Research on the Quality of Life of Glaucoma Patients

Chi Shian Feng; Kayoung Yi

doi:10.3341/jkos.2014.55.12.1868

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Feng and Yi: Research on the Quality of Life of Glaucoma Patients

Original Article

J Korean Ophthalmol Soc 2014;55(12):1868-1877.

Published online: 2 September 2014

DOI: https://doi.org/10.3341/jkos.2014.55.12.1868

Research on the Quality of Life of Glaucoma Patients

Chi Shian Feng, MD, Kayoung Yi, MD, PhD

Department of Ophthalmology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea

Address reprint requests to Kayoung Yi, MD, PhD, Department of Ophthalmology, Hallym University Kangnam Sacred Heart Hospital, #1 Singil-ro, Yeongdeungpo-gu, Seoul 150-950, Korea, Tel: 82-2-829-5196, Fax: 82-2-829-4638, E-mail: harry92001@naver.com

Received 31 May 2014 Revised 2 October 2014 Accepted 5 November 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To compare subjective quality of life (QOL) of a glaucoma group with a control group.

Methods

The Korean version of the National Eye Institute Visual Function Questionnaire 25 (NEI-VFQ-25) was completed by 105 glaucoma clinic patients including 54 glaucoma group and 56 control group. We compared questionnaire scores and previous performed visual field parameters between a glaucoma group and a control group.

Results

The glaucoma group results were: Mean age: 55.73 ± 15.17 years; mean best corrected visual acuity (BCVA; log MAR) 0.05 ± 0.09 in better eyes and 0.06 ± 0.09 in worse eyes; and mean intraocular pressure (IOP) 15.94 ± 2.93 mm Hg in better eyes and 15.49 ± 3.18 mm Hg in worse eyes. Control group scores were: Mean age: 51.85 ± 11.36 years; mean BCVA (log MAR) 0.04 ± 0.07 in better eyes and 0.06 ± 0.08 in worse eyes; and mean IOP 16.40 ± 2.50 mm Hg in better eyes and 16.13 ± 2.16 mm Hg in worse eyes. Age, BCVA, and IOP were not significantly different between groups, but visual field index (VFI) score and visual function questionnaire (NEI-VFQ-25) total score were significantly lower in the glaucoma group (p < 0.01). Additionally, visual field parameters and QOL had a significant relationship in the glaucoma group, especially in better eyes.

Conclusions

The QOL of glaucoma patients was lower than that of normal controls regardless of visual acuity. The degree of visual field loss in the better eye may affect QOL more significantly.

Keywords: Glaucoma patients, Quality of life, Questionnaire

References

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Figure 1.

Negative correlation of age and NEI-VFQ-25 questionnaire total scale. (A) Age and total score in glaucoma group (r = −0.279, p < 0.05). (B) Age and total score in control group (r = −0.469, p < 0.01).

Figure 2.

NEI-VFQ-25 questionnaire total scale and visual field index of both eyes in glaucoma group showed significant correlation. (A) Visual field index and total score (r = 0.381, p < 0.01). (B) Mean deviation and total score (r = 0.411, p < 0.01). (C) Pattern standard deviation and total score (r = −0.321, p < 0.05). VFI = visual field index; MD = mean deviation; PSD = pattern standard deviation.

Table 1.

Baseline characteristic of study and control group

	Glaucoma	Control	p-value
Number	52	53
Age (years)	55.73 ± 15.17	51.85 ± 11.36	0.147
Sex (M/F)	27/25	25/28	0.630
Mean BCVA (log MAR)
Better eye	0.05 ± 0.09	0.04 ± 0.07	0.449
Worse eye	0.06 ± 0.09	0.06 ± 0.08	0.622
Mean IOP
Better eye	15.94 ± 2.93	16.40 ± 2.50	0.407
Worse eye	15.49 ± 3.18	16.13 ± 2.16	0.246
HT	17 (33%)	9 (17%)	0.071
DM	10 (19%)	7 (13%)	0.431
CVD	2 (4%)	2 (4%)	0.951
Visual field
VFI
Better eye	92.14 ± 11.17	98.52 ± 2.00	<0.01^*
Worse eye	79.27 ± 20.12	96.58 ± 3.21	<0.01^*
MD
Better eye	−4.25 ± 4.08	−1.79 ± 1.33	<0.01^*
Worse eye	−8.36 ± 6.44	−2.74 ± 1.70	<0.01^*
PSD
Better eye	4.66 ± 3.14	2.37 ± 1.32	<0.01^*
Worse eye	7.58 ± 3.93	3.75 ± 2.42	<0.01^*

