Visual field loss and vision-related quality of life in the Italian Primary Open Angle Glaucoma Study

Abstract

The aim of this study was to examine the relationship between visual field (VF) loss, vision-related quality of life (QoL) and glaucoma-related symptoms in a large cohort of primary open angle glaucoma (POAG) patients. POAG patients with or without VF defects or “glaucoma suspect” patients were considered eligible. QoL was assessed using the validated versions of the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) and glaucoma-related symptoms were assessed using the Glaucoma Symptom Scale (GSS). Patients were classified as having VF damage in one eye (VFD-1), both eyes (VFD-2), or neither eye (VFD-0). 3227 patients were enrolled and 2940 were eligible for the analysis. 13.4% of patients were classified in the VFD-0, 23.7% in the VFD-1, and 62.9% in the VFD-2 group. GSS visual symptoms domain (Func-4) and GSS non-visual symptoms domain (Symp-6) scores were similar for the VFD-0 and VFD-1 groups (p = 0.133 and p = 0.834 for Func-4 and Symp-6, respectively). VFD-0 group had higher scores than VFD-2 both in Func-4 (p < 0.001) and Symp-6 domains (p = 0.035). Regarding the NEI-VFQ-25, our data demonstrated that bilateral VF defects are associated with vision-related QoL deterioration, irrespective of visual acuity.

Impact of binocular integrated visual field defects on healthy related quality of life in glaucoma

“…[ 25 , 26 ] It was reported that the QOL in glaucoma was significantly correlated with visual impairment of physical function, social activities and psychosocial factors, [ 27 – 30 ] among which binocular visual function has the most intimate relationship. [ 31 , 32 ] In addition, once glaucoma is diagnosed, many patients’ QOL decreases significantly, mainly due to inconvenient treatment and afraid of blindness. [ 33 ] During clinical practice, patients with the same stage of VF defect showing various QOL, or same QOL demonstrate diverse severity of VF defect, which might not be explained by visual function assessment based on monocular VF loss.…”

Vision-related quality of life and symptom perception change over time in newly-diagnosed primary open angle glaucoma patients

“…Briefly, previously or newly diagnosed POAG patients aged 18 or more were consecutively enrolled during routine visits at 21 academic and non-academic centers in Italy. In the cross-sectional part of the study, vision-related QoL data were collected and their association with both clinical and socio-demographic variables was investigated 29,30 . In the prospective part of the study, consecutive newly-diagnosed glaucoma patients were evaluated at baseline and were followed-up for one year.…”

Influence of painless one-eye blindness on depression, anxiety and quality of life in glaucoma patients with a normal fellow eye

“…The results were compared to those obtained on an age-, sex- and education-level matched non-glaucomatous control group with no significant eye disease. The background of our investigation is that glaucoma patients are known to have an increased prevalence of anxiety and depression [ 10 , 25 ], and their QL is reduced [ 14 ]. These negative psychometric deviations can be caused both by the experienced visual impairment [ 26 ] and by anxiety about a potential future worsening of the visual functions [ 7 , 27 ].…”

“…Psychological alterations associated with glaucoma can be caused by the actual deterioration of the visual functions, but may also be induced by the possibility of future functional decline (glaucomatous progression) [ 14 ]. In the current study we investigated if increased anxiety, depression and decreased QL are present in glaucoma-related one-eye blindness, in which chronic painless blindness is present in one eye, but the visual functions of the fellow eye are normal, and a preventive laser intervention and/or regular eye examinations make the possibility of glaucoma-related future functional decline of the fellow eye unrealistic.…”