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L. Hyman, E. Komaroff, A. Heijl, B. Bengtsson, M.C. Leske, M. Hussein, EMGT Group; Vision-Related Quality of Life in Early Manifest Glaucoma Trial (EMGT) Patients . Invest. Ophthalmol. Vis. Sci. 2003;44(13):1275.
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Purpose: The NEI-VFQ was included in EMGT to evaluate the effect of treatment, visual function (VF) and other factors on vision targeted health-related quality of life (HRQOL) in patients with early glaucoma. Methods: EMGT enrolled 255 patients with newly detected open-angle glaucoma with repeatable early visual field defects, between ages 50-80 years (66% female), according to specified eligibility criteria. Randomized patients received betaxolol BID plus laser trabeculoplasty in eligible eye(s) or no initial treatment. A Swedish translation of the NEI-VFQ 25, developed from the original English version, was self-administered twice-once at a median of 3 years after baseline and again at a median of 2 years later. Responses were grouped by subscales and a composite score was determined (Mangione et al). Multivariate logistic regression models were used to evaluate associations between VFQ scores (divided by median split) and age, gender, VF [visual acuity (VA) or mean deviation(MD)], treatment, and EMGT progression at the first administration. Multivariate linear regression was used to model change in the VFQ composite score over time, adjusting for age, gender, first composite VFQ score, treatment, and EMGT progression. Results: 229 of 255 EMGT patients completed the NEI-VFQ once; 165 completed it twice. Internal consistency reliability was high for the composite score (Cronbach α=0.90) and adequate for subscales(α≥0.73), except social function (α=0.59) and driving(α=0.27). At the first administration, visual impairment was mild; 70% had VA> 0.8 and mean MD was -2.3 (SD: 3.7) dB, both based on the better eye. For these cross-sectional analyses, lower VFQ scores were related to worse VF (VA or MD) for each VFQ subscale (other than general health and ocular pain) and for the composite score, based on separate logistic regression models (p= < 0.0001-0.03). Age, gender, progression and treatment assignment were not consistently associated with NEI-VFQ scores in these models. There was a small but significant (p<0.0001) decrease in the mean composite VFQ score between visits of -2.5 (SD:8.1) (range: -46.2-16.7). Longitudinal changes were associated with decreased VA (p=0.02) and were more marked in women (p=0.007), but were not consistently associated with the other covariates. Conclusions: Vision-related quality of life, as measured by the NEI-VFQ, was related to VF in the better eye (VA or MD), but not to treatment assignment in EMGT patients. Over time, women showed more of a decrease in composite VFQ scores than men.
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