Vision-Related Quality of Life in Ocular Hypertension Patients: Effects of Treatment
Author(s)
Maria Kazaki1,
Ilias Georgalas1,
Alexandros Damanakis1,
Georgios Labiris2,
Sergios Taliantzis1*,
Chryssanthi Koutsandrea1,
Dimitris Papaconstantinou1
Affiliation(s)
1 Department of Glaucoma, University of Athens, Athens, Greece. 2 Department of Ophthalmology, University of Alexandroupolis, Alexandroupolis, Greece.
1 Department of Glaucoma, University of Athens, Athens, Greece. 2 Department of Ophthalmology, University of Alexandroupolis, Alexandroupolis, Greece.
ABSTRACT
Purpose: To evaluate the quality of life related to vision (QoL) in patients with ocular hypertension under treatment. Methods: The study included two groups. The first one consisted of 60 ocular hypertension patients under topical hypotensive medications and the second one of 60 healthy persons. The Greek language version of the National Eye Institute Visual Function Questionnaire 25 (NEI VFQ-25) was completed by all patients. Results: The median scores of the total score and also for almost all the NEI VFQ-25 subscales were significantly decreased for the first group of ocular hypertension patients (OHT) under topical therapy. Females presented higher QoL than that of males. The patients who used one medication presented higher QoL than that of the patients who used more than one. The best corrected visual acuity (BCVA) and the intraocular pressure (IOP) were significantly correlated with QoL. The index of the visual fields, pattern standard deviation (PSD), was significantly related to the quality of life of OHT. The age, the cup to disk ratio and the central corneal thickness had also significant correlations with subscales of the QoL. Conclusions: The quality of life OHT patients under topical treatment is significantly decreased than healthy persons. Male sex and the number of medications affect QoL more. BCVA and IOP represent the clinical findings that best correlate with several subscales of QoL. PSD is a significant index that correlates well with the quality of life of OHT patients.
Purpose: To evaluate the quality of life related to vision (QoL) in patients with ocular hypertension under treatment. Methods: The study included two groups. The first one consisted of 60 ocular hypertension patients under topical hypotensive medications and the second one of 60 healthy persons. The Greek language version of the National Eye Institute Visual Function Questionnaire 25 (NEI VFQ-25) was completed by all patients. Results: The median scores of the total score and also for almost all the NEI VFQ-25 subscales were significantly decreased for the first group of ocular hypertension patients (OHT) under topical therapy. Females presented higher QoL than that of males. The patients who used one medication presented higher QoL than that of the patients who used more than one. The best corrected visual acuity (BCVA) and the intraocular pressure (IOP) were significantly correlated with QoL. The index of the visual fields, pattern standard deviation (PSD), was significantly related to the quality of life of OHT. The age, the cup to disk ratio and the central corneal thickness had also significant correlations with subscales of the QoL. Conclusions: The quality of life OHT patients under topical treatment is significantly decreased than healthy persons. Male sex and the number of medications affect QoL more. BCVA and IOP represent the clinical findings that best correlate with several subscales of QoL. PSD is a significant index that correlates well with the quality of life of OHT patients.
Cite this paper
Kazaki, M. , Georgalas, I. , Damanakis, A. , Labiris, G. , Taliantzis, S. , Koutsandrea, C. and Papaconstantinou, D. (2015) Vision-Related Quality of Life in Ocular Hypertension Patients: Effects of Treatment. Open Journal of Ophthalmology, 5, 31-40. doi: 10.4236/ojoph.2015.51006.
Kazaki, M. , Georgalas, I. , Damanakis, A. , Labiris, G. , Taliantzis, S. , Koutsandrea, C. and Papaconstantinou, D. (2015) Vision-Related Quality of Life in Ocular Hypertension Patients: Effects of Treatment. Open Journal of Ophthalmology, 5, 31-40. doi: 10.4236/ojoph.2015.51006.
References
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http://dx.doi.org/10.1001/archopht.1988.01060130808027 [2] Cate, H., Bhattacharya, D., Clark, A., Holland, R. and Broadway, D.C. (2013) Patterns of Adherence Behaviour for Patients with Glaucoma. Eye, 27, 545-553.
http://dx.doi.org/10.1038/eye.2012.294 [3] Odberg, T. (1993) Visual Field Prognosis in Early Glaucoma. A Long-Term Clinical Follow-Up. Acta Ophthalmologica, 71, 721-726.
http://dx.doi.org/10.1111/j.1755-3768.1993.tb08590.x [4] Schwartz, G.F. and Quigley, H.A. (2008) Adherence and Persistence with Glaucoma Therapy. Survey of Ophthalmology, 53, S57-S68.
