Abstract
Purpose: :
To assess the relationship between structural alterations in the peripapillary retinal nerve fibre layer (RNFL) in patients with glaucoma and their functional impact on glaucoma specific health-related quality of life (hr-QoL).
Methods: :
Patients with glaucomatous optic neuropathy underwent the following examinations: spectral-domain optical coherence tomograpy (SD-OCT) of the peripapillary RNFL, standard automated perimetry (SAP), Goldman applanatory intraocular pressure (IOP) and a complete ophthalmological examination. Glaucoma specific hr-QoL was assessed using the German version of the Glaucoma Quality of Life 15-item questionnaire (GQL-15). The relationship between functional and structural impairment was determined using a modified GQL-15 analysis (range 0 -100), SAP parameters mean defect (MD) and pattern standard deviation (PSD), IOP and SD-OCT parameters for normality/borderline/abnormality from database deviations as well as total nerve fibre layer thickness for each sector.
Results: :
Fourty-one patients were included. MD for the better eye was mean -3.70+/-5.06 SD and -6.05+/-5.04 for the worse eye. The logarithmic values of GQL-15 mean score (79.92+/-16.86) showed significant correlations with the MD for the better eye (Spearman-Rho 0.408, p=0.013). PSD was not correlated. One way ANOVA revealed a significant relationship between logGQL-15 and SD-OCT absolute nerve fibre thickness and SD-OCT classification in the nasal sector of the better eye (p<0.0001 and 0.035, respectively) and between logGQL-15 and the OCT-classification in the temporal-inferior sector of the worse eye (p=0.009). The other sectors or the global value/classification revealed no significancy, neither did IOP or visual acuity.
Conclusions: :
Patients with glaucoma report a reduced hr-QoL assessed with the GQL-15, that is correlated with the MD of the better eye. Structural parameters assessed by SD-OCT associated with diminished hr-QoL are the nasal sector of the better eye and the temporal inferior sector of the worse eye. The findings may help to understand, which regions of glaucomatous damage have most important influence in quality of life in patients with glaucoma.
Keywords: quality of life • nerve fiber layer • visual fields