Purpose:
To evaluate the relationship between tests of peripheral and central visual function with quality of life (QoL) in patients with advanced to severe glaucomatous field loss and relative good central visual acuity (VA).
Methods:
41 glaucoma patients with advanced to severe field loss (modified Hodapp-Anderson-Parrish criteria, Mills RP et al., 2006), a mini-mental score > 23, and best-corrected VA of 20/60 or better were enrolled. Patients completed the NEI VFQ-25, Glaucoma Symptom Scale (GSS), Life Space Assessment (LSA), and Depression Scale (CES-D) questionnaires (all in interviewer-administered formats), and MR reading test. A complete ophthalmologic examination was done, and the following tests were performed: Contrast Sensitivity (Pelli-Robson), SITA 24-2, SITA 10-2 and Fine Matrix Mapping (FMM, central 10°) white-on-white visual fields on Humphrey perimetry, FDT-Matrix 10-2 field, and steady-state pattern electroretinogram (PERG). Correlations were evaluated between these measures of visual function and QoL including reading test results. Partial correlations coefficients (adjusted for potential confounding effects from age, LogMAR VA, CES-D, and number of chronic conditions) were obtained. Data from one eye per patient were included in the analysis (α = 0.05, 2-tailed).
Results:
After adjustment, measures of central visual field sensitivity correlated with reading test (critical print size), LSA, and VFQ-25 general health and composite scores. GSS did not show significant correlations.
Conclusions:
Measures of central visual field correlated better with quality of life scores than measures of peripheral function in patients with severe to advanced glaucoma. Fine Matrix Mapping perimetry showed highest correlations. Measurements of the central visual field along with tests of reading rather than standard visual fields may be a better method to monitor glaucomatous damage in patients with advanced stage of the disease.
Keywords: quality of life • visual fields • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)