Impact of visual field loss on health-related quality of life in glaucoma: the Los Angeles Latino Eye Study.

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.

[1]  J. Wild,et al.  The influence of forward light scatter on the visual field indices in glaucoma , 2004, Graefe's Archive for Clinical and Experimental Ophthalmology.

[2]  C. Johnson,et al.  Predicting binocular visual field sensitivity from monocular visual field results. , 2000, Investigative ophthalmology & visual science.

[3]  Roberta McKean-Cowdin,et al.  Severity of visual field loss and health-related quality of life. , 2007, American journal of ophthalmology.

[4]  R. Hays,et al.  Development of the 25-item National Eye Institute Visual Function Questionnaire. , 2001 .

[5]  W. Cleveland,et al.  Computational methods for local regression , 1991 .

[6]  B. Linn,et al.  CUMULATIVE ILLNESS RATING SCALE , 1968, Journal of the American Geriatrics Society.

[7]  Jacob Cohen.  Statistical Power Analysis for the Behavioral Sciences , 1969, The SAGE Encyclopedia of Research Design.

[8]  Rohit Varma,et al.  Using focus groups to develop a culturally sensitive methodology for epidemiological surveys in a Latino population: findings from the Los Angeles Latino Eye Study (LALES). , 2002, Ethnicity & disease.

[9]  Rohit Varma,et al.  Binocular visual acuity summation and inhibition in an ocular epidemiological study: the Los Angeles Latino Eye Study. , 2002, Investigative ophthalmology & visual science.

[10]  L. Hedges,et al.  The Handbook of Research Synthesis , 1995 .

[11]  J. Ware,et al.  A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. , 1996, Medical care.

[12]  C. O'brien,et al.  Patients’ perception of visual impairment in glaucoma: a pilot study , 1999, The British journal of ophthalmology.

[13]  R. Klein,et al.  Self-reported comorbidities and visual function in a population-based study: the Los Angeles Latino Eye Study. , 2005, Archives of ophthalmology.

[14]  Chris A. Johnson,et al.  Influence of glaucomatous visual field loss on health-related quality of life. , 1997, Archives of ophthalmology.

[15]  R. Klein,et al.  Prevalence of age-related macular degeneration in Latinos: the Los Angeles Latino eye study. , 2004, Ophthalmology.

[16]  S. Azen,et al.  The impact of visual impairment on self-reported visual functioning in Latinos: The Los Angeles Latino Eye Study. , 2004, Ophthalmology.

[17]  R M Kaplan,et al.  Depression, visual acuity, comorbidity, and disability associated with age-related macular degeneration. , 2001, Ophthalmology.

[18]  C. Owsley,et al.  Vision-specific health-related quality of life in age-related maculopathy patients presenting for low vision services , 2004, Ophthalmic epidemiology.

[19]  H. Quigley,et al.  The number of people with glaucoma worldwide in 2010 and 2020 , 2006, British Journal of Ophthalmology.

[20]  Barry L. Nelson,et al.  Multiple Comparisons in the General Linear Model , 1998 .

[21]  William H Swanson,et al.  A cortical pooling model of spatial summation for perimetric stimuli. , 2006, Journal of vision.

[22]  P. Lachenbruch.  Statistical Power Analysis for the Behavioral Sciences (2nd ed.) , 1989 .

[23]  G. Marks,et al.  Health risk behaviors of Hispanics in the United States: findings from HHANES, 1982-84. , 1990, American journal of public health.

[24]  R. Klein,et al.  Design, Methods, and Baseline Data , 2004 .

[25]  Beatriz Muñoz,et al.  Measures of visual function and their association with driving modification in older adults. , 2006, Investigative ophthalmology & visual science.

[26]  G. Marks,et al.  Acculturation, access to care, and use of preventive services by Hispanics: findings from HHANES 1982-84. , 1990, American journal of public health.

[27]  H. Jampel,et al.  Glaucoma Patients' Assessment of Their Visual Function and Quality of Life , 2002, Journal of glaucoma.

[28]  W. Feuer,et al.  Visual function and quality of life among patients with glaucoma. , 1997, Archives of ophthalmology.

[29]  J. Hsu.  Multiple Comparisons: Theory and Methods , 1996 .

[30]  H. Quigley.  Number of people with glaucoma worldwide. , 1996, The British journal of ophthalmology.

[31]  B W Gillespie,et al.  Quality of life in newly diagnosed glaucoma patients : The Collaborative Initial Glaucoma Treatment Study. , 2001, Ophthalmology.

[32]  A. Coleman,et al.  Functional status and well-being in patients with glaucoma as measured by the Medical Outcomes Study Short Form-36 questionnaire. , 1998, Ophthalmology.

[33]  R. Klein,et al.  The Los Angeles Latino Eye Study: design, methods, and baseline data. , 2004, Ophthalmology.

[34]  R. Rosenthal.  Parametric measures of effect size. , 1994 .

[35]  Mills Rp.  Correlation of quality of life with clinical symptoms and signs at the time of glaucoma diagnosis. , 1998 .

[36]  R. Klein,et al.  Prevalence of diabetic retinopathy in adult Latinos: the Los Angeles Latino eye study. , 2004, Ophthalmology.

[37]  J. Keeffe,et al.  Associations between glaucomatous visual field loss and participation in activities of daily living , 2003, Clinical & experimental ophthalmology.

[38]  R. Hays,et al.  Psychometric properties of the National Eye Institute Visual Function Questionnaire (NEI-VFQ). NEI-VFQ Field Test Investigators , 1998 .

[39]  M. Meltzer,et al.  Glaucoma's impact on quality of life and its relation to clinical indicators. A pilot study. , 1998, Ophthalmology (Rochester, Minn.).

[40]  S. Azen,et al.  The Los Angeles Latino Eye Study , 2008 .

[41]  C. O'brien,et al.  Quality of Life in Glaucoma and Its Relationship with Visual Function , 2003, Journal of glaucoma.