INFLUENCE OF GLAUCOMATOUS VISUAL-FIELD LOSS ON HEALTH-RELATED QUALITY-OF-LIFE

We examined the influence of glaucomatous visual field defects on visi on-targeted and generic health-related quality of life. Vision-targete d and generic health status were assessed across 5 glaucoma treatment categories and a normal reference group from 5 tertiary care ophthalmo logy practices during regularly scheduled eye care visits. The sample consisted of 147 patients who were members of specific glaucoma treatm ent categories and 44 reference group patients. For patients with glau coma, eligibility included a diagnosis of glaucoma at least 1 year pri or to enrollment and no evidence of other eye disease. Participants co mpleted 2 vision-targeted surveys, the National Eye Institute Visual F unctioning Questionnaire and the VF-14, and a generic health-related q uality of life measure, the Medical Outcomes Study 36-Item Short Form. Data from automated perimetry (Humphrey Field Analyzer 24-2, Humphrey Instruments, San Leandro, Calif) were used to generate Advanced Glauc oma Intervention Study scores for all participants. The Medical Outcom es Study 36-Item Short Form scores from glaucoma and reference group p articipants collected on a random half of the sample were similar. How ever, comparisons of the vision-targeted surveys demonstrated signific ant mean differences on 7 of 11 National Eye Institute Visual Function ing Questionnaire scales, and a trend toward significant differences f or the VF-14 (P < .07 by linear regression). Greater visual field defe cts in the better eye were significantly associated with poorer Nation al Eye Institute Visual Functioning Questionnaire scores (P < .05), as well as with worse VF-14 scores. These findings were most dramatic fo r patients with the most severe field loss in the better eye. Vision-t argeted questionnaires were more sensitive than a generic health-relat ed quality of life measure to differences between glaucoma and normal reference participants, Our findings indicate that self-reports of vis ion-targeted health-related quality of life are sensitive to visual fi eld loss and may be useful in tandem with the clinical examination to fully understand outcomes of treatment for glaucoma.