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Heather Livengood, Gadi Wollstein, Hiroshi Ishikawa, Mengfei Wu, Joel S Schuman; Association Between Task Performance and Structure-Function in Glaucoma. Invest. Ophthalmol. Vis. Sci. 2018;59(9):3412. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Glaucoma affects task performance, a measure of ability in the context of performing daily tasks. Task factors affected by glaucoma are not well characterized for practical ophthalmic application. This study identifies domains of task performance associated with structure-function measures in order to characterize task factors relevant in the context of glaucoma.
We recruited adults aged 50 years and older with glaucoma, with no other ocular comorbidities, who underwent ophthalmic evaluation. Eleven domains of task performance were analyzed (Table) using the standardized Assessment of Life Habits questionnaire to measure 1) ability to perform tasks (accomplishment, scale 0-10) and 2) satisfaction with task performance (satisfaction, scale 1-5). Better eye visual field mean deviation (MD) and OCT retinal nerve fiber layer (RNFL) and ganglion cell inner plexiform layer (GCIPL) average thickness were analyzed. Multivariable regression analyses determined the association between task performance and MD, RNFL, and GCIPL, adjusting for age, race, glaucoma and depressive symptoms. Depressive symptoms were in the models due to their known association with vision loss.
77 subjects of average age 68 ± 9.2 years and baseline MD of -3.7 ± 6.3 dB, RNFL of 76.1 ± 13.3 μm and GCIPL of 69.8 ± 10.7 μm were enrolled. Overall task performance scores were high (accomplishment 9.3 ± 0.6, satisfaction 4.5 ± 0.5). For accomplishment, MD, RNFL, and GCIPL were significant indicators for overall task performance scores (p < 0.001) and for ≥6 domains (p ≤ 0.028, Table). For satisfaction, RNFL was a significant indicator for overall task performance scores (p = 0.037). Unlike accomplishment, satisfaction was less associated with structure-function (3 domains across measures). Depressive symptoms were significantly associated with task performance (p ≤ 0.05) in all domains except communication.
Task performance affected by glaucoma is underrecognized in ophthalmic practice. Awareness of task performance accomplishment (ability) may be relevant in glaucoma more so than patients’ satisfaction. Satisfaction is a measure of patients’ perception and their reports often overestimate actual ability. Therefore, measuring accomplishment and its association with structure-function measures may guide future evaluation of those tasks most affected by glaucoma in order to enable timely treatment for task performance limitations.
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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