ImportanceThe association between diabetic retinopathy (DR) and quality of life (QoL) has not been thoroughly investigated.ObjectiveTo investigate the association between DR and both vision-related QoL (VRQoL) and general health-related QoL (HRQoL).Data SourcesMEDLINE, EBSCO, Embase, and Web of Science were searched from their inception to April 2022.Study SelectionStudies included adults with DR and a measure of QoL.Data Extraction and SynthesisPreferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Two assumption-free meta-analyses were conducted. Analysis 1 included studies with participants without DR as the referent group to which QoL scores of participants with DR, grouped according to DR severity, were compared. Analysis 2 included all studies with participants with DR and a measure of QoL. QoL scores were pooled within categories of DR severity, and comparisons were made between these categories.Main Outcome and MeasuresQoL measured using HRQoL and VRQoL scales.ResultsA total of 93 articles were included: 79 in the meta-analyses and 14 in the narrative results. VRQoL was recorded in 54 studies, HRQoL in 26, and both in 13 studies. The most commonly used scales were the National Eye Institute 25-item Visual Function Questionnaire (VFQ-25) (n = 49) for VRQoL and the Short Form (SF) Health Survey (n = 18) for HRQoL. Thirty-five studies reported VFQ-25 composite scores. Analysis 1 consisted of 8 studies including 1138 participants with DR and 347 participants without DR. Compared with participants without DR, the composite VFQ-25 score was 3.8 (95% CI, 1.0-6.7) points lower in those with non–vision-threatening DR (NVTDR), 12.5 (95% CI, 8.5-16.5) lower in those with any DR, and 25.1 (95% CI, 22.8-27.2) lower in VTDR (P < .001 for trend). Analysis 2 consisted of 35 studies including 6351 participants with DR. The pooled mean VFQ-25 composite score was 91.8 (95% CI, 91.0-92.7) for participants with NVTDR, 77.6 (95% CI, 76.9-78.3) for any DR, and 73.2 (95% CI, 72.6-73.7) for VTDR (P < .001 for trend). HRQoL scores had weak or no associations with NVTDR and strong associations with VTDR.Conclusions and RelevanceThis study found that VRQoL declined with the presence and severity of DR. Interventions to reduce progression of DR at both early and more advanced stages could improve VRQoL.

中文翻译：

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糖尿病视网膜病变与生活质量

重要性糖尿病视网膜病变 (DR) 与生活质量 (QoL) 之间的关联尚未得到彻底研究。目的调查 DR 与视力相关 QoL (VRQoL) 和一般健康相关 QoL (HRQoL) 之间的关联。数据来源 MEDLINE、EBSCO 、Embase 和 Web of Science 从成立到 2022 年 4 月均被搜索。研究选择研究包括患有 DR 的成年人和 QoL 测量。数据提取和合成遵循系统评价和荟萃分析指南的首选报告项目。进行了两项无假设荟萃分析。分析 1 包括以未患 DR 的参与者为参考组的研究，将根据 DR 严重程度分组的患有 DR 的参与者的生活质量得分进行比较。分析 2 包括所有 DR 参与者的研究和生活质量测量。将 QoL 分数汇总到 DR 严重程度类别中，并在这些类别之间进行比较。主要结果和测量使用 HRQoL 和 VRQoL 量表测量 QoL。结果总共纳入 93 篇文章：79 篇为荟萃分析，14 篇为叙述结果。54 项研究记录了 VRQoL，26 项研究记录了 HRQoL，13 项研究记录了两者。最常用的量表是针对 VRQoL 的国家眼科研究所 25 项视觉功能问卷 (VFQ-25) (n = 49) 和针对 HRQoL 的简表 (SF) 健康调查 (n = 18)。35 项研究报告了 VFQ-25 综合评分。分析 1 由 8 项研究组成，包括 1138 名患有 DR 的参与者和 347 名没有 DR 的参与者。与没有 DR 的受试者相比，患有非视力威胁 DR (NVTDR) 的受试者的综合 VFQ-25 评分低 3.8 分 (95% CI, 1.0-6.7)，患有非视力威胁 DR (NVTDR) 的受试者低 12.5 分 (95% CI, 8.5-16.5)。患有任何 DR 的患者，VTDR 降低 25.1（95% CI，22.8-27.2）（磷< .001 为趋势）。分析 2 包含 35 项研究，其中包括 6351 名 DR 参与者。患有 NVTDR 的参与者的汇总平均 VFQ-25 综合评分为 91.8（95% CI，91.0-92.7），任何 DR 的参与者为 77.6（95% CI，76.9-78.3），任何 DR 的参与者为 73.2（95% CI，72.6-73.7）。 VTDR（磷< .001 为趋势）。HRQoL 评分与 NVTDR 关联较弱或无关联，但与 VTDR 关联较强。结论和相关性本研究发现 VRQoL 随着 DR 的存在和严重程度而下降。在早期和晚期阶段减少 DR 进展的干预措施可以改善 VRQoL。