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Chad Hochberg, Eugenio Maul, Emilie Chan, Luigi Ferrucci, David S. Friedman, Pradeep Y. Ramulu; Visual Field Loss and Travel Outside of the Home in Glaucoma. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5554.
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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.
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.
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).
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.
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