Quality of Life According to Location of Integrated Binocular Visual Field Defect in Normal-Tension-Glaucoma Patients

PURPOSE: To investigate the relationship between vision-related quality of life (QOL) and integrated binocular visual field (IVF) defect and the difference in QOL based on the location of visual field defects in Korean normal tension glaucoma (NTG) patients. METHODS: Two hundred monocular visual fields from 100 patients diagnosed with normal tension glaucoma in at least one eye were integrated using the best location method, and the mean deviation (MD) of whole, superior, and inferior IVF was calculated. We analyzed the correlations between subscales of the National Eye Institute Visual Function Questionnaire 25 (NEI VFQ-25) and each calculated MD using Spearman correlation. After adjusting for confounding factors of age, visual acuity of the better eye, number of medications, and education level, the impact of IVF loss on the composite score of the NEI VFQ-25 was evaluated using multivariate linear regression analysis. RESULTS: The MDs of whole and inferior IVF were significantly associated with 7 of 12 NEI VFQ-25 subscales, and the superior IVF was associated with 3 subscales (p < 0.05). After adjusting confounding variables, the composite score of the NEI VFQ-25 showed significant correlation with whole, superior, and inferior IVF. The adjusted R2 and beta coefficient of the regression line were highest in the whole IVF (Adjusted R2 = 0.451, beta = 1.12), followed by the inferior and superior IVF (Adjusted R2 = 0.438, 0.395, beta = 0.95, 0.85). CONCLUSIONS: The IVF of Korean NTG patients can effectively reflect patient QOL, and the inferior IVF was significantly associated with more subscales of NEI VFQ-25 than was the superior IVF. However, overall QOL of patients is thought to be determined by severity of visual field loss rather than its location.

Comparison of Mean Deviation Between Integrated Binocular Visual Field and Monocular Visual Field

PURPOSE: To compare the mean deviation (MD) between monocular and integrated binocular visual field (BVF). METHODS: Thirty-six patients with glaucoma in at least 1 eye were recruited for the present study. Seventy-two threshold sensitivities of the BVF were obtained without additional visual field test by the Best Location and Binocular Summation methods using the 2 monocular visual fields of central 30degrees. The MD of the BVF was obtained by comparison to the value distribution in the age-matched population with normal BVF. After defining the better eye with the better MD value from the 2 eyes, comparison of the MDs between individual eyes and the integrated BVF were assessed. In addition, the MDs between the integrated BVF and actual BVF were compared in 11 patients. RESULTS: In patients with a mean age of 58.7 years, the MD of the better eye was -2.3 dB, and the worse eye was -4.9 dB (p 0.1). CONCLUSIONS: The integrated BVF more improved than the better eye. When providing guidance to glaucoma patients regarding therapeutic decisions considering the MD of IVF may be important.