September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Is Vision-Related Quality of Life Impaired in Patients with Preperimetric Glaucoma?
Author Affiliations & Notes
  • Roberta Andrade e Nascimento
    Laboratory of Performance and Visual Function, Department of Ophthalmology, University of California San Diego , La Jolla, California, United States
    Department of Ophthalmology, Federal University of São Paulo, São Paulo, São Paulo, Brazil
  • Carolina Pelegrini Gracitelli
    Laboratory of Performance and Visual Function, Department of Ophthalmology, University of California San Diego , La Jolla, California, United States
    Department of Ophthalmology, Federal University of São Paulo, São Paulo, São Paulo, Brazil
  • Alberto Diniz-Filho
    Laboratory of Performance and Visual Function, Department of Ophthalmology, University of California San Diego , La Jolla, California, United States
  • Linda M Zangwill
    Laboratory of Performance and Visual Function, Department of Ophthalmology, University of California San Diego , La Jolla, California, United States
  • Robert N Weinreb
    Laboratory of Performance and Visual Function, Department of Ophthalmology, University of California San Diego , La Jolla, California, United States
  • Augusto Paranhos Jr.
    Department of Ophthalmology, Federal University of São Paulo, São Paulo, São Paulo, Brazil
  • Felipe A Medeiros
    Laboratory of Performance and Visual Function, Department of Ophthalmology, University of California San Diego , La Jolla, California, United States
  • Footnotes
    Commercial Relationships   Roberta Nascimento, None; Carolina Gracitelli, None; Alberto Diniz-Filho, None; Linda Zangwill, Carl Zeiss Meditec Inc. (F), Heidelberg Engineering GmbH (F), Optovue Inc. (F); Robert Weinreb, Alcon (C), Allergan (C), Amateck (C), Bausch & Lomb (C), Carl Zeiss Meditec (C), Carl Zeiss Meditec (R), Forsight (C), Genentech (R), Heidelberg Engineering (R), Konan (R), National Eye Institute (R), Neurovision (R), Optovue (R), Quark (R), Reichert (R), Tomey (R), Topcon (C), Topcon (R), Valeant (C); Augusto Paranhos Jr., None; Felipe Medeiros, Alcon Inc (C), Alcon Inc (F), Allergan Inc (F), Allergan Inc (R), Allergan Inc (C), Baush & Lomb (F), Carl Zeiss Meditec Inc (F), Carl Zeiss Meditec Inc (C), Carl Zeiss Meditec Inc (R), Heidelberg Engineering Inc (F), Merck Inc (F), National Eye Institute (F), Novartis (C), Reichert Inc (R), Sensimed (F), Topcon (F)
  • Footnotes
    Support  National Institutes of Health/ National Eye Institute grant EY021818 (FAM), EY025056 (FAM), core grant P30EY022589; an unrestricted grant from Research to Prevent Blindness (New York, NY); fellowship from Brazilian National Council for Scientific and Technological Development (CNPq) 233829/2014-8 (ADF); fellowship from Brazilian Nacional Research Council - CAPES 12309-13-3 (CPBG)
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 3908. doi:
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      Roberta Andrade e Nascimento, Carolina Pelegrini Gracitelli, Alberto Diniz-Filho, Linda M Zangwill, Robert N Weinreb, Augusto Paranhos Jr., Felipe A Medeiros; Is Vision-Related Quality of Life Impaired in Patients with Preperimetric Glaucoma?. Invest. Ophthalmol. Vis. Sci. 2016;57(12):3908.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Previous studies have shown that patients with glaucomatous visual field loss may show significant loss in vision-related quality of life (QoL). However, many patients may develop structural glaucomatous damage before visual field loss is detectable and it is uncertain whether this might be associated with loss in QoL. The purpose of this study was to investigate vision-related QoL in patients with preperimetric glaucoma.

Methods : The study included 19 patients with preperimetric glaucoma and 176 control subjects. All patients had normal results on standard automated perimetry in both eyes at the time of QoL assessment and were also tested with spectral-domain optical coherence tomography (SDOCT). Preperimetric glaucoma was defined based on the presence of statistically significant decreased retinal nerve fiber layer (RNFL) thickness, with SDOCT average RNFL thickness with P<5% in at least 1 eye. Patient-reported QoL was assessed by the National Eye Institute Visual Function Questionnaire (NEI VFQ-25) and item response theory analysis was performed to obtain a summary score representing questionnaire responses. QoL scores of patients with preperimetric glaucoma were compared to those of control subjects after adjustment for potentially demographic and socio-economic confounding factors.

Results : Mean age was similar in the preperimetric and control groups (64.7±9.7 years vs. 60.7±9.9 years, respectively; P=0.088). SAP MD of the better eye was 1.11±0.8 dB vs. 0.84±0.69 dB, respectively (P=0.121). Global average RNFL thickness of the better eye was 78.2±8.6 μm vs. 96.9±9.8 μm, respectively (P<0.001). There was no significant difference in NEI VFQ-25 scores between the preperimetric and control groups (0.15±0.80 units vs. -0.09±0.87 units, respectively; P=0.263). When, the model was adjusted for confounding factors, diagnosis (preperimetric or not) remained non-significant (P=0.977).

Conclusions : There was no significant difference in vision-related QoL as measured by the NEI VFQ-25 questionnaire in patients with preperimetric glaucoma compared to healthy subjects. This finding suggests that some patients with glaucoma may have significant loss of RNFL detectable by SDOCT before development of significant functional limitations.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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