***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES To describe the vision-targeted , health-related quality of life , measured with the National Eye Institute Visual Function Question naire ( NEI-VFQ ) , in patients with age-related macular degeneration , cataract , or reduced visual acuity ; to determine the relationship between the NEI-VFQ subscale scores and clinical measures of visual function ; and to assess the internal consistency and reliability of the NEI-VFQ subscales . DESIGN The 39-item NEI-VFQ was administered at the 5-year clinic visit to 4077 Age-Related Eye Disease Study participants . RESULTS The subscales of the NEI-VFQ had moderate to high internal consistency ( Cronbach 's alpha = 0.58 - 0.91 ) . The NEI-VFQ scores for participants with advanced age-related macular degeneration in 1 or both eyes , severe nuclear opacity , reduced visual acuity , or cataract surgery generally were lower than scores for disease-free participants ( P<.001 ) . CONCLUSION These findings support the use of the NEI-VFQ as a measure of vision-targeted , health-related quality of life among patients with age-related macular degeneration , cataract , or reduced visual acuity OBJECTIVE To develop and test the psychometric properties of a 25-item version of the National Eye Institute Visual Function Question naire ( NEI VFQ-25 ) . DESIGN Prospect i ve observational cohort study of persons with 1 of 5 chronic eye diseases or low vision who were scheduled for nonurgent visits in ophthalmology practice s and a reference sample of persons without eye disease . SETTING Eleven university-based ophthalmology practice s and the NEI Clinical Center . PATIENTS Eligible participants had to have 1 of the following eye conditions : age-related cataracts , age-related macular degeneration , diabetic retinopathy , primary open-angle glaucoma , cytomegalovirus retinitis , or low vision from any cause . Seven of the 12 sites also enrolled persons in a reference sample . Reference sample participants had no evidence of underlying eye disease but were scheduled for either screening eye examinations or correction of refractive error . All eligible persons had to be 21 years or older , English speaking , and cognitively able to give informed consent and participate in a health status interview . MEASUREMENTS AND MAIN RESULTS To provide the data needed to create the NEI VFQ-25  , all subjects completed an interview that included the 51-item NEI VFQ . Estimates of internal consistency indicate that the subscales of the NEI VFQ-25 are reliable . The validity of the NEI VFQ-25 is supported by high correlations between the short- and long-form versions of the measure , observed between-group differences in scores for persons with different eye diseases of varying severity , and the moderate-to-high correlations between the NEI VFQ-25 subscales that have the most to do with central vision and measured visual acuity . CONCLUSIONS The reliability and validity of the NEI VFQ-25 are comparable to those of the 51-item NEI VFQ field test version of the survey . This shorter version will be more feasible in setting s such as clinical trials where interview length is a critical consideration . In addition , preliminary analyses indicate that the psychometric properties of the NEI VFQ-25 are robust for the eye conditions studied ; this suggests that the measure will provide reproducible and valid data when used across multiple conditions of varying severity OBJECTIVE To assess the impact of best-eye and worst-eye visual acuity ( BEVA and WEVA , respectively ) on health-related quality of life and utility in patients with wet age-related macular degeneration . DESIGN This cross-sectional , prospect i ve , observational , multicenter study was performed in France , Germany , and Italy . Patients were stratified into 4 severity groups ( BEVA , 20/40 ; WEVA , 20/200 ) . Patients completed the National Eye Institute 25-Item Visual Function Question naire , the Macular Disease Quality of Life Scale , and the Health Utility Index 3 . Analysis of variance was used to adjust for age , sex , and country . RESULTS Patients ( N = 360 ) were mainly female ( 59.6 % ) , with a mean age of 77 years and mean time since age-related macular degeneration diagnosis of 2.3 years .  Health Utility Index 3 scores decreased with VA severity from 0.62 to 0.39 . The National Eye Institute 25-Item Visual Function Question naire global score decreased with VA severity from 67.0 to 40.7 and was related to the BEVA ( P < .001 ) and WEVA ( P = .03 ) . Corresponding changes were observed on the general vision , distance vision , driving , and mental health dimensions . The average weighted impact score on the Macular Disease Quality of Life varied from -4.6 to -2.6 , decreasing with VA severity . Both eyes contributed to the average weighted impact score . CONCLUSION The BEVA and WEVAs influenced vision-related quality of life independently , as measured by the National Eye Institute 25-Item Visual Function Question naire and Macular Disease Quality of Life Scale BACKGROUND The National Eye Institute Visual Function Question naire ( NEI-VFQ ) measures vision-targeted quality of life , but it is unclear whether it is sensitive to changes within individuals over time . OBJECTIVE To determine the responsiveness of the NEI-VFQ to " within-individual " changes in visual acuity in patients who had subfoveal choroidal neovascularization in at least one eye secondary to age-related macular degeneration , ocular histoplasmosis syndrome , or idiopathic causes , and who participated in r and omized trials of submacular surgery . METHODS Trained telephone interviewers administered the NEI-VFQ as part of annual follow-up data collection for pilot trials and larger clinical trials of submacular surgery .  