Correlation among Lens Opacities Classification System III grading, the 25-item National Eye Institute Visual Functioning Questionnaire, and Visual Function Index-14 for age-related cataract assessment

Purpose To evaluate the relationship between cataract types and subjective visual function among patients with age-related cataract. Methods This was a prospective, multicenter, 831 Chinese patient-based, cross-sectional study. Patients were administered the Visual Function Index-14 (VF-14) and the 25-item National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) to evaluate their subjective visual function. Lens Opacities Classification System III (LOCS III) was used to evaluate the type of cataract. Relationships among these parameters were analyzed. Results LOCS III cortical (C) and posterior subcapsular scores are negatively associated with VF-14 (r = - 0.188, P < 0.01; r = - 0.146, P < 0.01) and total score of NEI-VFQ-25 (r = - 0.223, P < 0.01; r = - 0.160, P < 0.01), respectively; LOCS III nuclear opalescence (NO) score is positively associated with VF-14 (r = 0.087, P < 0.05) and total score of NEI-VFQ-25 (r = 0.097, P < 0.05). In multiple linear regression, a decrease in the LOCS III C score is a significant predictor for improvement of the total score of NEI-VFQ-25 (beta = - 1.286, P < 0.05). In contrast, an increase in LOCS III NO score is a significant predictor for improvement of VF-14 (beta = 3.826, P < 0.01) and total score of NEI-VFQ-25 (beta = 4.618, P < 0.01). Patients with LOCS III C score <= 2 have higher VF-14 (49.38 versus 43.74, P < 0.01), total (80.73 versus 71.58, P < 0.01) and subscale scores of NEI-VFQ-25 than patients with LOCS III C score > 2. Conclusion Cortical cataract has adverse effects on subjective visual function, while mild-to-moderate nuclear cataract has positive effects. Furthermore, LOCS III C score > 2 can be a potential cutoff as a reference for cataract surgery without self-assessing questionnaires.