This article is more than 5 years old. Information may no longer be current.
Vision loss in glaucoma may be more gradual than originally thought
Click Here to Manage Email Alerts
DENVER – Quality of life (QOL) and aggressive treatment during earlier stages of glaucoma may prevent further vision loss, according to a study presented here at the American Academy of Optometry meeting.
"It has been increasingly recognized that glaucoma affects quality of life," said Richard Madonna, OD, author of the study. "A lot of research has been done on this over the years. Visual field loss is the factor focus on."
"Dr. Madonna questioned the widely held belief that glaucoma is a "sneak-thief of sight."
"Many believe that this is a disease in which the patient doesn't really know they have it and are slowly losing their vision," he said. "The idea is that the patient functions normally until the later stages. I don't know that this is true."
For this reason, Dr. Madonna said, his study sought to find a correlation between scores on a QOL indicator and visual field loss.
"If this could be shown, glaucoma therapy could be aimed at prevention of levels of visual field loss that correlated with decreases in visual function," he said.
In the study, the National Eye Institute VFQ-25 (a standardized measure of visual function) was administered to patients with moderate open-angle glaucoma in the more advanced eye. This was administered as determined by the Hodapp-Anderson-Parrish criteria. Patients with visual field loss related to anything other than glaucoma or with visual acuity of worse than 20/40 were excluded.
Humphrey SITA Standard 24-2 (Carl Zeiss Meditec, Dublin, Calif.) visual fields were given to all subjects. AGIS scores were used to determine the severity of visual field loss. The NEI VFQ-25 was scored based on existing criteria. Overall and subscale scores were assigned to the subjects.
Seventeen of the subjects met the criteria and were given the questionnaire. All subjects had AGIS scores between 4 and 9 in the eye with more advanced field loss. A link was found between more advanced field loss and lower overall VFQ-25 score, as well as advanced field loss and the sub-score for ocular pain, near vision, distance vision, mental health peripheral vision and driving score. Near vision and distance vision showed the highest correlation (P < 0.5).
The study concluded that the overall score and some subscale scores on the NEI VFQ-25 are linked to advanced visual field loss as gauged by the AGIS score.
"This is important because we've taken on a new mantra in glaucoma treatment, and that is to prevent functional vision loss in the patient's lifetime," Dr. Madonna said. "Perhaps we can garner information that can alert us to vision loss through these quality of life measurements."