Abstract
Purpose :
To investigate the relationship between longitudinal changes in fear of falling and quality of life with severity of visual field (VF) damage in glaucoma.
Methods :
Data was gathered during the Falls In Glaucoma Study (FIGS) - a three-year-long, prospective cohort study conducted at the Johns Hopkins Wilmer Eye Institute. Visual field (VF) data was collected at the baseline for each eye separately and combined to create integrated VF (IVF) sensitivity. Fear of falling (FoF) and Quality of life (QoL) were assessed annually at baseline and follow-up visits using the standardized questionnaires, with lower Rasch-analyzed composite scores indicating less fear or better QoL, respectively. Patients were categorized by severity of IVF damage at baseline as: normal/mild (IVF, >28 dB), moderate (IVF, 23-28 dB), or severe (IVF, <23 dB). Change rates over time for FoF and QoL were derived from models utilizing generalized estimating equations and adjusting for age, race, sex, living arrangement, education, comorbidity, and polypharmacy.
Results :
The analysis included 244 individuals. On average, participants were 71 years of age, half (49%) were female and third (29%) were Black. Across the three years of observation, increased FoF and the worse QoL were observed in patients with normal/mild and moderate IVF damage (β=0.07 logits/year, β=0.05 logits/year, β=0.06 logits/year, β=0.05 logits/year, p<0.01 for all, respectively), but did not change in patients with severe damage. Overall, over time those with moderate IVF damage reported significantly worse QoL (β=0.43 logits, p<0.001), while those with severe IVF damage reported significantly higher FoF and worse QoL compared to those with normal/mild IVF damage (β=0.54 logits and β = 1.48 logits, respectively, p<0.01 for all). No differences in the longitudinal change in FoF and QoL over time were noted for those with severe or moderate IVF damage compared to those with normal/mild IVF damage (p>0.05 for all).
Conclusions :
Patients with mild and moderate IVF damage exhibited deterioration in QoL as well as increased FoF over time, while for those with severe IVF damage poor QoL and high FoF remained throughout the study. Further studies are needed to evaluate these relationships and find ways in which QoL can be improved and FoF reduced for those with IVF damage and especially in those with severe damage.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.