Values are presented as mean ± SD unless otherwise indicated.

BCVA = best corrected visual acuity; IOP = intraocular pressure; HT = systemic hypertention; DM = diabetes mellitus; CVD = cardiovascular disease; VFI = visual field index; MD = mean deviation; PSD = pattern standard deviation.

^* Independent t-test, p < 0.01.

Table 2.

Comparison of NEI-VFQ-25 questionnaire scale between the study group and control group

VFQ-25 questionnaire scale	Glaucoma group (n = 53)	Control group (n = 54)	p-value
General health	40.20 ± 24.02	53.65 ± 25.78	0.008^*
General vision	49.41 ± 17.60	61.25 ± 19.09	0.002^*
Ocular pain	81.62 ± 19.74	86.72 ± 16.39	0.166
Near activities	81.54 ± 21.56	89.67 ± 13.34	0.026^*
Distance activities	81.70 ± 17.32	90.71 ± 12.78	0.004^*
Social functioning	92.14 ± 12.33	96.35 ± 7.72	0.121
Mental health	79.29 ± 24.89	90.36 ± 8.05	0.004^*
Role difficulties	78.92 ± 28.01	89.58 ± 17.17	0.024^*
Dependency	92.48 ± 17.89	98.09 ± 5.50	0.037^*
Color vision	95.10 ± 13.25	95.83 ± 10.74	0.763
Driving	87.22 ± 12.14	89.42 ± 12.14	0.581
Peripheral vision	89.22 ± 18.20	92.19 ± 13.80	0.364
Total	81.07 ± 15.74	88.69 ± 8.96	0.004^*

Values are presented as mean ± SD.

^* Independent t-test, p < 0.05.

Table 3.

Correlations between NEI-VFQ-25 questionnaire scale and visual field index in the better eye of glaucoma group

VFQ-25 questionnaire scale	Mean BCVA (log MAR)	VFI	MD	PSD
General health	0.316	0.697	0.651	0.859
	(-0.148)	(0.053)	(0.058)	(-0.024)
General vision	0.857	0.547	0.245	0.255
	(-0.027)	(0.083)	(0.148)	(-0.151)
Ocular pain	0.838	0.568	0.800	0.055
	(-0.028)	(0.073)	(0.030)	(-0.255)
Near activities	0.692	0.022^*	0.015^*	0.008^*
	(-0.065)	(0.320)	(0.311)	(-0.379)
Distance activities	0.143	0.002^*	0.004^*	0.010^*
	(-0.218)	(0.426)	(0.398)	(-0.338)
Social functioning	0.203	0.006^*	0.014^*	0.022^*
	(-0.183)	(0.355)	(0.298)	(-0.291)
Mental health	0.035^*	0.013^*	0.010^*	0.013^*
	(-0.292)	(0.315)	(0.307)	(-0.307)
Role difficulties	0.459	0.008^*	0.031^*	0.010^*
	(-0.104)	(0.333)	(0.256)	(-0.316)
Dependency	0.056	<0.001^*	<0.001^*	0.010^*
	(-0.272)	(0.541)	(0.474)	(-0.326)
Color vision	0.376	<0.001^*	<0.001^*	0.034^*
	(-0.129)	(0.604)	(0.459)	(-0.274)
Driving	0.958	0.239	0.414	0.056
	(-0.014)	(0.166)	(0.125)	(-0.290)
Peripheral vision	0.901	0.008^*	0.032^*	0.006^*
	(-0.019)	(0.365)	(0.281)	(-0.367)
Total	0.171	0.005^*	0.006^*	0.002^*
	(-0.202)	(0.368)	(0.338)	(-0.392)

Multiple linear regression analysis.

