Vitreous Floaters Functional Questionnaire for Vision-Degrading Myodesopsia From Vitreous Floaters.

Abstract

Vision-degrading myodesopsia (VDM) from vitreous floaters can be associated with degraded contrast sensitivity and poor visual quality of life, although it is unclear how to best evaluate subjective patient disturbances. Floater-specific, vision-related, patient-reported outcomes might improve assessment of disease severity and case selection for therapy as well as provide useful outcome measures of present and future treatments. To develop a Vitreous Floaters Functional Questionnaire (VFFQ) and to determine if the VFFQ score correlates with vitreous density measured by quantitative ultrasonography and with visual function evaluated by measuring contrast sensitivity. In a single-center cross-sectional study, Rasch analysis was performed in 169 participants with floaters. Test-retest reliability at 3 time points over 6 months was performed in 24 other participants. Correlations of the VFFQ score with contrast sensitivity and quantitative ultrasonography were performed in a separate group of 224 participants. Data analysis was performed from 2017 to 2024. Participants completed the self-administered questionnaire and underwent ultrasonography, measures of contrast sensitivity, and clinical evaluation. Contrast sensitivity (Freiburg Acuity Contrast Test), Cook distance, intraclass correlation, quantitative ultrasonography, Rasch analysis, and VFFQ composite score were measured. From 169 participants (mean [SD] age, 57.5 [14.4] years; 74 [43.8%] female), Rasch analysis eliminated 8 questions and identified 23 questions meeting acceptable criteria for the VFFQ. The intraclass correlation of Rasch-calibrated composite scores from 24 participants (mean [SD] age, 56.0 [13.5] years; 14 [58.3%] female) who completed the 23-item VFFQ (VFFQ-23) on 3 occasions found high test-retest reliability (0.850 [95% CI, 0.721 to 0.928]; P < .001). Clinical correlations were evaluated among 224 participants (mean [SD] age, 58.5 [15.0] years; 99 [44.2%] female). There were significant correlations between VFFQ-23 scores and both vitreous echodensity (r = -0.752 [95% CI, -0.805 to -0.688]; P < .001) and contrast sensitivity (r = -0.744 [95% CI, -0.799 to -0.677]; P < .001). The VFFQ-23 had high test-retest reliability and correlated with vitreous structure and visual function. This vision-related patient-reported outcome of disease severity in patients with vitreous floaters might be useful for individual patient evaluations, population screening and triage, and assessing the response to current therapies, like vitrectomy and YAG laser vitreolysis, and future therapies, such as nanoparticle treatments and pharmacologic vitreolysis.