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Michael Sullivan-Mee, Denise Pensyl, Suchitra Katiyar, Nimesh Bhikhu Patel; Does 10-2 visual field loss impair vision-related quality of life in early-stage glaucoma ?. Invest. Ophthalmol. Vis. Sci. 2019;60(9):1783. doi: https://doi.org/.
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To investigate the influence of 10-2 visual field (VF) loss on vision-related quality of life (Vr-QOL) in early glaucoma.
All subjects were participating in a longitudinal glaucoma research study at the Albuquerque VA Medical Center and were diagnosed primary open-angle glaucoma (POAG) or glaucoma suspect (GS). POAG subjects had glaucomatous optic neuropathy with corresponding VF loss on 24-2 and/or 10-2 achromatic threshold testing in at least one eye. GS subjects had ocular hypertension and/or optic nerve appearances that were suspicious or consistent with glaucoma but no repeatable VF loss. Exclusion factors included best corrected visual acuity worse than 20/25, greater than mild lens opacity, and vision loss due to non-glaucomatous conditions. Presence of VF loss was defined by standard cluster criteria, was reproducible on at least three VF tests, and required corresponding structural compromise (by clinical exam and SD-OCT imaging). Hodapp-Parrish-Anderson criteria were used to classify each eye’s 24-2 visual field loss, and only subjects with no or mild 24-2 VF loss in the better eye were included in this investigation. Vr-QOL was measured using the NEI-VFQ-25, and all subjects completed 24-2 and 10-2 VF testing within 6 months of completing that survey. Relationships between cumulative Vr-QOL scores and VF metrics were investigated using pair-wise tests and linear regression analyses. Central tendency data was expressed as median [IQR].
We studied 75 GS subjects (24-2 and 10-2 MD: -0.33 [-1.25,0.41] and -0.19 [-0.82,0.43]) and 91 early POAG subjects (24-2 and 10-2 MD: -2.56 [-4.46,-1.20] and -1.46 [-3.23,-0.43]). In POAG subjects (85 with 24-2 VF loss and 73 with 10-2 VF loss), Vr-QOL was significantly lower (89.8 [83.7,95.0]) versus GS subjects (93.4 [88.4,95.8], p=0.001). While Vr-QOL scores were not significantly different between subjects with no VF loss (n=75), monocular 10-2 VF loss (n=6), and monocular 10-2 and 24-2 VF loss (n=38), Vr-QOL was reduced when monocular 10-2 VF loss and bilateral 24-2 VF loss were present (n=21) and when 10-2 and 24-2 VF loss were present in both eyes (n=6).
10-2 VF loss did not impair Vr-QOL in our early glaucoma subjects until both eyes had 10-2 VF loss. Because 10-2 VF loss in early glaucoma is largely mild and monocular, these results suggest that 10-2 VF testing may be of limited value for early glaucoma staging.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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