Abstract
Purpose :
To characterize the High-Level Visual Functions(HLVF) of recognizing places and navigating through them in glaucoma subjects with bilateral visual field defects(VFD). We hypothesize that glaucoma subjects will have HLVF impairment that will impact specific vision related quality-of-life(VR-QoL) domains
Methods :
Glaucoma subjects(n=33) with bilateral VFDs and controls without field loss(n=17) were recruited. Inclusion criteria included Montreal Cognitive Assessment(MoCA) scores≥25, visual acuity≥20/40 and reliable, reproducible Humphrey Visual Field(HVF). All subjects completed previously validated computerized tasks of place recognition and navigation. VR-QoL was measured using National Eye Institute Visual Function questionnaire and generic QoL was measured using SF-36 questionnaire. Statistical significance was noted at p≦0.05
Results :
There was no significant difference in age, MoCA, race or gender between groups. Binocular VFI was 74.5%±18.3 for glaucoma and 98.2%±1.7 for controls. Glaucoma subjects were significantly impaired in tasks of recognizing places(p=0.04) and navigating through them(p<0.001) compared to controls(fig 1). Binocular VFI correlated significantly with place recognition(r=0.40) and navigation scores(r=0.59)(fig 2) Glaucoma subjects compared to controls, reported significantly lower composite VR-QoL scores and lower scores in general vision, dependency and peripheral vision while no difference was noted in generic QoL. Place recognition scores significantly correlated with VR QoL domains of composite score(r=0.3), general health(r=0.4) and general vision(r=0.3). Navigation scores significantly correlated with composite score(r=0.5), general health(r=0.3), general vision(r=0.5), near activities(r=0.4), distance activities(r=0.4), mental health(r=0.4), dependency(r=0.3), driving(r=0.4) and peripheral vision(r=0.5). On linear regression, task scores for navigation were a better predictor of composite VR-QoL scores than binocular VFI, place recognition, age, or MoCA
Conclusions :
Glaucoma subjects had impairments in place recognition and navigation compared to controls. Specific HLVF impairments impacted specific QoL domains. Scores on the navigation task had a larger impact than binocular VFI on VR-QoL and could serve as a valuable endpoint in clinical trials
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.