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Association of an Objective Structural and Functional Reference Standard for Glaucoma with Quality of Life Outcomes.

Publication ,  Journal Article
Naithani, R; Jammal, AA; Estrela, T; Onyekaba, N-AE; Medeiros, FA
Published in: Ophthalmol Glaucoma
2023

PURPOSE: To compare self-reported quality-of-life (QoL) outcomes of patients diagnosed as normal, glaucoma suspect, and glaucoma based on an objective reference standard for glaucomatous optic neuropathy (GON). DESIGN: Cross-sectional study. PARTICIPANTS: 1884 eyes of 1019 patients were included in the study. METHODS: The data was sourced from the Duke Glaucoma Registry. Eyes were classified according to the presence and topographic correspondence of functional and structural damage, as assessed by parameters from standard automated perimetry (SAP) and spectral-domain OCT (SD-OCT). The objective diagnosis of the worse eye was used to define patient-level diagnosis. To assess QoL in the diagnostic groups, 14 unidimensional vision-related items of the National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25) were used to assess QoL in the diagnostic groups. Association between NEI VFQ-25 Rasch-calibrated scores and diagnostic groups was assessed through multivariable regression that controlled for confounding demographic and socioeconomic variables such as age, sex, race, income, marriage status, insurance status, and highest education level. MAIN OUTCOME MEASURES: NEI VFQ-25 Rasch scores compared with objective criteria diagnosis based on SAP mean deviation (MD) and SD-OCT retinal nerve fiber layer (RNFL) thickness. RESULTS: Overall, eyes classified as normal, glaucoma suspect, and glaucoma had decreasing mean scores in SAP MD (0.2 ± 1.0 dB, -0.9 ± 2.4 dB, -6.2 ± 7.0 dB, respectively; P < 0.001) and SD-OCT RNFL thickness (97.8 ± 9.5 μm, 89.0 ± 13.1 μm, 64.5 ± 12.8 μm, respectively; P < 0.001). The mean Rasch-calibrated NEI VFQ-25 score was significantly different among normal, suspect, and glaucoma groups (82.9 ± 13.0, 78.2 ± 14.8, and 72.6 ± 16.2, respectively; P < 0.001). When adjusted for confounding socioeconomic variables, glaucoma patients had significantly worse QoL than those classified as normal (β = -6.8 Rasch score units; P < 0.001). CONCLUSION: A glaucoma diagnosis, based on an objective reference standard for GON, was significantly associated with worse Rasch-adjusted scores of QoL. Utilization of such objective criteria may provide clinically relevant metrics with potential to improve comparability of research findings and validation of newly proposed diagnostic tools. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found after the references.

Duke Scholars

Published In

Ophthalmol Glaucoma

DOI

EISSN

2589-4196

Publication Date

2023

Volume

6

Issue

2

Start / End Page

160 / 168

Location

United States

Related Subject Headings

  • Visual Fields
  • Reference Standards
  • Quality of Life
  • Prospective Studies
  • Optic Nerve Diseases
  • Ocular Hypertension
  • Humans
  • Glaucoma
  • Cross-Sectional Studies
 

Citation

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MLA
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Naithani, R., Jammal, A. A., Estrela, T., Onyekaba, N.-A., & Medeiros, F. A. (2023). Association of an Objective Structural and Functional Reference Standard for Glaucoma with Quality of Life Outcomes. Ophthalmol Glaucoma, 6(2), 160–168. https://doi.org/10.1016/j.ogla.2022.08.013
Naithani, Rizul, Alessandro A. Jammal, Tais Estrela, Ndidi-Amaka E. Onyekaba, and Felipe A. Medeiros. “Association of an Objective Structural and Functional Reference Standard for Glaucoma with Quality of Life Outcomes.Ophthalmol Glaucoma 6, no. 2 (2023): 160–68. https://doi.org/10.1016/j.ogla.2022.08.013.
Naithani R, Jammal AA, Estrela T, Onyekaba N-AE, Medeiros FA. Association of an Objective Structural and Functional Reference Standard for Glaucoma with Quality of Life Outcomes. Ophthalmol Glaucoma. 2023;6(2):160–8.
Naithani, Rizul, et al. “Association of an Objective Structural and Functional Reference Standard for Glaucoma with Quality of Life Outcomes.Ophthalmol Glaucoma, vol. 6, no. 2, 2023, pp. 160–68. Pubmed, doi:10.1016/j.ogla.2022.08.013.
Naithani R, Jammal AA, Estrela T, Onyekaba N-AE, Medeiros FA. Association of an Objective Structural and Functional Reference Standard for Glaucoma with Quality of Life Outcomes. Ophthalmol Glaucoma. 2023;6(2):160–168.
Journal cover image

Published In

Ophthalmol Glaucoma

DOI

EISSN

2589-4196

Publication Date

2023

Volume

6

Issue

2

Start / End Page

160 / 168

Location

United States

Related Subject Headings

  • Visual Fields
  • Reference Standards
  • Quality of Life
  • Prospective Studies
  • Optic Nerve Diseases
  • Ocular Hypertension
  • Humans
  • Glaucoma
  • Cross-Sectional Studies