http://dx.doi.org/10.1016/j.survophthal.2008.08.002 [5] Iester, M. and Zingirian, M. (2002) Quality of Life in Patients with Early, Moderate and Advanced Glaucoma. Eye, 16, 44-49.
http://dx.doi.org/10.1038/sj.eye.6700036 [6] Weinstein, J.M., Duckrow, R.B., Beard, D. and Brennan, R.W. (1983) Regional Optic Nerve Blood Flow and Its Autoregulation. Investigative Ophthalmology & Visual Science, 24, 1559-1565. [7] Mills, R.P., Janz, N.K., Wren, P.A. and Guire, K.E. (2001) Correlation of Visual Field with Quality-of-Life Measures at Diagnosis in the Collaborative Initial Glaucoma Treatment Study (CIGTS). Journal of Glaucoma, 10, 192-198.
http://dx.doi.org/10.1097/00061198-200106000-00008 [8] Nelson, P., Aspinall, P., Papasouliotis, O., Worton, B. and O’Brien, C. (2003) Quality of Life in Glaucoma and Its Relationship with Visual Function. Journal of Glaucoma, 12, 139-150.
http://dx.doi.org/10.1097/00061198-200304000-00009 [9] Watson, P.G. and Grierson, I. (1981) The Place of Trabeculectomy in the Treatment of Glaucoma. Ophthalmology, 88, 175-196.
http://dx.doi.org/10.1016/S0161-6420(81)35051-9 [10] Sleath, B., Robin, A.L., Covert, D., Byrd, J.E., Tudor, G. and Svarstad, B. (2006) Patient-Reported Behavior and Problems in Using Glaucoma Medications. Ophthalmology, 113, 431-436. http://dx.doi.org/10.1016/j.ophtha.2005.10.034 [11] Wolfram, C., Lorenz, K., Breitscheidel, L., Verboven, Y. and Pfeiffer, N. (2013) Health- and Vision-Related Quality of Life in Patients with Ocular Hypertension or Primary Open-Angle Glaucoma. Ophthalmologica, 229, 227-234.
http://dx.doi.org/10.1159/000350553 [12] Shaffer, R. (1977) “Glaucoma Suspect” or “Ocular Hypertension”. Archives of Ophthalmology, 95, 588.
http://dx.doi.org/10.1001/archopht.1977.04450040054004 [13] Asaoka, R., Iwase, A., Hirasawa, K., Murata, H. and Araie, M.I. (2014) Identifying “Preperimetric” Glaucoma in Standard Automated Perimetry Visual Fields. Investigative Ophthalmology & Visual Science, 55, 7814-7820.
http://dx.doi.org/10.1167/iovs.14-15120 [14] Mangione, C.M., Lee, P.P., Gutierrez, P.R., Spritzer, K., Berry, S. and Hays, R.D. (2001) Development of the 25-Item National Eye Institute Visual Function Questionnaire. Archives of Ophthalmology, 119, 1050-1058.
http://dx.doi.org/10.1001/archopht.119.7.1050 [15] Wren, P.A., Musch, D.C., Janz, N.K., Niziol, L.M., Guire, K.E. and Gillespie, B.W., CIGTS Study Group (2009) Contrasting the Use of 2 Vision-Specific Quality of Life Questionnaires in Subjects with Open-Angle Glaucoma. Journal of Glaucoma, 18, 403-411.
http://dx.doi.org/10.1097/IJG.0b013e3181879e63 [16] Lisboa, R., Chun, Y.S., Zangwill, L.M., Weinreb, R.N., Rosen, P.N., Liebmann, J.M., Girkin, C.A. and Medeiros, F.A. (2013) Association between Rates of Binocular Visual Field Loss and Vision-Related Quality of Life in Patients with Glaucoma. JAMA Ophthalmology, 131, 486-494.
http://dx.doi.org/10.1001/jamaophthalmol.2013.2602 [17] Sawada, H., Fukuchi, T. and Abe, H. (2011) Evaluation of the Relationship between Quality of Vision and the Visual Function Index in Japanese Glaucoma Patients. Graefe’s Archive for Clinical and Experimental Ophthalmology, 249, 1721-1727.
http://dx.doi.org/10.1007/s00417-011-1779-5 [18] Mangione, C.M., Lee, P.P., Pitts, J., Gutierrez, P., Berry, S. and Hays, R.D. (1998) Psychometric Properties of the National Eye Institute Visual Function Questionnaire (NEI-VFQ). Archives of Ophthalmology, 116, 1496-1504.