Best-corrected visual acuity was measured by local vision examiners at 12 months after enrollment and , typically , by central " traveling " vision examiners at 24 months after enrollment . Changes in visual acuity and NEI-VFQ scores from 12 to 24 months were analyzed using linear regression methods . RESULTS Two-hundred eighteen patients had both interviews and visual acuity measurements at 12 and 24 months after enrollment . Changes in the overall NEI-VFQ score and in 9 of the subscales ( near activities , dependency , driving , role difficulties , distance activities , mental health , general vision , peripheral vision , and social functioning ) were related to changes in visual acuity of the better-seeing eye based on linear regression analysis ( P<.05 ) . In our analysis , a 3-line decrease in the visual acuity of the better-seeing eye was associated with 3.6- to 16.2-point decreases in the overall NEI-VFQ score and 9 subscale scores . CONCLUSIONS Most of the NEI-VFQ subscales were responsive to changes in the visual acuity of the better-seeing eye over a 12-month interval in this patient population . Thus , the NEI-VFQ can be used to measure change in vision-targeted quality of life over time to augment clinical measurements of visual acuity PURPOSE To quantify decreases in health-related quality of life ( HRQoL ) for given deterioration in clinical measures of vision ; to describe the shape of these relationships ; and to test whether the gradients of these relationships change with duration of visual loss . DESIGN A prospect i ve , longitudinal study of patients treated with verteporfin photodynamic therapy in the United Kingdom National Health Service . PARTICIPANTS Patients with neovascular age-related macular degeneration ( AMD ) treated in 18 ophthalmology departments in the United Kingdom with expertise in management of neovascular AMD . METHODS Responses to HRQoL question naires ( Short Form 36 [ SF-36 ] and National Eye Institute Visual Functioning Question naire [ NEIVFQ ] ) and clinical measures of vision were recorded at baseline and at follow-up visits . Mixed regression models were used to characterize the relationships of interest . MAIN OUTCOME MEASURES Measures of vision were best-corrected visual acuity ( BCVA ) and contrast sensitivity ( CS ) . The SF-36 physical and mental component scores ( PCS and MCS ) , SF-6D utility , and distance , near , and composite NEIVFQ scores were derived to characterize HRQoL. RESULTS The SF-6D , PCS , and MCS were linearly associated with BCVA ; predicted decreases for a 5-letter drop in BCVA in the better-seeing eye were 0.0058 , 0.245 , and 0.546 , respectively ( all P<0.0001 ) . Gradients were not influenced by duration of follow-up . Models predicting distance , near , and composite NEIVFQ scores from BCVA were quadratic ; predicted decreases for a 5-letter drop in BCVA in the better-seeing eye were 5.08 , 5.48 , and 3.90 , respectively ( all P<0.0001 ) . The BCVA predicted HRQoL scores more strongly than CS . CONCLUSIONS Clinical ly significant deterioration in clinical measures of vision is associated with small decreases in generic and vision-specific HRQoL. Our findings are important for further research modeling the cost effectiveness of current and future interventions for neovascular AMD PURPOSE To describe the health-related quality of life , measured with the National Eye Institute Visual Function Question naire ( NEI-VFQ ) , of patients several years after the onset of optic neuritis , according to their neurologic and visual status ; to assess the relationship between the NEI-VFQ subscales and clinical measures of visual function ; and to assess the internal consistency reliability of the NEI-VFQ subscales . METHODS The NEI-VFQ was administered to 244 patients 5 to 8 years after treatment for an episode of acute optic neuritis as part of the Optic Neuritis Treatment Trial .  Visual acuity , visual field , contrast sensitivity , and color vision were measured at the same time as question naire completion . RESULTS The  NEI-VFQ scores generally were lower than those reported for a disease-free group . Reported dysfunction was greater when multiple sclerosis was present and when visual acuity was abnormal , supporting the construct validity of the NEI-VFQ . Rank correlations between the NEI-VFQ subscales and clinical measures of visual function were moderate at best . Internal consistency reliability was generally high for most of the NEI-VFQ subscales . CONCLUSIONS These findings add support to the use of the NEI-VFQ as a valuable measure of self-reported visual impairment 
    Output:
    
Visual loss was associated with a marked impact on health utilities .
However , the relationship was not comparable between conditions or by measure of HSUVs .
Key results included the finding that overall , self-rated time-trade off estimates were more likely to discriminate between different VA levels than EQ-5D values .
Additionally , a stronger correlation was observed between HSUVs and better-seeing eye VA compared to worse-seeing eye VA .
Conclusions Visual acuity has a significant impact on HSUVs .