Urata Carla N, Mazzoli Livia S, Kasahara Niro
Irmandade da Santa Casa de Misericordia de Sao Paulo, Sao Paulo, Brazil.
Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo, Brazil.
Transl Vis Sci Technol. 2018 Oct 1;7(5):17. doi: 10.1167/tvst.7.5.17. eCollection 2018 Sep.
Falls are very prevalent in the older population. Visually impaired elderly patients are prone to falls as the result of visual loss and ageing. The purpose of the study was to compare the fear of falling (FoF) between primary open angle glaucoma (POAG) and age-related macular degeneration (ARMD) patients who live in a developing country.
This was a cross-sectional observational study. After a complete eye examination including measurement of best-corrected visual acuity, ophthalmoscopy, and automated visual field, all subjects completed the Fall Efficacy Scale International Brazil (FES-I-Brazil) questionnaire.
The sample comprised 64 patients with POAG, 48 with ARMD, and 52 controls. All groups were matched for age, sex, comorbidity, and ethnic distribution. The FES-I score was 24.6 ± 8.7, 25.3 ± 6.3, and 24.2 ± 7.7 for glaucoma, ARMD, and controls, respectively ( = 0.894). A post hoc analysis comparing all subjects with advanced visual field defect (mean deviation [MD] < -12 dB) revealed a higher FES-I score in ARMD patients as compared to POAG ones (46.2 ± 16.8 and 24.0 ± 7.7 for ARMD and POAG, respectively, < 0.001).
In this cohort of elderly subjects with eye diseases, the FoF was similar among groups; however, ARMD patients with more compromised visual field had higher FoF as compared to POAG patients and controls.
A high rate of fear of falling exists in ARMD patients with compromised visual field. This finding may be useful in developing multidimensional strategies to decrease fear of falling and improve quality of life in older persons living in a developing country.
跌倒在老年人群中非常普遍。视力受损的老年患者由于视力丧失和衰老而容易跌倒。本研究的目的是比较生活在发展中国家的原发性开角型青光眼（POAG）患者和年龄相关性黄斑变性（ARMD）患者的跌倒恐惧（FoF）。
这是一项横断面观察性研究。在进行包括最佳矫正视力测量、检眼镜检查和自动视野检查在内的全面眼部检查后，所有受试者完成了巴西国际跌倒效能量表（FES-I-巴西）问卷。
样本包括64例POAG患者、48例ARMD患者和52例对照。所有组在年龄、性别、合并症和种族分布方面相匹配。青光眼、ARMD和对照组的FES-I评分分别为24.6±8.7、25.3±6.3和24.2±7.7（=0.894）。对所有有严重视野缺损（平均偏差[MD]<-12 dB）的受试者进行的事后分析显示，与POAG患者相比，ARMD患者的FES-I评分更高（ARMD和POAG分别为46.2±16.8和24.0±7.7，<0.001）。
在这个患有眼部疾病的老年受试者队列中，各组之间的跌倒恐惧相似；然而，与POAG患者和对照组相比，视野受损更严重的ARMD患者有更高的跌倒恐惧。
视野受损的ARMD患者存在较高的跌倒恐惧率。这一发现可能有助于制定多维度策略，以减少跌倒恐惧，提高生活在发展中国家的老年人的生活质量。
