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      Visual field loss and vision-related quality of life in the Italian Primary Open Angle Glaucoma Study

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          Abstract

          The aim of this study was to examine the relationship between visual field (VF) loss, vision-related quality of life (QoL) and glaucoma-related symptoms in a large cohort of primary open angle glaucoma (POAG) patients. POAG patients with or without VF defects or “glaucoma suspect” patients were considered eligible. QoL was assessed using the validated versions of the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) and glaucoma-related symptoms were assessed using the Glaucoma Symptom Scale (GSS). Patients were classified as having VF damage in one eye (VFD-1), both eyes (VFD-2), or neither eye (VFD-0). 3227 patients were enrolled and 2940 were eligible for the analysis. 13.4% of patients were classified in the VFD-0, 23.7% in the VFD-1, and 62.9% in the VFD-2 group. GSS visual symptoms domain (Func-4) and GSS non-visual symptoms domain (Symp-6) scores were similar for the VFD-0 and VFD-1 groups (p = 0.133 and p = 0.834 for Func-4 and Symp-6, respectively). VFD-0 group had higher scores than VFD-2 both in Func-4 (p < 0.001) and Symp-6 domains (p = 0.035). Regarding the NEI-VFQ-25, our data demonstrated that bilateral VF defects are associated with vision-related QoL deterioration, irrespective of visual acuity.

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          Development of the 25-item National Eye Institute Visual Function Questionnaire.

          C M Mangione, P P Lee, P Gutiérrez … (2001)
          To develop and test the psychometric properties of a 25-item version of the National Eye Institute Visual Function Questionnaire (NEI VFQ-25). Prospective observational cohort study of persons with 1 of 5 chronic eye diseases or low vision who were scheduled for nonurgent visits in ophthalmology practices and a reference sample of persons without eye disease. Eleven university-based ophthalmology practices and the NEI Clinical Center. Eligible participants had to have 1 of the following eye conditions: age-related cataracts, age-related macular degeneration, diabetic retinopathy, primary open-angle glaucoma, cytomegalovirus retinitis, or low vision from any cause. Seven of the 12 sites also enrolled persons in a reference sample. Reference sample participants had no evidence of underlying eye disease but were scheduled for either screening eye examinations or correction of refractive error. All eligible persons had to be 21 years or older, English speaking, and cognitively able to give informed consent and participate in a health status interview. To provide the data needed to create the NEI VFQ-25, all subjects completed an interview that included the 51-item NEI VFQ. Estimates of internal consistency indicate that the subscales of the NEI VFQ-25 are reliable. The validity of the NEI VFQ-25 is supported by high correlations between the short- and long-form versions of the measure, observed between-group differences in scores for persons with different eye diseases of varying severity, and the moderate-to-high correlations between the NEI VFQ-25 subscales that have the most to do with central vision and measured visual acuity. The reliability and validity of the NEI VFQ-25 are comparable to those of the 51-item NEI VFQ field test version of the survey. This shorter version will be more feasible in settings such as clinical trials where interview length is a critical consideration. In addition, preliminary analyses indicate that the psychometric properties of the NEI VFQ-25 are robust for the eye conditions studied; this suggests that the measure will provide reproducible and valid data when used across multiple conditions of varying severity.
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            Psychometric properties of the National Eye Institute Visual Function Questionnaire (NEI-VFQ). NEI-VFQ Field Test Investigators.

