Pujol Carreras O, Anton A, Mora C, Pastor L, Gudiña S, Maull R, Vega Z, Castilla M
Hospital de l' Esperança-Parc de Salut Mar, Barcelona, España; Institut Català de la Retina, Barcelona, España.
Hospital de l' Esperança-Parc de Salut Mar, Barcelona, España; Institut Català de la Retina, Barcelona, España; Universitat Internacional de Catalunya, Barcelona, España.
Arch Soc Esp Oftalmol. 2017 Nov;92(11):521-527. doi: 10.1016/j.oftal.2016.10.005. Epub 2017 Jun 7.
To assess the quality of life in glaucoma patients and normal subjects, and to assess its relationship with the severity of damage in each eye.
A cross-sectional study was conducted with prospective selection of cases. The study included 464 subjects and were distributed into 4categories. Subjects included in group 1 had both eyes normal, that is with a normal intraocular pressure (IOP), optic disk and visual fields (VF), or mild glaucoma, defined as untreated IOP>21mmHg and abnormal VF with mean defect (MD) over -6dB. Group 2 consisted of patients with both eyes with mild or moderate glaucoma, defined as untreated IOP>21mmHg and abnormal VF with MD between -6 and -12dB. Group 3 included patients with moderate to severe glaucoma, that is, untreated IOP>21mmHg and abnormal VF with MD of less than -12dB in both eyes. Group 4 consisted of patients with asymmetric glaucoma damage, that is, they had one eye with severe glaucoma and the other eye normal or with mild glaucoma. All subjects completed 3 different questionnaires. Global quality of life was evaluated with EuroQol-5D (EQ-5D). Vision related quality of life was assessed with Visual Function Questionnaire (VFQ-25). Quality of life related to ocular surface disease was measured with Ocular Surface Disease Index (OSDI).
VFQ-25 showed that group 3 had significantly lower scores than group 1 in mental health (P=.006), dependence (P=.006), colour vision (P=.002), and peripheral vision (P=.002). EQ-5D showed no significant differences between any group, but a trend was found to greater difficulty in group 3 than in groups 1 and 2, and in all dimensions. OSDI showed a higher score, or which was the same as a major disability, in groups 2 and 3 than group 1 (P=.021 and P=.014, respectively). VFQ-25 only found significant differences between group 1 and group 4. Dimensions with significant differences were found between group 1 and 3 (both eyes with advanced or moderate glaucoma). These were not found between group 1 and group 4 (the group in which one eye has only mild glaucoma or no glaucoma). This finding confirms that the eye with less glaucoma damage determines the quality of life.
Our results demonstrate that quality of life is impaired in patients with glaucoma, and this alteration is greater the more advanced is glaucoma damage in the best or both eyes.
评估青光眼患者和正常受试者的生活质量，并评估其与每只眼睛损伤严重程度的关系。
进行了一项横断面研究，前瞻性选择病例。该研究纳入了464名受试者，分为4组。第1组受试者双眼正常，即眼压（IOP）、视盘和视野（VF）正常，或患有轻度青光眼，定义为未经治疗的眼压>21mmHg且视野异常，平均缺损（MD）超过-6dB。第2组由双眼患有轻度或中度青光眼的患者组成，定义为未经治疗的眼压>21mmHg且视野异常，MD在-6至-12dB之间。第3组包括中度至重度青光眼患者，即未经治疗的眼压>21mmHg且双眼视野异常，MD小于-12dB。第4组由青光眼损伤不对称的患者组成，即一只眼睛患有严重青光眼，另一只眼睛正常或患有轻度青光眼。所有受试者完成了3份不同的问卷。用欧洲五维健康量表（EQ-5D）评估总体生活质量。用视觉功能问卷（VFQ-25）评估与视力相关的生活质量。用眼表疾病指数（OSDI）测量与眼表疾病相关的生活质量。
VFQ-25显示，第3组在心理健康（P=0.006）、依赖性（P=0.006）、色觉（P=0.002）和周边视力（P=0.002）方面的得分显著低于第1组。EQ-5D显示各组之间无显著差异，但发现第3组在所有维度上比第1组和第2组有更大的困难趋势。OSDI显示，第2组和第3组的得分高于第1组（分别为P=0.021和P=0.014），得分高等同于严重残疾。VFQ-25仅发现第1组和第4组之间存在显著差异。在第1组和第3组（双眼患有晚期或中度青光眼）之间发现了存在显著差异的维度。在第1组和第4组（其中一只眼睛仅有轻度青光眼或无青光眼的组）之间未发现这些差异。这一发现证实，青光眼损伤较轻的眼睛决定了生活质量。
我们的结果表明，青光眼患者的生活质量受损，且青光眼在最佳眼或双眼的损伤越严重，这种改变就越大。
