June 2020
Volume 61, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2020
Relationships Between Vision-Related Performance, Vision-Related Quality of Life, Clinical Findings, and Symptom Stage in Patients with Glaucoma
Author Affiliations & Notes
  • Eric J Shiuey
    Sidney Kimmel Medical College, Philadelphia, Pennsylvania, United States
  • Benjamin E Leiby
    Division of Biostatistics, Department of Pharmacology and Experimental Therapeutics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
  • Sheryl S Wizov
    Glaucoma Research Center, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Carina Sanvicente
    Emory Eye Center, Emory University, Atlanta, Georgia, United States
  • Michael Waisbourd
    Department of Ophthalmology, Tel Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Israel
  • George Spaeth
    Glaucoma Research Center, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Footnotes
    Commercial Relationships   Eric Shiuey, None; Benjamin Leiby, None; Sheryl Wizov, None; Carina Sanvicente, None; Michael Waisbourd, None; George Spaeth, 8,042,946 (P)
  • Footnotes
    Support  Merck Sharp & Dohme Corp. IISP #39138
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 1935. doi:
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      Eric J Shiuey, Benjamin E Leiby, Sheryl S Wizov, Carina Sanvicente, Michael Waisbourd, George Spaeth; Relationships Between Vision-Related Performance, Vision-Related Quality of Life, Clinical Findings, and Symptom Stage in Patients with Glaucoma. Invest. Ophthalmol. Vis. Sci. 2020;61(7):1935.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To examine associations between clinical visual measurements, vision-related performance (VRP), and vision-related quality of life (VRQoL) in patients with glaucoma.

Methods : This 4-year, prospective cohort study recruited patients with moderate-stage glaucoma seen at the Wills Eye Hospital Glaucoma Service between May 2012 and May 2014. Patients received a complete ocular exam, automated visual field (VF) test, and spectral domain optical coherence tomographic scan. Contrast sensitivity was measured using the Pelli-Robson (PR) and Spaeth-Richman Contrast Sensitivity (SPARCS) tests. VRP was assessed with the Compressed Assessment of Ability Related to Vision (CAARV). VRQoL was assessed using the National Eye Institute Visual Function Questionnaire 25 (VFQ-25) and a modified Glaucoma Symptom Scale (MGSS). Patients were staged using the MGSS (symptomatic <85) and presenting clinical “warning signs” (intraocular pressure [IOP] >30 mmHg, IOP difference between eyes >5 mmHg, mean deviation [MD] <-5 dB, SPARCS score <70, retinal nerve fiber layer thickness [RNFLT] <70 μm). Mixed effects models were used to estimate rate of change of each variable over time for each subject and ordinal mixed effects logistic regression was used to assess associations between variables and stage.

Results : A total of 161 patients were enrolled. Annual change in CAARV variables were strongly correlated with change in bilateral visual acuity (VA) (r=0.71), SPARCS score in the better eye (r=0.61), and PR CS (r=0.47) (all p<0.0001). Change in RNFLT and VF MD did not correlate strongly with any VRP or VRQoL measures. Worse symptom stage was associated with worse VA in the better eye (odds ratio [OR]=1.26, 95% confidence interval [CI] 1.03-1.53, p=0.023), larger SPARCS score difference between eyes (OR=1.35, 95% CI 1.05-1.72, p=0.017), lower total CAARV score (OR=1.17, 95% CI=1.05-1.30, p=0.006), and lower VFQ-25 score (OR=3.23, 95% CI 2.46-4.24, p<0.001). Greater difference between eyes in RNFLT, MD, and logMAR did not significantly influence symptom stage.

Conclusions : In patients with glaucoma, performance-based tests correlate strongly with clinical variables, especially contrast sensitivity. VFQ-25, SPARCS, CAARV score, and logMAR were significant predictors of worse symptom stage. Contrast sensitivity, VRQoL, and VRP may be useful in evaluating patients with glaucoma.

This is a 2020 ARVO Annual Meeting abstract.

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