BCVA = best corrected visual acuity; VFI = visual field index; MD = mean deviation; PSD = pattern standard deviation.

^* p < 0.05.

Table 4.

Correlations between NEI-VFQ-25 questionnaire scale and visual field index in the worse eye of glaucoma group

VFQ-25 questionnaire scale	Mean BCVA (log MAR)	VFI	MD	PSD
General health	0.197	0.850	0.633	0.185
	(-0.167)	(0.027)	(0.067)	(-0.202)
General vision	0.156	0.049^*	0.025^*	0.113
	(-0.182)	(0.280)	(0.305)	(-0.241)
Ocular pain	0.833	0.414	0.212	0.335
	(-0.026)	(0.109)	(0.161)	(-0.137)
Near activities	0.142	0.048^*	0.058	0.362
	(-0.208)	(0.311)	(0.288)	(-0.155)
Distance activities	0.014^*	0.004^*	0.006^*	0.226
	(-0.312)	(0.403)	(0.379)	(-0.188)
Social functioning	0.009^*	0.027^*	0.053	0.568
	(-0.319)	(0.305)	(0.260)	(-0.086)
Mental health	0.144	0.011^*	0.003^*	0.026^*
	(-0.179)	(0.339)	(0.376)	(-0.319)
Role difficulties	0.079	0.110	0.098	0.255
	(-0.212)	(0.216)	(0.216)	(-0.165)
Dependency	0.226	0.025^*	0.022^*	0.310
	(-0.154)	(0.310)	(0.305)	(-0.152)
Color vision	0.235	0.114	0.332	0.888
	(-0.151)	(0.224)	(0.134)	(-0.022)
Driving	0.900	0.972	0.732	0.615
	(-0.019)	(0.008)	(0.075)	(-0.127)
Peripheral vision	0.261	0.038^*	0.127	0.914
	(-0.151)	(0.308)	(0.220)	(-0.017)
Total	0.068	0.010^*	0.007^*	0.043^*
	(-0.232)	(0.361)	(0.367)	(-0.296)

Multiple linear regression analysis.

BCVA = best corrected visual acuity; VFI = visual field index; MD = mean deviation; PSD = pattern standard deviation.

^* p < 0.05.

Table 5.

Comparison of NEI-VFQ-25 questionnaire scale according to hypertension in glaucoma group

VFQ-25 questionnaire scale	HT (+) (n = 18)	HT (-) (n = 35)	p-value	p-value (adjusted)^†
General health	29.41 ± 25.36	45.59 ± 21.73	0.010^*	0.219
General vision	41.18 ± 13.17	53.53 ± 18.24	0.020^*	0.239
Ocular pain	80.15 ± 17.71	82.35 ± 20.89	0.474	0.611
Near activities	68.14 ± 28.14	88.23 ± 13.47	0.018^*	0.128
Distance activities	73.04 ± 20.73	86.03 ± 13.72	0.021^*	0.277
Social functioning	90.44 ± 15.01	94.48 ± 10.74	0.435	0.507
Mental health	71.32 ± 30.46	83.09 ± 24.79	0.071	0.325
Role difficulties	70.58 ± 32.76	83.08 ± 24.78	0.178	0.582
Dependency	84.31 ± 26.00	96.57 ± 10.28	0.005^*	0.339
Color vision	89.71 ± 19.88	97.79 ± 7.19	0.053	0.908
Driving	75.01 ± 12.23	88.09 ± 12.10	0.315	0.859
Peripheral vision	77.94 ± 24.82	94.85 ± 10.26	0.003^*	0.164
Total	73.03 ± 19.58	85.09 ± 11.81	0.140	0.228

Values are presented as mean ± SD.

HT = systemic hypertension.

^* Mann-Whitney test, p < 0.05;

^† ANCOVA.

