Comparison of Impact of Monocular and Integrated Binocular Visual Fields on Vision-related Quality of Life.

PURPOSE OF THE STUDY: The purpose of the study was to investigate the relationship between vision-related quality of life (VRQOL) and mean deviation (MD) of the monocular visual field and integrated binocular visual field (IBVF). METHODS: One hundred eighty VFs (90 pairs) obtained from 90 patients with normal tension glaucoma were included. VRQOL was evaluated using the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25). IBVF was calculated using maximal sensitivity and binocular summation and IBVF MD was calculated. Multiple linear regression analysis was used to assess the impact of IBVF deficit on VRQOL after adjusting for confounding factors. These results were compared to those of monocular visual field. RESULTS: Mean subject age was 59.4 years. The average MD of maximal sensitivity was significantly higher than that of binocular summation, the better eye, and the worse eye (-3.27, -3.78, -3.96, and -8.66 dB, respectively, P<0.001). Rasch-analyzed NEI VFQ-25 subscales and composite scores were significantly correlated with IBVF deficit. The impact that IBVF had on VRQOL was similar to that of the better eye (R of 0.431, 0.422, and 0.422 for MD of the better eye, binocular summation, and maximal sensitivity, respectively). In contrast, the worse eye showed the least correlation with VRQOL (0.363). CONCLUSIONS: The impact of IBVF on VRQOL was similar to that of the better eye irrespective of integration method. Therefore, better eye MD could be a good indicator for VRQOL.

Assessment of the vision-specific quality of life using clustered visual field in glaucoma patients.

PURPOSE: To investigate the significance of vision-specific quality of life (QOL) in glaucoma patients based on the location of visual field defects. PATIENTS AND METHODS: We examined 336 eyes of 168 patients. The 25-item National Eye Institute Visual Function Questionnaire was used to evaluate patients' QOL. Visual field testing was performed using the Humphrey Field Analyzer; the visual field was divided into 10 clusters. We defined the eye with better mean deviation as the better eye and the fellow eye as the worse eye. A single linear regression analysis was applied to assess the significance of the relationship between QOL and the clustered visual field. RESULTS: The strongest correlation was observed in the lower paracentral visual field in the better eye. The lower peripheral visual field in the better eye also showed a good correlation. Correlation coefficients in the better eye were generally higher than those in the worse eye. For driving, the upper temporal visual field in the better eye was the most strongly correlated (r=0.509). For role limitation and peripheral vision, the lower peripheral visual field in the better eye had the highest correlation coefficients at 0.459 and 0.425, respectively. CONCLUSIONS: Overall, clusters in the lower hemifield in the better eye were more strongly correlated with QOL than those in the worse eye. In particular, the lower paracentral visual field in the better eye was correlated most strongly of all. Driving, however, strongly correlated with the upper hemifield in the better eye.

Clinical profiles of primary open angle glaucoma versus normal tension glaucoma patients: a pilot study.

PURPOSE: To study the health profiles and behavioral differences between primary open angle glaucoma (POAG) and normal tension glaucoma (NTG) patients. METHODS: Confidential mail survey of ICD-9 defined POAG (n = 277) and NTG (n = 116) patients was carried out to collect information regarding age, gender, height, weight, waist circumference, blood pressure (BP), medications [prescription (Rx) and over the counter (OTC)], education, and the Short Health Anxiety Inventory (SHAI). RESULTS: NTG patients (59/116) were significantly more likely to respond to the survey than POAG patients (43/277), p = 0.0001, and to have obtained college level education (70% vs. 42%), p = 0.003. Body weight, waist circumference, body mass index, systolic BP, pulse pressure, and ratio of prescription medications to OTC medications were significantly lower in the NTG group (p < 0.0001). The SHAI score, mean age, and diastolic BP were not different between the two groups. A subgroup analysis of college-educated patients in both groups revealed persisting significant differences in waist circumference, systolic BP, and ratio of Rx to OTC medications. CONCLUSIONS: NTG patients do not have significantly greater health anxiety than POAG patients. NTG patients are more likely to have lower BMI, systolic BP, and ratio of Rx to OTC medications than POAG patients. The pilot nature of this study limits generalizability of these findings. Larger studies confirming these findings and elucidating the role of refractive error and medical history on such differences are needed.