Vision-related quality of life and symptom perception change over time in newly-diagnosed primary open angle glaucoma patients

Abstract

To evaluate the change over time of vision-related quality of life (QoL) and glaucoma symptoms in a population of newly-diagnosed primary open angle glaucoma (POAG) patients. Multicenter, prospective study. Consecutive newly-diagnosed POAG patients were enrolled and followed-up for one year. Follow-up visits were scheduled at 6 and 12 months from baseline. At each visit, vision-related QoL and glaucoma-related symptoms were assessed by the means of the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) and the Glaucoma Symptom Scale (GSS), respectively. Trends over time for NEI-VFQ-25 and GSS scores were evaluated with longitudinal linear mixed models. One-hundred seventy-eight patients were included in the analysis. At baseline, early to moderate glaucoma stages were associated with higher scores for most GSS and NEI-VFQ-25 items, while lower best-corrected visual acuity was associated with lower scores for 4 of the 12 NEI-VFQ-25 items. During the follow-up, all the GSS scores, the NEI-VFQ-25 total score, and 7 of the 12 NEI-VFQ-25 scores significantly improved (p < 0.05). In multivariate model, higher increases of most GSS and NEI-VFQ-25 scores were modeled in patients with low scores at baseline. Vision-related QoL and glaucoma-related symptom perception significantly improved during the one-year follow-up in this population of newly diagnosed POAG patients.

Figure 1

Trends over time of Glaucoma Symptom Scale (GSS) and 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) scores. (A) Trends over time of GSS total score, Function-4 and Symptoms-6 subscale scores; (B) Trends over time of NEI-VFQ-25 total score, general health and general vision subscale scores.

Figure 2

Estimated quality of life scores by time and covariates (multivariable analysis). (A) Estimated GSS Symp-6 (Symptoms), Func-4 (Function) and Total score variations over time, according to score at baseline; (B) Estimated NEI-VFQ-25 General Health, General Vision and Total score variations over time, according to score at baseline.

Figure 3

Estimated quality of life scores by time and covariates (multivariable analysis). (A) Estimated GSS Func-4 score variation over time, according to score at baseline and baseline stage of the disease; (B) Estimated NEI-VFQ-25 Ocular Pain score variation over time, according to score at baseline and baseline stage of the disease.

Figure 4

Estimated probability to achieve maximum qualitative QoL score (100) by time and covariates. (A) Probability over time to achieve NEI-VFQ-25 Vision-specific Role Difficulties maximum score (100), according to score at baseline and baseline stage of the disease; (B) Probability to achieve NEI-VFQ-25 Peripheral Vision maximum score (100), according to score at baseline and baseline stage of the disease.