Table 6.

Comparison of NEI-VFQ-25 questionnaire scale according to sex in glaucoma group

VFQ-25 questionnaire scale	Man (n = 28)	Woman (n = 25)	p-value^*
General health	42.59 ± 24.82	37.50 ± 23.31	0.984
General vision	48.89 ± 16.01	50.01 ± 19.56	0.261
Ocular pain	81.02 ± 23.61	82.29 ± 14.71	0.846
Near activities	87.65 ± 18.68	74.65 ± 22.85	0.231
Distance activities	84.25 ± 18.24	78.82 ± 16.11	0.833
Social functioning	96.29 ± 10.86	89.58 ± 13.12	0.229
Mental health	82.17 ± 21.14	76.04 ± 28.65	0.566
Role difficulties	81.94 ± 26.25	75.52 ± 25.05	0.752
Dependency	94.22 ± 6.93	89.15 ± 24.21	0.120
Color vision	97.22 ± 8.01	92.71 ± 15.26	0.814
Driving	89.06 ± 10.85	79.16 ± 8.33	0.157
Peripheral vision	91.66 ± 18.34	86.45 ± 18.02	0.923
Total	84.21 ± 13.37	77.54 ± 17.66	0.458

Values are presented as mean ± SD.

^* ANCOVA.

Table 7.

Comparison of NEI-VFQ-25 questionnaire scale according to DM in glaucoma group

VFQ-25 questionnaire scale	DM (+) (n = 12)	DM (-) (n = 41)	p-value^*
General health	25.00 ± 16.67	43.90 ± 24.23	0.133
General vision	46.00 ± 16.46	50.24 ± 17.95	0.803
Ocular pain	86.25 ± 19.93	80.48 ± 19.77	0.410
Near activities	78.33 ± 23.30	82.32 ± 21.34	0.287
Distance activities	79.16 ± 18.53	82.31 ± 17.19	0.536
Social functioning	93.75 ± 15.86	92.78 ± 11.54	0.181
Mental health	79.37 ± 23.76	79.26 ± 25.44	0.804
Role difficulties	76.25 ± 31.57	79.57 ± 26.33	0.882
Dependency	87.50 ± 21.93	93.69 ± 14.28	0.682
Color vision	87.50 ± 24.29	93.95 ± 8.28	0.180
Driving	83.33 ± 9.25	87.49 ± 11.52	0.848
Peripheral vision	82.51 ± 26.48	89.85 ± 15.56	0.717
Total	78.49 ± 20.06	81.70 ± 14.73	0.716

Values are presented as mean ± SD.

DM = diabetes mellitus.

^* ANCOVA.

Table 8.

Comparison of NEI-VFQ-25 questionnaire scale according to topical medication in glaucoma group

VFQ-25 questionnaire scale	Glaucoma topical medication
VFQ-25 questionnaire scale	One eye drop (n = 39)	More than one (n = 14)	p-value^*
General health	41.67 ± 23.88	35.42 ± 24.91	0.392
General vision	50.77 ± 18.26	45.00 ± 15.08	0.278
Ocular pain	85.90 ± 13.20	67.71 ± 29.89	0.064
Near activities	83.12 ± 20.10	76.39 ± 26.07	0.242
Distance activities	84.40 ± 14.95	72.92 ± 21.94	0.122
Social functioning	94.23 ± 11.05	89.58 ± 15.84	0.196
Mental health	82.05 ± 23.44	70.31 ± 28.35	0.124
Role difficulties	82.05 ± 25.78	68.75 ± 33.50	0.126
Dependency	92.74 ± 19.70	91.67 ± 10.66	0.799
Color vision	95.51 ± 13.90	93.75 ± 11.31	0.585
Driving	86.81 ± 12.54	88.89 ± 12.73	0.930
Peripheral vision	90.38 ± 15.83	85.42 ± 24.91	0.334
Total	82.98 ± 15.22	74.87 ± 16.47	0.089

Values are presented as mean ± SD.

^* ANCOVA.

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