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Treatment and vision-related quality of life in the early manifest glaucoma trial

Hyman, LG; Komaroff, E; Heijl, Anders LU ; Bengtsson, Bo LU and Leske, MC (2005) In Ophthalmology 112(9). p.1505-1513
Abstract
Purpose: To evaluate the effect of treatment, visual function, and other factors on vision-targeted health-related quality of life (HRQOL) of patients with early glaucoma. Design: Randomized clinical trial. Participants: Two hundred fifty-five patients with newly detected open-angle glaucoma and repeatable early visual field (VF) defects, 50 to 80 years old (66% female). Methods: Patients were randomized to receive either betaxolol plus laser trabeculoplasty ineligible eye(s) or no initial treatment and had ophthalmologic examinations every 3 months. A Swedish translation of the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) was self-administered at 2 follow-up visits (3 and 6 years after randomization). Main... (More)
Purpose: To evaluate the effect of treatment, visual function, and other factors on vision-targeted health-related quality of life (HRQOL) of patients with early glaucoma. Design: Randomized clinical trial. Participants: Two hundred fifty-five patients with newly detected open-angle glaucoma and repeatable early visual field (VF) defects, 50 to 80 years old (66% female). Methods: Patients were randomized to receive either betaxolol plus laser trabeculoplasty ineligible eye(s) or no initial treatment and had ophthalmologic examinations every 3 months. A Swedish translation of the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) was self-administered at 2 follow-up visits (3 and 6 years after randomization). Main Outcome: Multiple linear regression analyses determined the effect of treatment and other factors on (1) VFQ-25 composite scores at the first administration and (2) change in scores between administrations. Results: Two hundred thirty-three patients had 1 NEI VFQ-25 administration and 167 patients had 2 administrations. Internal consistency reliability was high for the composite VFQ-25 score (Cronbach alpha = 0.88) and satisfactory (alpha >= 0.76) for most subscale scores. At the first administration, the composite score was high (88.8 +/- 11.7). Mean subscale scores were also generally high (98.0-58.3) and were similar for each study group when analyzed separately. Most lower subscale scores were modestly but significantly related to worse visual acuity (VA) or mean deviation (MD) (better eye, r = 0.15-0.35). Composite scores were similar for treated and untreated patients. Lower composite scores were associated with low VA in the better eye (worse than 0.70) and worse perimetric MD (< 4.16 decibels) and nuclear lens opacities (Lens Opacities Classification System 11 grade ! 2), but not with age, gender, VF progression, intraocular pressure, cardiovascular disease, or hypertension. Between VFQ-25 administrations, larger decreases in the composite score were associated with larger decreases in VA (P < 0.05), female gender (P = 0.001), and older age at first administration (P = 0.006). Treatment (assigned at randomization or later in the study) was not associated with change in HRQOL. Conclusions: Results suggest that absence or delay of treatment did not influence vision-targeted HRQOL in these newly diagnosed glaucoma patients. However, visual function affected vision-targeted quality of life up to 6 years after Early Manifest Glaucoma Trial enrollment. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Ophthalmology
volume
112
issue
9
pages
1505 - 1513
publisher
Elsevier
external identifiers
  • wos:000231544200005
  • pmid:16019074
  • scopus:24944562844
ISSN
1549-4713
DOI
10.1016/j.ophtha.2005.03.028
language
English
LU publication?
yes
id
d0c87cbc-2872-4c65-aee5-792cef97b9a0 (old id 892068)
date added to LUP
2008-01-16 11:22:14
date last changed
2017-07-30 03:36:59
@article{d0c87cbc-2872-4c65-aee5-792cef97b9a0,
  abstract     = {Purpose: To evaluate the effect of treatment, visual function, and other factors on vision-targeted health-related quality of life (HRQOL) of patients with early glaucoma. Design: Randomized clinical trial. Participants: Two hundred fifty-five patients with newly detected open-angle glaucoma and repeatable early visual field (VF) defects, 50 to 80 years old (66% female). Methods: Patients were randomized to receive either betaxolol plus laser trabeculoplasty ineligible eye(s) or no initial treatment and had ophthalmologic examinations every 3 months. A Swedish translation of the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) was self-administered at 2 follow-up visits (3 and 6 years after randomization). Main Outcome: Multiple linear regression analyses determined the effect of treatment and other factors on (1) VFQ-25 composite scores at the first administration and (2) change in scores between administrations. Results: Two hundred thirty-three patients had 1 NEI VFQ-25 administration and 167 patients had 2 administrations. Internal consistency reliability was high for the composite VFQ-25 score (Cronbach alpha = 0.88) and satisfactory (alpha &gt;= 0.76) for most subscale scores. At the first administration, the composite score was high (88.8 +/- 11.7). Mean subscale scores were also generally high (98.0-58.3) and were similar for each study group when analyzed separately. Most lower subscale scores were modestly but significantly related to worse visual acuity (VA) or mean deviation (MD) (better eye, r = 0.15-0.35). Composite scores were similar for treated and untreated patients. Lower composite scores were associated with low VA in the better eye (worse than 0.70) and worse perimetric MD (&lt; 4.16 decibels) and nuclear lens opacities (Lens Opacities Classification System 11 grade ! 2), but not with age, gender, VF progression, intraocular pressure, cardiovascular disease, or hypertension. Between VFQ-25 administrations, larger decreases in the composite score were associated with larger decreases in VA (P &lt; 0.05), female gender (P = 0.001), and older age at first administration (P = 0.006). Treatment (assigned at randomization or later in the study) was not associated with change in HRQOL. Conclusions: Results suggest that absence or delay of treatment did not influence vision-targeted HRQOL in these newly diagnosed glaucoma patients. However, visual function affected vision-targeted quality of life up to 6 years after Early Manifest Glaucoma Trial enrollment.},
  author       = {Hyman, LG and Komaroff, E and Heijl, Anders and Bengtsson, Bo and Leske, MC},
  issn         = {1549-4713},
  language     = {eng},
  number       = {9},
  pages        = {1505--1513},
  publisher    = {Elsevier},
  series       = {Ophthalmology},
  title        = {Treatment and vision-related quality of life in the early manifest glaucoma trial},
  url          = {http://dx.doi.org/10.1016/j.ophtha.2005.03.028},
  volume       = {112},
  year         = {2005},
}