A Longitudinal Analysis of the Impact of Glaucoma on Performance in Daily Life.

Abstract

Purpose : Current glaucoma research lacks longitudinal studies that combine clinical evaluations, patient perceptions of symptoms and quality of life (QoL), and performance-based function evaluations. We performed a four year, prospective, observational, clinical study to evaluate data from these three domains. This analysis focuses on patients’ subjective self-reported outcomes in patients diagnosed with glaucoma, specifically using the National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25) and its subscales.

Methods : The study collected participant measurements for clinical, QoL, and performance-based measures in yearly visits over four years. The investigators recruited patients who had a minimum 2-year diagnosis of primary open-angle glaucoma or chronic closed-angle glaucoma at a moderate-stage, as defined by the Disc Damage Likelihood Scale between 5-8 in at least one eye. During each visit, best corrected visual acuity (BCVA), intraocular pressure (IOP), visual field, objective performance-based measures, and subjective QoL measures were collected. The NEI VFQ-25 was used to measure subjective QoL. The NEI VFQ-25 is a 42-question exam (with 25 primary questions) evaluating participant vision and their emotions experienced with limited vision. The NEI VFQ-25 composite and twelve subscales can be viewed in Table 1.

Results : The NEI VFQ-25 composite dropped -2.05 points over the 4-year span (95% CI (-3.65, -0.45), p=0.012). Only three of the NEI VFQ subscales had a significant drop: near activities -3.27 (95% CI (-5.43, -1.10), p = .003), distance activities -1.94 (95% CI (-3.86, -0.01), p = .049 and role difficulties -2.93 (95% CI (-5.83, -0.04), p = .047). Over the 4-year span, there were also significant drops in visual acuity as well as performance based measures.

Conclusions : Although there was a significant drop in the NEI VFQ-25 composite and three of the subscales, there was no significance in the change of eye-related mental health. Further data needs to be collected regarding longitudinal eye-related mental health in glaucoma.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.