Glaucoma's impact on quality of life and its relation to clinical indicators. A pilot study

M B Sherwood, A Garcia-Siekavizza, M I Meltzer, A Hebert, A F Burns, S McGorray
Ophthalmology 1998, 105 (3): 561-6

OBJECTIVE: This study aimed to compare the quality of life (Q of L) of patients with glaucoma and control subjects and to determine the relationships between Q of L and demographic and clinical variables in patients with glaucoma.

DESIGN: The study design was a stratified cross-sectional study.

PARTICIPANTS: A gender-, race-, and age-stratified cross-sectional sample of patients with glaucoma (n = 56) and control subjects (n = 54) was obtained. Additional patients (n = 12) were included to examine the relationships between glaucoma, its therapy, and Q of L.

INTERVENTION: The Medical Outcomes Study short form (MOS-20), the Activities of Daily Vision Scale (ADVS), and questions related to glaucoma and side effects of treatment were administered. Descriptive statistics characterized demographic variables and MOS and ADVS scales. Group differences were evaluated using chi-square, Fisher's and Ordinal Exact, Wilcoxon rank-sum, and two-sample t tests. Spearman rank correlations were obtained between MOS-ADVS scores and clinical and demographic variables. Regression was used for multivariate analysis.

MAIN OUTCOME MEASURES: The MOS scores, ADVS scores, visual acuity, visual fields, and demographic variables were measured.

RESULTS: Patients scored significantly lower than did the control subjects in all MOS-20 categories except pain. Differences were physical (-20%), role (-43%), mental health (-10%), general health (-22%), and social (-9%). The only category that was not statistically significant was that of pain (P = 0.075). In the glaucoma subgroup, there were differences between whites and nonwhites in MOS subscales physical, role, social, pain, and health, and ADVS near vision. In patients, current medications and previous surgeries correlated with ADVS subscales night vision, near vision, and glare; visual acuity and fields correlated with MOS subscales physical, role and health, and all ADVS subscales. A multiple regression model including visual acuity and fields, urban residence, and female gender explained 61% of the variability in ADVS overall score.

CONCLUSIONS: The Q-of-L perception differed between patients with glaucoma and control subjects. Increasing field loss, decreased visual acuity, and complexity of therapy correlated with patients' reduction in activities of daily vision.

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