A Review of Studies of the Association of Vision-Related Quality of Life with Measures of Visual Function and Structure in Patients with Glaucoma in the United States

ABSTRACT

Purpose: To investigate the association of quality of life (QoL) with ocular structure and function in glaucoma patients, and to identify which aspects of QoL are most closely tied to Visual Field (VF) and Visual Acuity (VA).

Methods: We conducted a comprehensive review of studies on QoL in glaucoma patients using PubMed, Web of Science, and Google Scholar (from 1 January 1997 to 7 December 2019). A total of 21 studies in the United States that used the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ) or 51-item NEI VFQ were included. A descriptive analysis of data from the selected studies was conducted. The association between QoL scores and visual function and structure was investigated by ranking the strength of association on a scale from 1 (weakest) to 12 (strongest).

Results: Studies reported correlations between QoL scores and Visual Structure. Associations were also reported between QoL and Visual Function both cross-sectionally and longitudinally, with a stronger association of VF and VA with distance activities (average ranking 9.1 and 9.6), vision-specific dependency (8.7 and 8.9), and driving (8.6 and 9.7). Vision-specific mental health (6.5 and 4.9), vision-specific social functioning (8.4 and 6.2), and vision-specific role difficulties (7.1 and 6.6) domains were more associated with VF than with VA.

Conclusion: Our study was the first to quantify and rank the strength of association between visual function and QoL domains. Driving and psycho-social QoL domains tended to be most affected by glaucoma-related deterioration of visual function. QoL scores could be used for more patient-centered disease management.

KEWORDS:

• Glaucoma
• quality of life
• visual structure
• visual function

Disclosure of interest

None of the authors have any proprietary interests or conflicts of interest related to this submission.

Supplementary material

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Additional information

Funding

This work was supported by the National Eye Institute, Bethesda, Maryland [grant #1RO1EY023557-01] and the Department of Ophthalmology at the Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Funds also come from the Vision Research Core Grant [P30 EY001583], F.M. Kirby Foundation, Research to Prevent Blindness, UPenn Hospital Board of Women Visitors, Paul and Evanina Bell Mackall Foundation Trust. The Ophthalmology Department at the Perelman School of Medicine and the VA Hospital in Philadelphia, PA also provided support. The sponsor or funding organization had no role in the design or conduct of this research.