The impact of structural and functional parameters in glaucoma patients on patient-reported visual functioning
- PMID: 24312500
- PMCID: PMC3849027
- DOI: 10.1371/journal.pone.0080757
The impact of structural and functional parameters in glaucoma patients on patient-reported visual functioning
Abstract
Background: To evaluate the impact of structural changes of the retinal nerve fiber layer (RNFL), and visual field loss, on functional impairment assessed by patient-reported visual functioning in glaucoma.
Methods: Patients with glaucomatous optic nerve damage were enrolled in this cross-sectional study. Peripapillary RNFL thickness was obtained with spectral-domain optical coherence tomography (SD-OCT). Function was assessed by patient-reported visual functioning using the Rasch-calibrated Glaucoma Activity Limitation 9 (GAL-9) questionnaire and standard automated perimetry. The impact of peripapillary RNFL loss on functional impairment was analyzed with correlation and linear regression analyses.
Results: A total of 176 eyes from 88 glaucoma patients were included. The SD-OCT assessed temporal-superior and temporal-inferior RNFL sector of the worse eye revealed significant correlation with the GAL-9 scores (r=-0.298, p=0.011 and r=-0.251, p=0.033, respectively). In mutivariate regression analysis, the best predictors for patient-reported visual functioning were visual acuity of the better eye and mean defect of the worse eye (R(2)=0.334), while structural parameters could not enhance the prediction of GAL-9 scores.
Conclusions: Self-reported visual functioning of patients with glaucoma is better predicted by visual performance data than structural parameters. However, some structural changes of the worse eye are significantly correlated with patient-reported visual functioning.
Conflict of interest statement
References
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- Schuman JS, Pedut-Kloizman T, Pakter H, Wang N, Guedes V et al. (2007) Optical coherence tomography and histologic measurements of nerve fiber layer thickness in normal and glaucomatous monkey eyes. Invest Ophthalmol Vis Sci 48: 3645-3654. doi: 10.1167/iovs.06-0876. PubMed: 17652734. - DOI - PMC - PubMed
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