Glaucoma reduces vision-related quality of life: results from the population-based Gutenberg Health Study

Abstract

Purpose : Glaucoma patients suffer from visual field defects and ultimately blindness due to progressive loss of retinal nerve fibers. It is one of the leading causes of visual impairment in developed countries. The aim of this study is to determine the relationship between glaucoma and vision-related quality of life (VRQoL) and to explore associated factors of VRQoL in participants with glaucoma.

Methods : Participants in the population-based prospective observational cohort study (Gutenberg Health Study) underwent an ophthalmological examination including optic nerve head photography, intraocular pressure (IOP) measurement and a screening visual field exam between 2007-2012. Optic nerve head photographs were graded and classified according to the modified “International Society of Geographical and Environmental Ophthalmology” (ISGEO) glaucoma classification including adjustment for optic disc size. History of glaucoma or ocular hypertension (OHT) was defined as an ongoing prescription of IOP lowering medication or a history of glaucoma surgery. VRQoL was quantified using the German version of the Visual Function Questionnaire-25 and the Rasch-transformed visual functioning scale (VFS) was computed. A priori defined multivariable quantile regression models were carried out to analyze relationships.

Results : A total of 10,075 enrolled participants had both glaucoma grading and VRQoL investigation and were included in the study. Of these, 108 (1.1%) had glaucoma based on the ISGEO classification and 226 (2.2%) had a history of glaucoma or OHT. Glaucoma was associated with a significantly reduced VFS in both, participants with treatment (-8.14 [ 95% CI, -11.00 - -2,79]; P=0.005) and without treatment (-5.53 [ 95% CI, -8.31- -2.80]; P <0.001) compared to participants without glaucoma. IOP treatment without an ISGEO glaucoma diagnosis, such as in OHT, was also associated with a reduction on the VFS (-2.71 [95% CI, -5.39 - -0.01]; P=0.046).
Within participants with glaucoma impaired visual acuity of the better seeing eye (-5.62 [95% CI, -9.16 - -3.63] per each 0.1 on the logMAR chart; P=0.020) was associated with lower VFS, whereas history of glaucoma surgery, glaucoma medication use, IOP, size of the visual field defect, and family history of glaucoma were not associated with VFS.

Conclusions : Glaucoma is a common eye disease that reduces VRQoL.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.