            Meredith Berry, P. Gutierrez, Steven Pitts … (1998)
            To test the reliability and validity of the 51-item Field Test Version of the National Eye Institute Visual Function Questionnaire (NEI-VFQ) across 5 common chronic eye conditions. Prospective observational cohort study of persons with 1 of 5 chronic eye diseases who were scheduled for nonurgent visits in ophthalmology practices or had low vision from any cause, and a reference sample of persons without eye disease. Six university-based ophthalmology practices and the National Eye Institute Clinical Center, Bethesda, Md. Eligible participants had to have 1 of the following eye conditions: age-related cataracts, age-related macular degeneration, diabetic retinopathy, primary open-angle glaucoma, cytomegalovirus retinitis, or low vision from any cause. Each of the 7 sites also enrolled persons in a reference sample. Reference sample participants had no evidence of underlying eye disease but were scheduled for either screening eye examinations or correction of refractive error. All eligible persons had to be aged 21 years or older, English speaking, and cognitively able to give informed consent and participate in a health status interview. To provide the data needed to assess the reliability and validity of the 51-item NEI-VFQ, all subjects completed an interview that consisted of the 51-item NEI-VFQ, the Medical Outcomes Study 36-Item Short-Form Health Survey, and at least 1 measure of vision-targeted functional status. Estimates of internal consistency and test-retest reproducibility indicate that the 51-item NEI-VFQ is reliable. Tests of association with other scales and clinical variables support the construct validity of the survey. In this cross-sectional study, the 51-item NEI-VFQ seems to be reliable and valid and should be a useful tool for group-level comparisons of vision-targeted, health-related quality of life in clinical research. Additionally, the psychometric properties of the NEI-VFQ were not influenced by the type or severity of the underlying eye disease, suggesting that the measure will provide reproducible and valid data when used across multiple eye conditions.
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              Quality of life in glaucoma and its relationship with visual function.

