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R. McKean-Cowdin, R. Varma, Y. Wang, J. Wu, S. Azen, LALES Group; Impact of Visual Field Loss on Health Related Quality of Life in Glaucoma Participants. The Los Angeles Latino Eye Study (LALES). Invest. Ophthalmol. Vis. Sci. 2007;48(13):1560.
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© ARVO (1962-2015); The Authors (2016-present)
To examine the association between self-reported, health related quality of life (HRQOL) and visual field loss (VFL) in participants with glaucoma in The Los Angeles Latino Eye Study (LALES).
Participants in LALES - a population-based prevalence study of eye disease in Latinos residing in Los Angeles, CA - underwent a detailed eye examination including an assessment of their visual field (VF) using the Humphrey Automated Field Analyzer (SITA Standard 24-2). Open-Angle Glaucoma (OAG) was determined by clinical examination; VF test results and optic disc photographs were independently reviewed by 2 glaucoma specialists. Mean Deviation (MD) scores were used to assess severity of VFL both as a continuous variable and stratified by severity: no VFL (MD≥-2 decibels [dB]), mild VFL (-6dB<MD<-2dB), moderate/severe VFL (MD<-6dB). HRQOL was assessed by the Medical Outcomes Study 12-Item Short-Form Health Survey (SF-12) and the National Eye Institute Visual Function questionnaire (NEI-VFQ-25). Linear regression and analysis of covariance were used to assess the relationship between HRQOL scores and VFL. Models were adjusted for age, gender, employment status, income, acculturation, co-morbidities, health insurance, vision insurance, and visual acuity.
The analyses include 218 participants identified with OAG; 93 (43%) had no VFL, 106 (49%) and unilateral or bilateral peripheral VFL, 6 (3%) had central VFL, and 13 (6%) had unilateral or bilateral central and peripheral VFL. A monotonic decreasing trend was observed between VFL and most NEI-VFQ-25 subscale scores and the SF-12, such that glaucoma participants with severe VFL had lower QOL scores than participants with no VFL. Persons with VFL had the greatest difficulty with driving activities, dependency, role function and mental health. A 3 dB difference in VFL was associated with a clinically meaningful 5 point difference in the NEI-VFQ driving subscale. Glaucoma participants with central and peripheral VFL had lower HRQOL scores than individuals with only peripheral or no VFL, however these differences were statistically significant only for driving tasks.
Loss in HRQOL scores for glaucoma participants was present in people with mild VFL and continuing through moderate/severe VFL. This relationship applies to most NEI-VFQ-25 subscales and the SF-12. These data suggest that prevention of early VFL in persons with glaucoma is important in preventing a worsening in HRQOL.
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