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Glaucoma and associated visual acuity and field loss significantly affect glaucoma-specific psychosocial functioning.

Publication ,  Journal Article
Chan, EW; Chiang, PPC; Liao, J; Rees, G; Wong, TY; Lam, JSH; Aung, T; Lamoureux, E
Published in: Ophthalmology
March 2015

OBJECTIVE: To examine the impact of glaucoma and visual acuity (VA) and visual field (VF) losses on psychosocial functioning (PF). DESIGN: Cross-sectional study. PARTICIPANTS: We compared PF between 192 participants with bilateral glaucoma with VA or VF losses and 40 controls from a tertiary eye hospital clinic in Singapore. METHODS: Glaucoma was defined using the Hodapp-Anderson-Parish criteria. Four psychosocial outcomes of the Glaucoma Quality of Life 36 questionnaire were psychometrically assessed using Rasch analysis. Multivariate regression was performed to determine the independent impact of glaucoma and VA and VF losses on PF. The impact of VA and VF on PF were evaluated by restricted cubic spline analysis. MAIN OUTCOME MEASURES: Anxiety, self-image, psychological well-being, and confidence in health care. RESULTS: The mean age of participants was 66.2±11.0 years, and 63% were male. In the better eye, VA and mean deviation were Snellen 20/25 and -8.89±6.52 dB, respectively. In multivariate models, glaucoma patients had 63.0% greater anxiety (95% confidence interval [CI], -66.0% to -61.2%; P<0.001), 71.0% lower self-image (95% CI, -74.1% to -68.5%; P<0.001), 38.3% less psychological well-being (95% CI, -37.4% to -39.0%; P<0.001), and 32.4% reduced confidence in health care than patients without glaucoma. The worst VA and VF categories had the most reduced PF (range, 26.0% to 81.5%; P<0.001 for all associations) compared with controls. With worsening VA, there was a linear increase in anxiety (P=0.009) and decrease in self-image (P=0.005). With worsening VF from 0 to -12.1 dB (P=0.003), anxiety increased before plateauing. Self-image decreased as VF worsened from 0 to -10 dB (P<0.001), and confidence in health care decreased when VF worsened from 0 to -9.3 dB (P=0.008). However, self-image and confidence in health care actually improved at greater levels of VF loss beyond these thresholds. CONCLUSION: Glaucoma negatively affects PF. Early stage glaucoma with mild VF loss adversely affects anxiety, self-image, and confidence in health care. As VA worsens in advanced glaucoma, anxiety further increases and self-image deteriorates. Ophthalmologists and glaucoma patients need to be aware that both VA and VF losses at different stages of glaucoma negatively impact PF.

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Published In

Ophthalmology

DOI

EISSN

1549-4713

Publication Date

March 2015

Volume

122

Issue

3

Start / End Page

494 / 501

Location

United States

Related Subject Headings

  • Visual Fields
  • Visual Acuity
  • Vision Disorders
  • Tertiary Care Centers
  • Surveys and Questionnaires
  • Singapore
  • Sickness Impact Profile
  • Self Concept
  • Quality of Life
  • Psychometrics
 

Citation

APA
Chicago
ICMJE
MLA
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Chan, E. W., Chiang, P. P. C., Liao, J., Rees, G., Wong, T. Y., Lam, J. S. H., … Lamoureux, E. (2015). Glaucoma and associated visual acuity and field loss significantly affect glaucoma-specific psychosocial functioning. Ophthalmology, 122(3), 494–501. https://doi.org/10.1016/j.ophtha.2014.09.030
Chan, Errol W., Peggy P. C. Chiang, Jiemin Liao, Gwyneth Rees, Tien Y. Wong, Janice S. H. Lam, Tin Aung, and Ecosse Lamoureux. “Glaucoma and associated visual acuity and field loss significantly affect glaucoma-specific psychosocial functioning.Ophthalmology 122, no. 3 (March 2015): 494–501. https://doi.org/10.1016/j.ophtha.2014.09.030.
Chan EW, Chiang PPC, Liao J, Rees G, Wong TY, Lam JSH, et al. Glaucoma and associated visual acuity and field loss significantly affect glaucoma-specific psychosocial functioning. Ophthalmology. 2015 Mar;122(3):494–501.
Chan, Errol W., et al. “Glaucoma and associated visual acuity and field loss significantly affect glaucoma-specific psychosocial functioning.Ophthalmology, vol. 122, no. 3, Mar. 2015, pp. 494–501. Pubmed, doi:10.1016/j.ophtha.2014.09.030.
Chan EW, Chiang PPC, Liao J, Rees G, Wong TY, Lam JSH, Aung T, Lamoureux E. Glaucoma and associated visual acuity and field loss significantly affect glaucoma-specific psychosocial functioning. Ophthalmology. 2015 Mar;122(3):494–501.
Journal cover image

Published In

Ophthalmology

DOI

EISSN

1549-4713

Publication Date

March 2015

Volume

122

Issue

3

Start / End Page

494 / 501

Location

United States

Related Subject Headings

  • Visual Fields
  • Visual Acuity
  • Vision Disorders
  • Tertiary Care Centers
  • Surveys and Questionnaires
  • Singapore
  • Sickness Impact Profile
  • Self Concept
  • Quality of Life
  • Psychometrics