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Angeline Michelle Nguyen, Suzanne W van Landingham, Robert W Massof, Gary S Rubin, Pradeep Y Ramulu; Difficulty with and Restriction of Specific Reading Tasks in Glaucoma. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4577.
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To evaluate the impact of glaucoma-related vision loss on self-reported difficulty with and engagement in ten distinct reading activities.
Glaucoma patients with bilateral visual field (VF) loss and glaucoma suspect controls were administered a questionnaire to evaluate reading difficulty and reading engagement. Responses regarding difficulty for each of ten reading tasks were analyzed in separate ordinal logistic regression models as well as in a Rasch analytic model to determine reading task difficulty (item measure scores) and overall reading ability (person measure scores). Reading engagement was assessed by asking subjects to report the number of days in a typical week they engaged in each of the ten reading activities.
Glaucoma subjects more often described a greater level of reading difficulty than controls for all reading tasks except puzzles (p < 0.05 for all). In the Rasch analytic model, the reading tasks with the highest item measure scores were puzzles, books, and finances, while the tasks with the lowest item measure scores were notes, bills, and mail. In multivariable analyses adjusting for age, sex, race, education level, cognitive impairment and depressive symptoms, lower person-measure scores (indicating greater reading difficulty) were associated with glaucoma (β = -1.47 logits, 95% confidence interval [CI] = -2.76 to -0.18, p = 0.03), severity of VF loss (β = -0.50 logits per 5-dB decrement in the better-eye VF mean deviation, 95% CI = -0.88 to -0.12, p = 0.01), and contrast sensitivity (β = -0.40 logits per 0.1-unit lower log CS, 95% CI = -0.66 to -0.13, p = 0.004). In multivariable models, each 5-dB decrement in the better-eye VF MD was associated with book reading on 18% fewer days (CI 7% - 29%, p=0.003) and newspaper reading on 10% fewer days (CI 3% - 17%, p=0.008). No statistically significant reading restriction was observed for other reading activities.
Glaucoma patients have difficulty with a variety of reading tasks, particularly tasks requiring sustained reading. Glaucoma patients are also less likely to engage in activities requiring sustained reading. Future work should distinguish the mechanisms underlying reading difficulty in glaucoma to determine how patients can maintain reading ability.
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