Abstract
Purpose :
To evaluate the impact of previous pharmacological and/or surgical treatments on quality of life (QoL) in a population of primary open-angle glaucoma (POAG) patients.
Methods :
Italian, multicenter, observational study. Demographic characteristics, medical history, clinical presentation and treatments of patients affected by POAG were collected in 21 academic and non-academic glaucoma centers in Italy. Vision-related QoL was investigated with the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25), and glaucoma symptoms were evaluated with the Glaucoma Symptom Scale (GSS) questionnaire. The influence of glaucoma treatments on QoL was investigated using general linear models and logistic models, adjusted for demographic and clinical characteristics.
Results :
Two thousand five hundred seventy-seven glaucoma patients were included in the analysis. Among them, 2153 patients (81%) had only pharmacological treatment (only pharmacological group), 424 (16%) had both pharmacological and surgical treatment (pharmacological and surgical group), and 76 (3%) had only surgical treatment (only surgical group). The only pharmacological group showed better vision-related QoL in comparison with the pharmacological and surgical group (significant scores: GSS Func-4, 8 of the 12 NEI-VFQ-25 subscores and NEI-VFQ-25 total score) (Fig. 1). Only surgical group was linked to higher values of NEI-VFQ-25 General Health score (p=0.03), when compared with the pharmacological and surgical group (Fig. 1). For subjects taking at least one drug, number of medications (1, 2, 3 or more) negatively impacted QoL. Taking 3 or more medications vs. 1 medication had a negative effect on all the GSS scores, on 9 NEI-VFQ-25 subscores and on NEI-VFQ-25 total score. Interaction between the number of medications and the type of treatment was significant for three QoL scores, i.e. GSS Func-4 (p<0.01), NEI-VFQ-25 Ocular pain (p<0.01) and NEI-VFQ-25 Driving (p=0.04) (Fig. 2). For these scores, the negative impact on QoL of the increase in the number of medications was greater for patients with a previous surgery.
Conclusions :
Surgical treatment and number of topical medications negatively impacted vision-related QoL. In patients with a previous surgery, the increase in the number of medications may cause an important drop in QoL.
This is a 2020 ARVO Annual Meeting abstract.