Severity of Visual Field Loss and Health-related Quality of Life

Abstract

Purpose-To examine the association between severity of visual field loss (VFL) and self-reported health-related quality of life (HRQOL) in a population-based sample.Design-Population-based cross-sectional study.Methods-Participants in the Los Angeles Latino Eye Study underwent a comprehensive ophthalmic examination including visual field testing using the Humphrey Automated Field Analyzer II (SITA Standard 24-2). Mean Deviation (MD) scores were used to determine severity of VFL both as a continuous variable and stratified by severity: no VFL (MD≥ − 2 decibels [dB]), mild VFL (6dB<MD<−2dB), moderate/severe VFL (MD<−6dB). HRQOL was assessed by the Medical Outcomes Study 12-Item Short-Form Health Survey (SF-12) and the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25). Linear regression analyses and analysis of covariance were used to assess the relationship between HRQOL scores and VFL.Results-Of the 5,213 participants included in this study, 18% had unilateral mild, 1.5% unilateral moderate/severe, 19% bilateral mild, and 6.5% bilateral moderate/severe VFL. Worse NEI-VFQ-25 and SF-12 HRQOL scores were associated with VFL in a linear manner. 4-5 dB differences in VFL were associated with a 5-point difference in the NEI-VFQ composite and most subscale scores. Persons with VFL had the greatest difficulty with driving activities, dependency, mental health, distance vision and peripheral vision.

Quality of Life (QoL) in Glaucoma Patients

“…40,55 Furthermore, there are a series of studies confirming the negative impact of visual field deterioration expressed by means of scores such as MD, pattern standard deviation (PSD), Advanced Glaucoma Intervention Study (AGIS) and CIGTS on the total QoL status of individuals with glaucoma. 30,39,46,[57][58][59][60][61][62] These findings are further supported by the presence of the correlation between QoL and VF scores even among individuals who were unaware of having glaucoma. 62 …”

Daily functioning, problem solving and satisfaction for quality of life in visually impaired old persons

“…These studies usually are based on Health Survey Questionnaire, known as SF-36 [12], a general health status questionnaire, and on the National Eye Institute visual function questionnaire [13] which measures the impact of vision in task oriented domains related to daily VFQ. When studying perceived physical and mental status, visually impaired individuals report poorer health status with more severe impairment [14][15][16][17]. Additionally, they seem to be at increased risk for disabling outcomes such as falls, injury, accidents, inability to drive, social dependence and increased mortality [18][19][20].…”

Quality of life and glaucoma

“…2 In general, there is evidence in the literature that the more advanced glaucoma is, the worst the QoL. [4][5] However, this may be impaired even at early stages of the disease, as observed in the Los Angeles Latinos Eye Study (LALES). 5 The loss of the visual function is the main determinant for a worse QoL in glaucoma, and may compromise the patient's daily activities such as reading, driving, walking, estimating distances and seeing objects approaching from the side.…”

“…5 The loss of the visual function is the main determinant for a worse QoL in glaucoma, and may compromise the patient's daily activities such as reading, driving, walking, estimating distances and seeing objects approaching from the side. 4 The psychological effects (fear of blindness and social withdrawal) of glaucoma in the individual are also not negligible and tend to increase with the disease progress. The treatment itself may have a major impact in the QoL.…”

“…The treatment itself may have a major impact in the QoL. 4 The antiglaucoma medications may influence the quality of life in different ways: the daily use of medications reminds the patient of their status as the carrier of an incurable disease; eyedrops can be expensive and difficult to be applied; local and systemic side effects, which can affect their vision and the general health; the scheme of doses, which can interfere in their daily life, leaving the patient anxious (if they are using the medication correctly). 6 It has been shown that the greater the number and the prevalence of side effects of the medication, the worse the quality of life 7 ; the greater the system of droplets, the worse the quality of life [8][9] ; the more expensive the treatment, the worse the quality and life [8][9][10] .…”