The Collaborative Initial Glaucoma Treatment Study - Interim quality of life findings after initial medical or surgical treatment of glaucoma

Objective. To present interim quality, of life (QOL) findings in the Collab orative Initial Glaucoma Treatment Study (CIGTS): using; all available foll ow-up through, 5 years from treatment initiation. Design: Randomized controlled clinical trial. Participants. Six hundred seven newly diagnosed patients with open-angle gl aucoma from 14 clinical centers. Intervention: Patients were randomly assigned to either initial medical the rapy or initial trabeculectomy. After treatment Initiation and early follow -up, patients received clinical and QOL evaluations at 6-month intervals. Q OL assessments were administered by telephone at a centralized interviewing center. Main Outcome Measures., The CIGTS collected comprehensive QOL information t hat included both generic and vision-specific QOL measures. This article fo cuses on initial treatment group differences related to symptom reporting, as measured by a Symptom and, Health Problem Checklist, and changes in dail y visual functioning, as measured by the, Visual Activities Questionnaire ( VAQ). Results: Across both treatment groups, there was an overall decline in the percent of participants reporting symptoms over time. Of 43 possible, sympt oms, 12 symptoms were reported with greater frequency by the surgically tre ated group and 7 symptoms more frequently by the medical ly-treated group. The surgical patients reported more total Symptom Impact Glaucoma (P=0.005) and, in particular, more bother related to local eye symptoms. Very few tr eatment group differences were noted in visual functioning, although surgic al patients reported more problems with activities related to their visual acuity (P=0.024). The percentage of patients across treatment groups report ing worry about blindness was 50% at baseline but declined to approximately 25% over time. Conclusions; Overall, the QOL impact reported by the two treatment groups a s measured by instruments used in this study is remarkably similar, with re latively few significant study group differences observed after up to 5 yea rs of follow-up in the. CIGTS. When significant differences in visual funct ion have been detected using the VAQ, they are consistent with the clinical outcomes. To date, the most persistent QOL finding is the increased impact of local eye symptoms reported by the surgical group compared with the med ical group. Although no changes are recommended in the treatment of newly d iagnosed glaucoma patients at the time of this interim report, further foll ow-up will allow for more definitive answers to the QOL impact of these two treatment approaches. Ophthalmology 2001;108:1954-1965 (C) 2001 by the Ame rican Academy of Ophthalmology.