http://dx.doi.org/10.1001/archopht.116.11.1496 [19] Mangione, C.M., Berry, S., Spritzer, K., Janz, N.K., Klein, R., Owsley, C. and Lee, P.P. (1998) Identifying the Content Area for the 51-Item National Eye Institute Vision Function Questionnaire: Results from Focus Groups with Visually Impaired Persons. Archives of Ophthalmology, 116, 227-233.
http://dx.doi.org/10.1001/archopht.116.2.227 [20] Cole, S.R., Beck, R.W., Moke, P.S., Gal, R.L. and Long, D.T. (2000) The National Eye Institute Visual Function Questionnaire: Experience of the ONTT. Optic Neuritis Treatment Trial. Investigative Ophthalmology & Visual Science, 41, 1017-1021. [21] Laboratory of Experimental Ophthalmology of Aristotle University (2000) Greek Language Translation of the National Eye Institute Visual Function Questionnaire. Aristotle University, Thessaloniki.
Http://www.rand.org/content/dam/rand/www/external/health/surveys_tools/vfq/vfq25
survey_greek.pdf [22] Massof, R.W. and Fletcher, D.C. (2001) Evaluation of the NEI Visual Functioning Questionnaire as an Interval Measure of Visual Ability in Low Vision. Vision Research, 41, 397-413.
http://dx.doi.org/10.1016/S0042-6989(00)00249-2 [23] Yamagishio, K., Keiji, Y., Kimura, T., Yamabayashi, S. and Katsushima, H. (2009) Quality of Life Evaluation in Elderly Normal Tension Glaucoma Patients Using the Japanese Version of VFQ-25. Nippon Ganka Gakkai Zasshi, 113, 964-971. [24] Richman, J., Lorenzana, L.L., Lankaranian, D., Dugar, J., Mayer, J.R., Wizov, S.S. and Spaeth, G.L. (2010) Relationships in Glaucoma Patients between Standard Vision Tests, Quality of Life, and Ability to Perform Daily Activities. Ophthalmic Epidemiology, 17, 144-151.
http://dx.doi.org/10.3109/09286581003734878 [25] Hyman, L.G., Komaroff, E., Heijl, A., Bengtsson, B. and Leske, M.C., Early Manifest Glaucoma Trial Group (2005) Treatment and Vision-Related Quality of Life in the Early Manifest Glaucoma Trial. Ophthalmology, 112, 1505-1513.
http://dx.doi.org/10.1016/j.ophtha.2005.03.028 [26] Labiris, G., Katsanos, A., Fanariotis, M., Zacharaki, F., Chatzoulis, D. and Kozobolis, V.P. (2010) Vision-Specific Quality of Life in Greek Glaucoma Patients. Journal of Glaucoma, 19, 39-43.
http://dx.doi.org/10.1097/IJG.0b013e31819d5cf7 [27] Tastan, S., Iyigun, E., Bayer, A. and Acikel, C. (2010) Anxiety, Depression, and Quality of Life in Turkish Patients with Glaucoma. Psychological Reports, 106, 343-357.
http://dx.doi.org/10.2466/pr0.106.2.343-357 [28] Odberg, T., Jakobsen, J.E., Hultgren, S.J. and Halseide, R. (2001) The Impact of Glaucoma on the Quality of Life of Patients in Norway. I. Results from a Self-Administered Questionnaire. Acta Ophthalmologica Scandinavica, 79, 116-120.
http://dx.doi.org/10.1034/j.1600-0420.2001.079002116.x [29] Skalicky, S.E., Goldberg, I. and McCluskey, P. (2012) Ocular Surface Disease and Quality of Life in Patients with Glaucoma. American Journal of Ophthalmology, 153, 1003-1004. [30] Nelson, P., Aspinall, P., Papasouliotis, O., Worton, B. and O’Brien, C. (2003) Quality of Life in Glaucoma and Its Relationship with Visual Function. Journal of Glaucoma, 12, 139-150.
http://dx.doi.org/10.1097/00061198-200304000-00009 [31] Iester, M. and Zingirian, M. (2002) Quality of Life in Patients with Early, Moderate and Advanced Glaucoma. Eye, 16, 44-49.
http://dx.doi.org/10.1038/sj.eye.6700036
[1] Cowan Jr., C.L., Worthen, D.M., Mason, R.P. and Anduze, A.L. (1988) Glaucoma in Blacks. Acta Ophthalmologica, 106, 738-739.
http://dx.doi.org/10.1001/archopht.1988.01060130808027 [2] Cate, H., Bhattacharya, D., Clark, A., Holland, R. and Broadway, D.C. (2013) Patterns of Adherence Behaviour for Patients with Glaucoma. Eye, 27, 545-553.
