A glaucoma diagnosis, based on an objective reference standard for glaucomatous optic neuropathy significantly worsens quality of life (QOL) compared with patients who have pre-perimetric glaucoma or healthy eyes, according to research published in Ophthalmology Glaucoma.
Investigators conducted a cross-sectional study to compare self-reported QOL outcomes of patients diagnosed as normal, glaucoma suspect, and glaucoma based on an objective reference standard for glaucomatous optic neuropathy.
They used data from the Duke Glaucoma Registry and classified eyes according to the presence of functional and structural damage, assessed by parameters from standard automated perimetry (SAP) and retinal nerve fiber layer (RNFL) thickness from spectral-domain optical coherence tomography (SD-OCT).
The researchers assessed QOL in the diagnostic groups using Rasch-calibrated scores based on 14 unidimensional vision-related items of the National Eye Institute Visual Functioning Questionnaire. They then used multivariable regression to test the association between QOL scores and diagnostic groups while controlling for demographic and socioeconomic variables.
A total of 1884 eyes of 1019 patients (mean age, 63.4±14.3; 58.5% women, 41.5% men) were included in the study. In the study population, 35.8% of patients had Black ethnicity.
The researchers found that eyes classified as normal, glaucoma suspect, and glaucoma had decreasing mean scores for SAP mean deviation (0.2±1.0 dB, -0.9±2.4 dB, and -6.2±7.0 dB, respectively; P <.001) and SD-OCT RNFL thickness (97.8±9.5, 89.0±13.1, and 64.5±12.8 μm, respectively; P <.001).
They demonstrated that across diagnostic groups, the mean QoL scores were significantly different (normal, 82.9±13.0; suspect, 78.2±14.8; and glaucoma groups, 72.6±16.2; P <.001). When adjusted for confounding factors, the team found that patients with glaucoma had significantly worse QoL than those classified as normal (β = -6.8 Rasch score units; P <.001).
“Utilization of such objective criteria [for glaucoma diagnosis] may provide clinically relevant metrics with potential to improve comparability of research findings and validation of newly proposed diagnostic tools,” concluded the researchers.
Disclosure: One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
Naithani R, Jammal AA, Estrela T, Onyekaba NE, Medeiros FA. Association of an objective structural and functional reference standard for glaucoma with quality-of-life outcomes. Ophthalmol Glaucoma. 2022;S2589-4196(22):00167-3. doi:10.1016/j.ogla.2022.08.013