Impact of Visual Field Loss on Health-Related Quality of Life in Glaucoma: The Los Angeles Latino Eye Study
Received 3 April 2007; received in revised form 9 August 2007; accepted 21 August 2007. published online 12 November 2007.
Purpose
To examine the association between health-related quality of life (HRQOL) and visual field (VF) loss in participants with open-angle glaucoma (OAG) in the Los Angeles Latino Eye Study (LALES).
Design
Population-based cross-sectional study.
Participants
Two hundred thirteen participants with OAG and 2821 participants without glaucoma or VF loss.
Methods
Participants in the LALES—a population-based prevalence study of eye disease in Latinos 40 years and older, residing in Los Angeles, California—underwent a detailed eye examination including an assessment of their VF using the Humphrey Automated Field Analyzer (Swedish interactive thresholding algorithm Standard 24-2). Open-angle glaucoma was determined by clinical examination. Mean deviation scores were used to assess severity of VF loss. Health-related QOL was assessed by the Medical Outcomes Study 12-item Short-Form Health Survey (SF-12) and 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25). Linear regression and analysis of covariance were used to assess the relationship between HRQOL scores and VF loss after adjusting for sociodemographic variables and visual acuity.
Main Outcome Measures
The 25-item NEI-VFQ and SF-12 scores.
Results
A trend of worse NEI-VFQ-25 scores for most subscales was observed with worse VF loss (using both monocular and calculated binocular data). Open-angle glaucoma participants with VF loss had lower scores than participants with no VF loss. This association was also present in participants who were previously undiagnosed and untreated for OAG (N = 160). Participants with any central VF loss had lower NEI-VFQ-25 scores than those with unilateral or bilateral peripheral VF loss. There was no significant impact of severity or location of VF loss on SF-12 scores.
Conclusion
Greater severity of VF loss in persons with OAG impacts vision-related QOL. This impact was present in persons who were previously unaware that they had glaucoma. Prevention of VF loss in persons with glaucoma is likely to reduce loss of vision-related QOL.
Available online: November 12, 2007.
1Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California.
2Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, California.
3Department of Clinical Pharmacy and Pharmaceutical Economics and Policy, School of Pharmacy, University of Southern California, Los Angeles, California.
Correspondence and reprint requests to Rohit Varma, MD, MPH, Doheny Eye Institute, Department of Ophthalmology, 1450 San Pablo Street, Room 4900, Los Angeles, CA 90033.
Manuscript no. 2007-462.
This work was supported by grants from the National Eye Institute, Bethesda, Maryland (no. NEI U10 EY-11753), and National Institutes of Health, Bethesda, Maryland (no. EY-03040).
No conflicting relationship exists for any author.
ABSTRACT