Early Glaucoma Doesn’t Impair Vision-Related Quality of Life

TOPLINE:

Patients with ocular hypertension who develop primary open-angle glaucoma (POAG) without visual field loss did experience a decreased vision-related quality of life compared with those who did not develop the condition.

METHODOLOGY:

• This cross-sectional study included 679 participants (mean age, 73.8 years; 60.7% women) with ocular hypertension from the Ocular Hypertension Treatment Study who completed a 20-year follow-up examination and surveys of their vision-related quality of life between 2016 and 2019.
• Among them, 321 participants developed POAG and were classified into:
  • Those with unilateral or bilateral disc POAG who had no loss of visual field in either eye.
  • Those with unilateral or bilateral POAG who had loss of visual field in one or both eyes, with or without disc changes.
• Those who did not develop POAG in either eye despite having ocular hypertension served as the control group (n = 358).
• The POAG endpoint was defined as reproducible changes in the visual field or optic disc, attributed to glaucoma and confirmed by a masked endpoint committee.
• The main outcomes were differences in the total scores on vision-related quality of life between participants who did not develop POAG and those with various stages of the condition.

TAKEAWAY:

• Scores on the Visual Function Questionnaire did not differ significantly between the participants with early disc PAOG who did not develop visual field loss compared with those without PAOG.
• Participants with unilateral visual field loss reported a slight decrease in visual function (mean difference, −3.33; P = .03), while those with bilateral visual field loss reported a substantial decrease in these scores (mean difference, −13.96; P < .001), compared with those without PAOG.
• The Glaucoma Quality of Life score was also significantly impaired in patients with vision loss in both eyes (P < .001) but remained unaffected in those whose eyesight did not deteriorate.
• Systemic comorbidities, bilateral visual field loss, and a history of treatment for eye problems other than glaucoma had the greatest effect on vision-related quality of life in patients with early glaucoma.

IN PRACTICE:

“This finding supports the idea that clinicians and ocular hypertensive patients have time to determine the optimum frequency of examinations and whether the initiation of treatment is appropriate,” the authors of the study wrote.

SOURCE:

The study was led by Mae O. Gordon, PhD, from the Washington University School of Medicine in St. Louis, St. Louis, Missouri. It was published online on August 29, 2024, in JAMA Ophthalmology.

LIMITATIONS:

Most participants who developed PAOG in this study had early or moderate visual field loss, and advanced glaucoma was underrepresented in this cohort. Many factors that might have affected the vision-related quality of life, such as socioeconomic status, personality traits, socioemotional support, and patient expectations, were not measured or were poorly assessed.

DISCLOSURES:

This study was supported by the National Institutes of Health and Washington University School of Medicine and an unrestricted grant from Research to Prevent Blindness. Some authors declared receiving grants or nonfinancial support or having other ties with pharmaceutical companies and institutions.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.