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Vijaya Gothwal, Sujata Sharma, Anil K Mandal; Beyond Intraocular Pressure: Visual Ability and Vision-related Quality of Life in Childhood Glaucoma . Invest. Ophthalmol. Vis. Sci. 2019;60(9):1766.
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To evaluate the visual ability (VA) and vision-related quality of life (VRQoL) of children treated for childhood glaucoma (CG).
In this cross-sectional study, 309 children (mean age, 12.4 yrs; 62% male) with treated primary or secondary CG (mean duration, 9.0 years) completed the 23-item L V Prasad Functional Vision Questionnaire –II (LVP-FVQ-II) as measure of VA and the 24-item Impact of Vision Impairment- Children (IVI-C) questionnaire as measure of VRQoL during their routine clinic visit. We investigated measurement properties of LVP-FVQ II and IVI-C questionnaire using Rasch analysis and generated interval-level estimates of VA and VRQoL respectively. Main outcome measures were VA and VRQoL (Rasch-derived scores). Predictors of VA and VRQoL were assessed using multivariable linear regression analyses adjusting for potential sociodemographic variables.
Majority (80%) of children had bilateral CG and had filtering surgery (83%) for control of intraocular pressure (IOP). 53% had primary CG and were diagnosed < 3 years of age. Mean (SD) better eye visual acuity (logMAR) was comparable between primary CG (0.49 [0.49]) and secondary CG group (0.52 [0.49]) (p>0.05). Mean last visit IOP was <20 mmHg in all the children over mean (SD) follow-up of 8.9 (4.5) years. 64% of children did not require medication for IOP control. Rasch analysis suggested minor modifications in IVI-C in order to obtain a psychometrically robust unidimensional 16-item IVI-C questionnaire. However, LVP-FVQ II demonstrated acceptable psychometric properties in its native form. Children with primary CG reported significantly better VA and VRQoL than secondary CG (mean difference = 0.82, p=0.002 for VA; mean difference = 0.39, p=0.001 for VRQoL). The adjusted model showed that worse logMAR visual acuity in better-seeing eye and secondary CG were significantly associated with worse VRQoL scores (P<0.05). Worse logMAR visual acuity in better-seeing eye, secondary CG, and bilateral CG were associated with worse VA scores (P<0.05).
With comparable visual acuities, children with primary CG reported significantly better VA and VRQoL that those with secondary CG. Interventions to enhance visual acuity may be effective in improving the VA and VRQoL of children with CG. It may be valuable to include assessments of VA and VRQoL in treatment process of CG.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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