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Denise Pensyl, Suchitra Katiyar, Nimesh Bhikhu Patel, Michael Sullivan-Mee; Influence of unilateral versus bilateral 10-2 and 24-2 glaucomatous visual field loss on vision-related quality of life. Invest. Ophthalmol. Vis. Sci. 2019;60(9):2456. doi: https://doi.org/.
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To compare vision-related quality of life (Vr-QOL) scores in subjects with unilateral versus bilateral glaucomatous visual field (VF) loss.
All subjects were participating in a longitudinal glaucoma research study at the Albuquerque VA Medical Center and diagnosed either 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 while GS subjects had ocular hypertension and/or optic nerve appearances suspicious or consistent with glaucoma but no repeatable VF loss. Presence of VF loss was defined by standard cluster criteria, was reproducible on at least 3 tests, and had corresponding structural compromise (clinically and/or with SD-OCT imaging). Subjects with acuity worse than 20/25, greater than mild lens opacity, and vision loss due to non-glaucomatous conditions were excluded. Vr-QOL was measured using the NEI-VFQ-25, and all subjects completed 24-2 and 10-2 VF testing within 6 months of survey completion. Relationships between cumulative Vr-QOL scores and VF metrics were investigated using pair-wise tests and linear regression analyses.
Our sample included 111 POAG (105 with 24-2 VF loss and 93 with 10-2 VF loss) and 75 GS subjects. Cumulative Vr-QOL score (median [IQR]) was significantly lower in POAG (88.8 [81.0,94.5]) versus GS (93.4 [88.4,95.8], p<0.001). Vr-QOL score was similar (range: 91.9 to 93.4) in the following groups: no VF loss (n=75), monocular 10-2 VF loss (n=6), monocular 24-2 VF loss (n=14), and monocular 10-2 and 24-2 VF loss (n=38). Conversely, Vr-QOL was reduced when binocular 24-2 VF loss with monocular 10-2 VF loss was present (87.7 [83.8,92.8], n=22) and markedly reduced with binocular 24-2 and 10-2 VF loss (78.0 [70.2,86.7], n=25). Vr-QOL was higher when 24-2 VF loss was present in one versus both eyes; 10-2 VF loss demonstrated the same pattern.
Monocular VF loss, regardless of whether characterized by 24-2, 10-2, or a combination of 10-2 and 24-2 VF loss, did not significantly impact Vr-QOL score in this study. Conversely, Vr-QOL score was most reduced when subjects had 24-2 and 10-2 VF loss in both eyes. These results suggest that preservation of better-eye vision and prevention of binocular VF loss is an important goal for glaucoma management.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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