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J. Richman, L. Lorenzana, G. L. Spaeth; The Relationship of Quality of Life With Disability and Various Aspects of Reduced Vision in Patients With Glaucoma. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1181. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To determine how glaucoma patients’ self-reported quality of life relates to their ability to perform tasks of daily living and to clinical measures of vision.
In a prospective, observational, case-control study, 194 glaucoma patients aged 24-93 with a full range of visual loss were evaluated subjectively by a vision-specific quality of life indicator, the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25). The NEI-VFQ-25 scores were compared with a novel, third-generation performance-based measure titled "The Assessment of Disability Related to Vision" (ADREV). The quality of life scores were also compared to clinical tests of visual function including visual acuity, visual fields, contrast sensitivity, stereopsis, and the Disc Damage Likelihood Scale.
None of the clinical tests correlated strongly with the NEI-VFQ-25 scores (mean defect of both eyes (r = 0.571), the binocular visual acuity (r = -0.502), and the Pelli-Robson contrast sensitivity (r = 0.501) had the highest correlations). The NEI-VFQ-25 scores had a correlation of 0.605 with the ADREV scores. The ADREV scores had stronger correlations than the NEI-VFQ-25 scores for the mean defect of both eyes (r = 0.661), the binocular visual acuity (r = -0.815), and the Pelli-Robson contrast sensitivity (r = 0.798). Of the ADREV tasks, entering numbers on a calculator (r = 0.556), recognizing facial expression (r = 0.544), and finding objects around a room (r = 0.541) had the best correlations with the NEI-VFQ-25. Following a prescribed obstacle walking course (r = 0.268) and reading in differing amounts of illumination (r = 0.345) had the worst correlations with the NEI-VFQ-25.
Among glaucoma patients, the NEI-VFQ-25 scores had weaker relationships with each of the traditional clinical indicators of visual function than the ADREV scores. As subjective tests, the scores of vision-specific questionnaires appear to be influenced by factors besides ocular disease such as personality, emotion, and desire to please. Performance based measures such as ADREV may be a better way of assessing how glaucoma affects people’s daily lives than the current vision specific quality of life questionnaires.
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