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Stereoacuity lower in patients with glaucoma
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Near and distance stereoacuity were significantly lower in patients with primary open-angle glaucoma than in controls, according to researchers.
The cross-sectional study included 94 eyes of 47 patients with POAG and 80 eyes of 40 control subjects.
Researchers used the Randot Stereotest (Stereo Optical Co.) to test stereoacuity and the Distance Randot Stereotest to detect abnormalities in distance stereopsis.
POAG severity was graded on the basis of the visual field defects using a Humphrey Field Analyzer II 750i (Carl Zeiss Meditec).
Researchers found no differences in age, sex and best-corrected visual acuity between the two groups. There was a difference, however, in the cup-to-disc ratio, which was larger in the POAG group, according to the study.
The median near and distance stereoacuity were worse and significantly different in the POAG group than in the control group.
Using the Hodapp-Anderson-Parrish classification (HAP), near stereoacuity was significantly different between the HAP categories, and the median near stereoacuity deteriorated as the HAP classification became more severe, researchers wrote.
The proportion of subjects with reduced near stereoacuity was significantly higher in the POAG group (76.4%) than in the control group (45%).
No significant difference was found in near and distance stereoacuity between the subjects with superior- and inferior-dominant visual field defects.
Researchers also found that the degree of near stereoacuity corresponded with the severity of glaucomatous visual field loss. However, no association was observed between distance stereoacuity and POAG severity.
In conclusion, researchers found that near and distance stereoacuity were significantly lower in the POAG group than in the control group. Near stereoacuity worsened with POAG severity, and the proportion of subjects with a lack of distance stereoacuity was much higher in the POAG group than in the control group, they wrote.
“These factors may increase the frequency of falls and influence the quality of life among patients with POAG, as decreased stereoacuity can affect activities of daily living,” researchers wrote. – by Abigail Sutton
Disclosures: The researchers reported no relevant financial disclosures.
Perspective
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Carl H. Jacobsen, OD, FAAO
Do you think your glaucoma patients are doing well as long as they aren’t bumping into doorways or experiencing “jack-in-the-box” surprises? Think again. There is a large body of research proving that glaucoma affects many activities of daily living such as walking, driving and reading. Add to that emotional effects such as depression, and it’s easy to appreciate that glaucoma, even in its earlier stages, takes a toll.
Park and colleagues found that glaucoma patients have reduced stereoacuity, and it’s no surprise that this effect is more pronounced as glaucoma worsens. They go further and suggest that distance stereoacuity might be a good functional test to help identify early glaucoma. This is an interesting idea that deserves more investigation.
My take-home message from this paper is to discuss challenges of daily living with your patients. Consider taking a baseline stereoacuity measurement and monitor occasionally. It might be helpful. Most importantly, glaucoma-related vision loss (perhaps in part due to reduced stereoacuity) may contribute to an increased fall risk. Falls can be devastating for our elderly patients. If you can heighten your patient’s awareness of this risk, you are truly making a positive impact.
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