http://dx.doi.org/10.1038/eye.2012.294 [3] Odberg, T. (1993) Visual Field Prognosis in Early Glaucoma. A Long-Term Clinical Follow-Up. Acta Ophthalmologica, 71, 721-726.
http://dx.doi.org/10.1111/j.1755-3768.1993.tb08590.x [4] Schwartz, G.F. and Quigley, H.A. (2008) Adherence and Persistence with Glaucoma Therapy. Survey of Ophthalmology, 53, S57-S68.
http://dx.doi.org/10.1016/j.survophthal.2008.08.002 [5] Iester, M. and Zingirian, M. (2002) Quality of Life in Patients with Early, Moderate and Advanced Glaucoma. Eye, 16, 44-49.
http://dx.doi.org/10.1038/sj.eye.6700036 [6] Weinstein, J.M., Duckrow, R.B., Beard, D. and Brennan, R.W. (1983) Regional Optic Nerve Blood Flow and Its Autoregulation. Investigative Ophthalmology & Visual Science, 24, 1559-1565. [7] Mills, R.P., Janz, N.K., Wren, P.A. and Guire, K.E. (2001) Correlation of Visual Field with Quality-of-Life Measures at Diagnosis in the Collaborative Initial Glaucoma Treatment Study (CIGTS). Journal of Glaucoma, 10, 192-198.
http://dx.doi.org/10.1097/00061198-200106000-00008 [8] Nelson, P., Aspinall, P., Papasouliotis, O., Worton, B. and O’Brien, C. (2003) Quality of Life in Glaucoma and Its Relationship with Visual Function. Journal of Glaucoma, 12, 139-150.
http://dx.doi.org/10.1097/00061198-200304000-00009 [9] Watson, P.G. and Grierson, I. (1981) The Place of Trabeculectomy in the Treatment of Glaucoma. Ophthalmology, 88, 175-196.
http://dx.doi.org/10.1016/S0161-6420(81)35051-9 [10] Sleath, B., Robin, A.L., Covert, D., Byrd, J.E., Tudor, G. and Svarstad, B. (2006) Patient-Reported Behavior and Problems in Using Glaucoma Medications. Ophthalmology, 113, 431-436. http://dx.doi.org/10.1016/j.ophtha.2005.10.034 [11] Wolfram, C., Lorenz, K., Breitscheidel, L., Verboven, Y. and Pfeiffer, N. (2013) Health- and Vision-Related Quality of Life in Patients with Ocular Hypertension or Primary Open-Angle Glaucoma. Ophthalmologica, 229, 227-234.
http://dx.doi.org/10.1159/000350553 [12] Shaffer, R. (1977) “Glaucoma Suspect” or “Ocular Hypertension”. Archives of Ophthalmology, 95, 588.
http://dx.doi.org/10.1001/archopht.1977.04450040054004 [13] Asaoka, R., Iwase, A., Hirasawa, K., Murata, H. and Araie, M.I. (2014) Identifying “Preperimetric” Glaucoma in Standard Automated Perimetry Visual Fields. Investigative Ophthalmology & Visual Science, 55, 7814-7820.
http://dx.doi.org/10.1167/iovs.14-15120 [14] Mangione, C.M., Lee, P.P., Gutierrez, P.R., Spritzer, K., Berry, S. and Hays, R.D. (2001) Development of the 25-Item National Eye Institute Visual Function Questionnaire. Archives of Ophthalmology, 119, 1050-1058.
http://dx.doi.org/10.1001/archopht.119.7.1050 [15] Wren, P.A., Musch, D.C., Janz, N.K., Niziol, L.M., Guire, K.E. and Gillespie, B.W., CIGTS Study Group (2009) Contrasting the Use of 2 Vision-Specific Quality of Life Questionnaires in Subjects with Open-Angle Glaucoma. Journal of Glaucoma, 18, 403-411.
http://dx.doi.org/10.1097/IJG.0b013e3181879e63 [16] Lisboa, R., Chun, Y.S., Zangwill, L.M., Weinreb, R.N., Rosen, P.N., Liebmann, J.M., Girkin, C.A. and Medeiros, F.A. (2013) Association between Rates of Binocular Visual Field Loss and Vision-Related Quality of Life in Patients with Glaucoma. JAMA Ophthalmology, 131, 486-494.
http://dx.doi.org/10.1001/jamaophthalmol.2013.2602 [17] Sawada, H., Fukuchi, T. and Abe, H. (2011) Evaluation of the Relationship between Quality of Vision and the Visual Function Index in Japanese Glaucoma Patients. Graefe’s Archive for Clinical and Experimental Ophthalmology, 249, 1721-1727.
