中国青光眼患者视觉功能的主观和客观临床结局与生活质量的相关性：一项横断面研究。
Associations of subjective and objective clinical outcomes of visual functions with quality of life in Chinese glaucoma patients: a cross-sectional study.
作者信息
Yang Li, Shi Xuefeng, Tang Xin
机构信息
Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, 300020, China.
Tianjin Eye Hospital, Tianjin, 300020, China.
出版信息
BMC Ophthalmol. 2019 Jul 31;19(1):166. doi: 10.1186/s12886-019-1176-0.
BACKGROUND
The cost of managing a chronic disease like glaucoma is quite large. A convenient and economical monitoring tool like self-reported measures of Quality of Life (QoL) could have the potential to significantly reduce the health economic burden of this disease. However, evidence about whether QoL can effectively reflect both subjective and objective clinical outcomes of visual functions in glaucoma patients is lacking. In this paper, we examined the relationships between both subjective and objective visual functions and QoL in glaucoma patients.
METHODS
This cross-sectional study enrolled 107 patients with a broad range of glaucomatous visual function loss. Subjective visual function loss was assessed using tests of visual acuity (VA), contrast sensitivity (CS) and visual field (VF). Evaluation of objective visual function was performed using pattern visual evoked potentials (PVEP). National Eye Institute Visual Function Questionnaire 25 (NEI VFQ-25) and Glaucoma Quality of Life-15 (GQL-15) were used to measure QoL. Uni- and multivariable linear regression analyses were performed to investigate the associations between all the clinical variables with Rasch-calibrated QoL scores.
RESULTS
Univariate analysis revealed that worse Rasch-calibrated NEI VFQ and GQL scores were associated with poorer VA and CS in both the better eye (BE) and the worse eye (WE), and with worse VF mean deviation, VF pattern standard deviation and PVEP latency and amplitude in 15 min check size in the WE (P < 0.05). Multivariable linear regression analysis revealed that, after adjusting for age, gender, duration of glaucoma, glaucoma severity and glaucoma type, Rasch-calibrated NEI VFQ-25 person measure scores were significantly associated with PVEP latency in 15 min check size [β = - 0.347, 95% CI: (- 0.618, - 0.118), P = 0.001] in the WE; Rasch-calibrated GQL-15 person measure scores were significantly associated with PVEP amplitude in 15 min check size [β = - 0.338, 95% CI: (- 0.588, - 0.108), P < 0.001] in the WE.
CONCLUSIONS
Self-reported measures of QoL could be supplemental tools for assessing both subjective and objective visual functions in glaucoma patients.
背景
管理像青光眼这样的慢性疾病成本相当高昂。一种便捷且经济的监测工具，如生活质量（QoL）的自我报告测量方法，有可能显著减轻这种疾病的健康经济负担。然而，关于QoL是否能有效反映青光眼患者视觉功能的主观和客观临床结果的证据尚缺。在本文中，我们研究了青光眼患者主观和客观视觉功能与QoL之间的关系。
方法
这项横断面研究纳入了107例青光眼视觉功能丧失程度范围广泛的患者。主观视觉功能丧失通过视力（VA）、对比敏感度（CS）和视野（VF）测试进行评估。客观视觉功能评估采用图形视觉诱发电位（PVEP）。使用美国国立眼科研究所视觉功能问卷25（NEI VFQ - 25）和青光眼生活质量 - 15（GQL - 15）来测量QoL。进行单变量和多变量线性回归分析，以研究所有临床变量与Rasch校准的QoL分数之间的关联。
结果
单变量分析显示，在较好眼（BE）和较差眼（WE）中，Rasch校准的NEI VFQ和GQL分数越低，与VA和CS越差相关，并且在较差眼中，与VF平均偏差、VF模式标准差以及15分钟检查大小下的PVEP潜伏期和波幅越差相关（P < 0.05）。多变量线性回归分析显示，在调整年龄、性别、青光眼病程、青光眼严重程度和青光眼类型后，Rasch校准的NEI VFQ - 25个人测量分数与较差眼中15分钟检查大小下的PVEP潜伏期显著相关[β = - 0.347，95%CI：（- 0.618， - 0.118），P = 0.001]；Rasch校准的GQL - 15个人测量分数与较差眼中15分钟检查大小下的PVEP波幅显著相关[β = - 0.338，95%CI：（- 0.588， - 0.108），P < 0.001]。
结论
自我报告的QoL测量方法可作为评估青光眼患者主观和客观视觉功能的补充工具。
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