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Sheryl S Wizov, Michael Waisbourd, Clinton Jordan, Eric Shiuey, Lauren Gianchetti, Judie Tran, Carina Sanvicente, George L Spaeth; Fall Risk in Moderate Glaucoma. Invest. Ophthalmol. Vis. Sci. 2018;59(9):5186.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate factors related to the occurrence of falls in people with moderate glaucoma. Falls are a significant public health concern due to high associated costs and numbers of reported injuries and fatalities.
Patients diagnosed with moderate glaucoma were prospectively examined at a baseline (n=161) visit and 4 annual follow-up visits. Examinations assessed visual acuity, visual field, and contrast sensitivity. Compressed assessment of ability related to vision (CAARV) was used to track performance-based visual function, and the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) measured vision-related quality of life (QoL). Number of falls and broken bones over the past year or during the time between each visit were recorded. The percentage of patients with falls and the number of falls were summarized by visit. Linear growth models for zero-inflated Poisson data were fit using Mplus version 8.
In our cohort, the overall probability of having no falls increased over time (72.2% in visit 1 to 81.3% in visit 5), but among those who had falls, the mean number of falls increased over time (2.5 in visit 1 to 6.2 in visit 5). Mean deviation (MD) in the better eye was associated with higher likelihood of having zero falls at visit 1 (odds ratio [OR]=1.42; p<0.001) but this effect decreased over time (OR=0.90; p=.003). Among the patients who suffered falls, a higher difference between eyes in visual field MD (incidence rate ratio [IRR]=1.17; p=0.009), difference in visual acuity (IRR=1.62; p=0.018), and difference in contrast sensitivity as measured by the Spaeth/Richman Contrast Sensitivity test (SPARCS) (IRR=1.86; p=0.026) were all associated with an increased risk of falls. None of the topical medications used for the treatment of glaucoma were associated with an increased risk of falls.
Visual impairment, especially increasing difference between the two eyes of the same person in visual field, visual acuity, or contrast sensitivity was associated with a significant increase in the number of falls suffered by individuals with moderate visual loss due to glaucoma. Education of physicians and patients may help prevent falls in patients with glaucoma.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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