Abstract
Purpose: :
While many have studied the impact of glaucoma on function in clinical research settings, documentation of real-life activity restriction has rarely been reported. Here we examine how travel outside the home is affected by glaucoma.
Methods: :
Glaucoma subjects with bilateral visual field loss and control subjects without significant central acuity deficits or visual field loss (as defined by standard automated perimetry) wore cellular network-based devices that tracked their spatial location over one week. Location data were used to calculate the number of daily excursions outside of the home for the two groups.
Results: :
62 subjects with glaucoma and 37 control subjects completed the study. Glaucoma subjects did not differ from control subjects in regard to age, race, gender, employment status or educational level (p>0.15 for all). Overall, 623 person-days of data were collected, with each participant yielding an average 6.3 +/- 1.6 days of tracking data. The range of average daily excursions was 0-5 with a median of 1.14 (IQR=0.7 -1.4), and glaucoma subjects took fewer average excursions per day than controls (median=1.00 vs. 1.33; p=.02). In multivariable models, glaucoma was associated with higher odds of being in the lowest tertile of excursions per day as compared to controls (OR=3.45, p=.014, 95% CI: 1.3-9.3). The odds of being in the tertile with the lowest excursion rate were 54% higher for every 5db of mean deviation loss (OR=1.54, p=0.018, CI: 1.08 - 2.19). The percentage of subjects with no excursions on a given day was 18.6% for controls and 28.2% for glaucoma subjects (p=0.007). Using a generalized estimating equation, glaucoma was associated with higher odds of not leaving the home on a given day (OR=1.7, p=0.077, CI: 0.94 - 3.1).
Conclusions: :
Bilateral glaucoma and greater visual field loss are both correlated with less travel outside of the home. Decreased out-of-home travel is associated with frailty, higher mortality, and less independence, pointing to a higher risk of specific health and quality of life impairments in glaucoma.
Keywords: quality of life • low vision • visual fields