Ramulu Pradeep Y, Hochberg Chad, Maul Eugenio A, Chan Emilie S, Ferrucci Luigi, Friedman David S
*MD, PhD †BS ‡MS Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland (PYR, CH, EAM, ESC, DSF); and Longitudinal Studies Section, Clinical Research Branch, National Institute on Aging, National Institutes of Health, Bethesda, Maryland (LF).
Optom Vis Sci. 2014 Feb;91(2):187-93. doi: 10.1097/OPX.0000000000000139.
To determine the association between glaucoma and travel away from home.
Fifty-nine glaucoma suspect controls with normal vision and 80 glaucoma subjects with bilateral visual field (VF) loss wore a cellular tracking device during 1 week of normal activity. Location data were used to evaluate the number of daily excursions away from home as well as daily time spent away from home.
Control and glaucoma subjects were similar in age, race, sex, employment, driving support, cognitive ability, mood, and comorbid illness (p > 0.1 for all). Better-eye VF mean deviation (MD) averaged 0.0 decibels (dB) in controls and -11.1 dB in glaucoma subjects. In multivariable models, glaucoma was associated with fewer daily excursions (β = -0.20; 95% confidence interval [95% CI], -0.38 to -0.02) and a greater likelihood of not leaving home on a given day (odds ratio [OR], 1.82; 95% CI, 1.05 to 3.06). Each 5-dB decrement in the better-eye VF MD was associated with fewer daily excursions (β = -0.06; 95% CI, -0.11 to -0.01) and a greater chance of not leaving home on a given day (OR, 1.24; 95% CI, 1.04 to 1.47). Time spent away from home did not significantly differ between the glaucoma subjects and suspects (p = 0.18). However, each 5-dB decrement in the better-eye MD was associated with 6% less time away (95% CI, -12 to -1%).
Individuals with glaucoma, particularly those with greater VF loss, are more home bound and travel away from home less than individuals with normal vision. Because being confined to the home environment may have detrimental effects on fitness and health, individuals with glaucoma should be considered for interventions such as orientation and mobility training to encourage safe travel away from home.
确定青光眼与离家出行之间的关联。
59名视力正常的青光眼疑似对照者和80名双侧视野（VF）受损的青光眼患者在正常活动的1周内佩戴了细胞追踪设备。位置数据用于评估每日离家出行的次数以及每日离家在外的时间。
对照者和青光眼患者在年龄、种族、性别、就业情况、驾驶支持、认知能力、情绪和合并症方面相似（所有p>0.1）。对照者较好眼的VF平均偏差（MD）平均为0.0分贝（dB），青光眼患者为-11.1 dB。在多变量模型中，青光眼与每日出行次数较少相关（β=-0.20；95%置信区间[95%CI]，-0.38至-0.02），且在特定日期不离开家的可能性更大（优势比[OR]，1.82；95%CI，1.05至3.06）。较好眼VF MD每降低5 dB，与每日出行次数减少相关（β=-0.06；95%CI，-0.11至-0.01），且在特定日期不离开家的可能性更大（OR，1.24；95%CI，1.04至1.47）。青光眼患者和疑似患者离家在外的时间没有显著差异（p=0.18）。然而，较好眼MD每降低5 dB，离家在外的时间减少6%（95%CI，-12至-1%）。
青光眼患者，尤其是那些视野损失较大的患者，比视力正常的人更居家，离家出行更少。由于局限于家庭环境可能对健康和体能产生不利影响，对于青光眼患者应考虑采取诸如定向与移动训练等干预措施，以鼓励其安全离家出行。
