Evaluation of quality of life in glaucoma patients

The aim of the study was to evaluate health related quality of life in patients having different stages of glaucoma and investigate the affect of patient demograpics, clinical characteristics, visual functions on quality of life. This study included prospectively 160 patients with glaucoma suspect and glaucoma diagnosis at Ankara University Faculty of Medicine, Department of Eye Diseases, Glaucoma Clinic. Sociodemographic characteristics and ophtalmic examination findings were obtained from each patients. Monocular visual filed test, optical coherence tomography test for peripepiller retinal nerve fiber and macula analysis, additionally computerized contrast sensitivity test (Metrovision® Monpack 3) were used. Reading performance in glaucoma patients was examined by the Turkish version of the Minnesota Reading Acuity Chart (MNREAD). The participants completed a questionnaire on Turkish version of NEI VFQ-25 and SF-36. Glaucoma were classified into the the basis of MD value via Hoddap-Parrish-Anderson staging system. Age, gender, educational level, working state were related to physical component score (SF-36). Patients who living in urban areas, having chronic diseases achieved significantly higher scores on NEI-VFQ-25 questionnaire. In NEI-VFQ-25 scoring; the general health subscale was the lowest score and the color vision subscale was the highest score. From early to severe stage as the severity of glaucoma increase, the role difficulties and driving was the most affected domain. Whereas no relation between visual functions and SF-36 questionnaire, NEI-VFQ-25 composite scores have a low-moderate correlation with all visual functions, but worse eye VFI was the strongest. The MD of the better eye was much more influential on NEI-VFQ-25 composite score in advanced glaucoma. Furthermore moderate correlation was found between contrast sensitivity, structural tests and NEIVFQ-25 total score. Although visual funcitons has no affect on questionnaire scores in glaucoma suspect cases, there should be other factors rather than visual functions. Physical component score (SF-36) and NEI-VFQ-25 composite score, most of subscores acts like mostly same way. Therefore our findings suggest that the individual questionnaire capture different dimensions of the same daily activities concerning visual function. In conclusion, there is still obscurity about quality of life in glaucoma patients. Vision related quality of life in patients with glaucoma is more influenced by visual parameters in the later stages. SF-36 is a generic health questionnaire and useful for interpreting quality of life but NEI-VFQ-25 questionnaire gives more information about vision spesific quality of life. We should pay attention to contrast sensitivity and structural test for assessing quality of life in daily practice. Key Words: Glaucoma, NEI-VFQ-25, Quality of Life, SF-36, Visual Functions