We think that arterial insufficiency might be responsible for the conversion from venous stasis retinopathy to hemorrhagic retinopathy of CRVO.