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

Abstract

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.

Figure 1

Locally weighted least squares plot of the relationship of predicted 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) composite scores and the driving subscale score (adjusted for covariates) by visual field loss in the better seeing eyes of participants with open-angle glaucoma in the Los Angeles Latino Eye Study. dB = decibels.

Figure 2

Locally weighted least squares plot of the relationship of predicted 12-item Short-Form Health Survey (SF-12) Physical Component Summary Scores and Mental Component Summary Scores (adjusted for covariates) by visual field loss in the better seeing eyes of participants with open-angle glaucoma in the Los Angeles Latino Eye Study. dB = decibels.

Figure 3

Locally weighted least squares plot of the relationship of predicted 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) composite scores (adjusted for covariates) and calculated binocular visual field loss (VFL) (probability summation of data from the two eyes was used to compute a single binocular VFL score) of participants with open-angle glaucoma in the Los Angeles Latino Eye Study.