              O Papasouliotis, Colm O’Brien, Bruce Worton … (2003)
              The aims of this study were (a) to explore patients self-reported visual disability resulting from glaucoma by means of a questionnaire developed for this purpose; (b) identify activities strongly associated with a measure of visual field loss, (c) to quantify different psychophysical aspects of visual function; (d) to assess the relationship between objective measures of visual function and patients' perception of their vision-related quality of life. Three groups of glaucoma patients (n = 47) with mild (n = 18), moderate (n = 19), and severe visual field loss (n = 10) and a group of normal controls (n = 19) underwent a comprehensive clinical examination, completed a questionnaire and, on a separate visit, performed a number of psychophysical tests of visual function. Questionnaire responses (vision-related quality of life, general health and psychosocial variables), visual acuity, visual fields, Esterman binocular disability scores, contrast sensitivity, critical flicker frequency, color vision, dark adaptation, glare disability (brightness acuity), and stereoacuity scores were measured. Fifteen of the 50 questions were noted to have a strong significant relationship with a measure of visual field loss and were included in a new questionnaire scale, the Glaucoma Quality of Life - 15 (GQL-15). The scale validity showed a significant correlation with perimetric mean deviation (MD) values (r = -0.6; P < 0.0001), the reliability of the scale was high (Cronbach alpha = 0.95), and test-retest reliability of the questionnaire was strong (r = 0.87). An overall statistically significant decrease in performance-related quality of life was noted between normal subjects and all groups of glaucoma patients. A significant relationship was found between the scale questionnaire summary performance measure and a number of psychophysical tests: Pelli-Robson contrast sensitivity (r = -0.45, P < 0.001), glare disability (r = -0.41, P < 0.001), Esterman binocular visual field test (r = -0.39, P < 0.001), dark adaptation (r = 0.34, P = 0.007), and stereopsis (r = 0.26, P = 0.04). Perceived visual disability relating to certain tasks (particularly involving dark adaptation and disability glare, activities demanding functional peripheral vision such us tripping over and bumping into objects and outdoor mobility tasks) was significantly associated with the severity of binocular visual field loss. As a result, a new glaucoma-specific questionnaire scale with good performance characteristics is presented in this study. The difficulties encountered by patients in everyday life (as measured with the questionnaire) were also mirrored in their performance on a number of psychophysical tests, especially contrast sensitivity, glare disability, Esterman binocular visual field test, and dark adaptation.
              Article 0 comments Cited 106 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Luciano Quaranta: luciano.quaranta@unibs.it
                Journal
                Journal ID (nlm-ta): Sci Rep
                Journal ID (iso-abbrev): Sci Rep
                Title: Scientific Reports
                Publisher: Nature Publishing Group UK (London )
                ISSN (Electronic): 2045-2322
                Publication date (Electronic): 12 January 2018
                Publication date PMC-release: 12 January 2018
                Publication date Collection: 2018
                Volume: 8
                Electronic Location Identifier: 619
                Affiliations
                [1 ]ISNI 0000000106678902, GRID grid.4527.4, IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, ; Milan, Italy
                [2 ]ISNI 0000000417571846, GRID grid.7637.5, DMSS, , University of Brescia, ; Brescia, Italy
                [3 ]ISNI 0000 0004 1796 1828, GRID grid.420180.f, IRCCS - Fondazione GB Bietti per lo Studio e la Ricerca in Oftalmologia, ; Rome, Italy
                [4 ]ISNI 0000 0001 2107 4242, GRID grid.266100.3, Hamilton Glaucoma Center, Shiley Eye Institute, and the Department of Ophthalmology, , University of California, ; San Diego, CA USA
                [5 ]ISNI 0000 0001 2168 2547, GRID grid.411489.1, Università degli Studi “Magna Graecia”, ; Catanzaro, Italy
                [6 ]ISNI 0000 0004 1757 4641, GRID grid.9024.f, A.O.U. Senese Ospedale Santa Maria delle Scotte, , Università di Siena, ; Siena, Italy
                [7 ]ISNI 0000 0004 1760 3027, GRID grid.419425.f, Fondazione IRCCS Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, ; Pavia, Italy
                [8 ]ISNI 0000 0004 1757 9530, GRID grid.418224.9, IRCCS Istituto di Ricovero e Cura a Carattere Scientifico Istituto Auxologico Italiano, ; Milano, Italy
                [9 ]ISNI 0000 0001 2336 6580, GRID grid.7605.4, Università degli Studi di Torino, ; Torino, Italy
                [10 ]ISNI 0000 0004 1757 8749, GRID grid.414818.0, Fondazione IRCCS Istituto di Ricovero e Cura a Carattere Scientifico Ca’ Granda Ospedale Maggiore Policlinico, ; Milano, Italy
                [11 ]A.O.U. di Parma, Parma, Italy
                [12 ]A.O.U. Cagliari - Ospedale Civile San Giovanni di Dio, Cagliari, Italy
                [13 ]A.O.U. “Policlinico Vittorio Emanuele” P.O. Gaspare Rodolico, Catania, Italy
                [14 ]ISNI 0000 0004 4671 8595, GRID grid.417543.0, A.O.U. “Ospedale Maggiore”, ; Trieste, Italy
                [15 ]A.O. Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
                [16 ]ISNI 0000 0001 2300 0941, GRID grid.6530.0, Università Tor Vergata, Fondazione Policlinico Tor Vergata, ; Roma, Italy
                [17 ]A.O. S. Paolo, Milano, Italy
                [18 ]A.O.U. Policlinico, Bari, Italy
                [19 ]Ospedale Clinicizzato SS. Annunziata, Chieti, Italy
                [20 ]GRID grid.412311.4, A.O.U. Policlinico S. Orsola Malpighi, ; Bologna, Italy
                [21 ]A.O. di Desenzano del Garda, Desenzano del Garda, Brescia, Italy
                [22 ]ISNI 0000000122055422, GRID grid.10373.36, Dipartimento SPES, , Università del Molise, ; Campobasso, Italy
                [23 ]ISNI 0000 0004 1756 7871, GRID grid.410345.7, IRCCS AOU San Martino - IST, ; Genova, Italy
                Author information
                http://orcid.org/0000-0003-1058-4137
                Article
                Publisher ID: 19113
                DOI: 10.1038/s41598-017-19113-z
                PMC ID: 5766542
                PubMed ID: 29330448
                SO-VID: 1bf2e7c5-1baf-408a-9832-e4440dc13be6
                Copyright © © The Author(s) 2017
                License:

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

                History
                Date received : 28 July 2017
                Date accepted : 20 December 2017
                Categories
                Subject: Article
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                issue-copyright-statement © The Author(s) 2018

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