http://dx.doi.org/10.1007/s00417-011-1779-5 [18] Mangione, C.M., Lee, P.P., Pitts, J., Gutierrez, P., Berry, S. and Hays, R.D. (1998) Psychometric Properties of the National Eye Institute Visual Function Questionnaire (NEI-VFQ). Archives of Ophthalmology, 116, 1496-1504.
http://dx.doi.org/10.1001/archopht.116.11.1496 [19] Mangione, C.M., Berry, S., Spritzer, K., Janz, N.K., Klein, R., Owsley, C. and Lee, P.P. (1998) Identifying the Content Area for the 51-Item National Eye Institute Vision Function Questionnaire: Results from Focus Groups with Visually Impaired Persons. Archives of Ophthalmology, 116, 227-233.
http://dx.doi.org/10.1001/archopht.116.2.227 [20] Cole, S.R., Beck, R.W., Moke, P.S., Gal, R.L. and Long, D.T. (2000) The National Eye Institute Visual Function Questionnaire: Experience of the ONTT. Optic Neuritis Treatment Trial. Investigative Ophthalmology & Visual Science, 41, 1017-1021. [21] Laboratory of Experimental Ophthalmology of Aristotle University (2000) Greek Language Translation of the National Eye Institute Visual Function Questionnaire. Aristotle University, Thessaloniki.
Http://www.rand.org/content/dam/rand/www/external/health/surveys_tools/vfq/vfq25
survey_greek.pdf [22] Massof, R.W. and Fletcher, D.C. (2001) Evaluation of the NEI Visual Functioning Questionnaire as an Interval Measure of Visual Ability in Low Vision. Vision Research, 41, 397-413.
http://dx.doi.org/10.1016/S0042-6989(00)00249-2 [23] Yamagishio, K., Keiji, Y., Kimura, T., Yamabayashi, S. and Katsushima, H. (2009) Quality of Life Evaluation in Elderly Normal Tension Glaucoma Patients Using the Japanese Version of VFQ-25. Nippon Ganka Gakkai Zasshi, 113, 964-971. [24] Richman, J., Lorenzana, L.L., Lankaranian, D., Dugar, J., Mayer, J.R., Wizov, S.S. and Spaeth, G.L. (2010) Relationships in Glaucoma Patients between Standard Vision Tests, Quality of Life, and Ability to Perform Daily Activities. Ophthalmic Epidemiology, 17, 144-151.
http://dx.doi.org/10.3109/09286581003734878 [25] Hyman, L.G., Komaroff, E., Heijl, A., Bengtsson, B. and Leske, M.C., Early Manifest Glaucoma Trial Group (2005) Treatment and Vision-Related Quality of Life in the Early Manifest Glaucoma Trial. Ophthalmology, 112, 1505-1513.
http://dx.doi.org/10.1016/j.ophtha.2005.03.028 [26] Labiris, G., Katsanos, A., Fanariotis, M., Zacharaki, F., Chatzoulis, D. and Kozobolis, V.P. (2010) Vision-Specific Quality of Life in Greek Glaucoma Patients. Journal of Glaucoma, 19, 39-43.
http://dx.doi.org/10.1097/IJG.0b013e31819d5cf7 [27] Tastan, S., Iyigun, E., Bayer, A. and Acikel, C. (2010) Anxiety, Depression, and Quality of Life in Turkish Patients with Glaucoma. Psychological Reports, 106, 343-357.
http://dx.doi.org/10.2466/pr0.106.2.343-357 [28] Odberg, T., Jakobsen, J.E., Hultgren, S.J. and Halseide, R. (2001) The Impact of Glaucoma on the Quality of Life of Patients in Norway. I. Results from a Self-Administered Questionnaire. Acta Ophthalmologica Scandinavica, 79, 116-120.
http://dx.doi.org/10.1034/j.1600-0420.2001.079002116.x [29] Skalicky, S.E., Goldberg, I. and McCluskey, P. (2012) Ocular Surface Disease and Quality of Life in Patients with Glaucoma. American Journal of Ophthalmology, 153, 1003-1004. [30] Nelson, P., Aspinall, P., Papasouliotis, O., Worton, B. and O’Brien, C. (2003) Quality of Life in Glaucoma and Its Relationship with Visual Function. Journal of Glaucoma, 12, 139-150.
http://dx.doi.org/10.1097/00061198-200304000-00009 [31] Iester, M. and Zingirian, M. (2002) Quality of Life in Patients with Early, Moderate and Advanced Glaucoma. Eye, 16, 44-49.
http://dx.doi.org/10.1038/sj.eye.6700036