Impact of Glaucoma on Vision-Specific Functioning in An Asian Population

Abstract

Purpose: : To examine the impact of glaucoma on vision-specific functioning in an Asian population.

Methods: : The Singapore Malay Eye Study (SiMES) was a population-based, cross-sectional study of 3280 Malays (78.7% response rate) aged between 40 and 80 years. Glaucoma was assessed using the International Society of Geographical and Epidemiologic Ophthalmology (ISGEO) criteria. The glaucoma case identification strategy in SiMES established a subgroup with complete glaucoma evaluation comprising dilated optic disc examination, Goldmann applanation tonometry, gonioscopy and visual field testing on the Humphrey Automated Field Analyzer (SITA Standard 24-2). Glaucoma severity was scored on the modified Hodapp Anderson Parish criteria using Mean Deviation (MD) thresholds: none or minimal defect; early (MD>-6 dB); moderate (MD -6.01 to -12 dB); advanced (MD -12.01 to -20 dB); and severe (MD<-20.0 dB). Vision-specific functioning was determined with the modified Vision-Specific Functioning scale (VF-11) scale and validated using Rasch analysis.

Results: : Of 945 participants (mean age 57±11 years, 54.7% males) with complete glaucoma evaluations, 14.7% had glaucoma (5.6%, 3.6%, 2.8% and 2.4% with early, moderate, advanced and severe glaucoma). In multivariate linear regression models adjusting for age, gender, socioeconomic factors, glaucoma risk factors, non-glaucoma ocular and systemic conditions, and presenting visual acuity, the presence of glaucoma was independently associated with poorer vision-specific functioning [β, -0.27; p=0.04; 95% confidence interval (CI) -0.53, -0.01]. Patients with severe glaucoma had significantly poorer vision functioning (β, -0.86; p=0.039; 95% CI -1.67, -0.04) than those with earlier stages of glaucoma.

Conclusions: : Glaucoma, and particularly severe glaucoma, is associated with poorer vision-specific functioning independent of visual acuity. These findings reinforce the need for the detection and timely treatment of early stage glaucoma.

Keywords: quality of life • visual fields