Evaluation of the Cat-PROM 5 visual function questionnaire in epiretinal membrane surgery outcomes

Author: Christopher Holmes (United Kingdom)

Co-authors: Christopher Holmes, Chloe Robson, Margot McLauchlan, Timothy Cochrane, Alistair Laidlaw, Luke Membrey

Purpose

To investigate the effect of epiretinal membrane (ERM) peel on subjective visual function measured by the Cat-PROM 5 questionnaire, and its relationship to anatomical and visual acuity (VA) response.

Setting/Venue

Maidstone and Tunbridge Wells Hospitals NHS trust

Methods

Retrospective observational case series comparing consecutive cases of ERM peel +/- phacoemulsification and intraocular lens insertion in 56 eyes from 56 patients between 1st August 2018 and 1st August 2019. Pre-operative and post-operative data was collated including VA, central retinal thickness (CRT), evidence of ellipsoid zone disruption, lens status, and complications. All patients were asked to participate in a survey questionnaire about their visual function before and after surgery including the Cat-PROM 5 questionnaire.

Results

Pre-operative median VA was 62.5 ETDRS letters (range 35-78) and increased to 69.0 (range 35-80) post operatively (p=0.003). Median pre-operative CRT was 433µm (range 293-670), improving to 385µm (range 308-531) post-operatively (p<0.001). Responses to the survey were received in 45 (80.4%) patients, and results of the pre-operative Cat-PROM 5 questionnaire revealed a median Rasch measure of -2.29 logits (range -9.18-4.23), improving to 0.18 logits (range -9.18-17.0) post operatively (p=0.001). Change in Cat-PROM 5 score was negatively correlated with pre-operative score (<0.001), but it was not significantly correlated with pre-operative or change in VA or CRT. Of the 20 patients who underwent vitrectomy without phaco + IOL, 15 (75%) responded to the survey. Median Rasch measure pre operatively was -2.29 logits (range -6.8-3.56) improving to 0.18 logits (range -9.18-17.0) post operatively (p=0.09).

Conlusions

The Cat-PROM 5 questionnaire may be able to assess subjective change in functional vision after ERM peel. Patients with worse Cat-PROM 5 scores pre-operatively may see greater subjective benefit post operatively.