Abstract
Purpose :
To evaluate long-term vision-related quality of life (QoL) change outcomes in primary open angle glaucoma (POAG) patients identified as progressors over a short 6-month interval using a clustered testing approach.
Methods :
This was a prospective cohort study with POAG patients. Subjects underwent two sets of 5 weekly visits (clusters) separated by an average of 6 months, then were followed with single visits every 6 months for an overall mean follow-up of 33 months. Each visit consisted of 24-2 standard automated perimetry (SAP) and peripapillary optical coherence tomography (OCT) tests. Subjects were classified as progressors based on statistically significant (P<0.05) negative slopes for SAP mean deviation and OCT retinal nerve fiber layer calculated over the initial 6-month clustering period. QoL was evaluated by Rasch analysis of the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25). Change in QoL was calculated as the difference in scores at baseline and at the end of the overall follow-up. Linear regression models with robust sandwich variance estimators were used to evaluate the association of glaucoma progression identified by the 6-month clustered testing and changes in QoL, while adjusting for baseline age, sex, race, baseline disease severity, and changes in media opacity as measured by the HD Analyzer (Visiometrics, Spain) objective scattering index (OSI).
Results :
A total of 51 POAG patients (100 eyes) with mean age of 68.2±7.5 years were included, with a total follow-up of 33.7±13.3 months. 23 subjects were identified as glaucoma progressors by the clustered approach in at least one eye. The mean NEI VFQ-25 standardized Rasch-adjusted score was similar at baseline for progressors and non-progressors (54.1±23.0% vs. 58.1±23.0%, respectively, P=0.534), but significantly worse for progressors compared with non-progressors at the end of follow-up (49.4±22.2% vs 64.5±20.1%; P=0.014, respectively). After adjusting for confounding factors, subjects with glaucoma progression during the 6-month clustering period had significantly larger decline in QoL compared to non-progressors (b=-11.5%, P=0.019).
Conclusions :
Glaucoma progression identified using an intensive clustered testing approach over 6 months was associated with significantly worse long-term QoL outcomes.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.