National Taiwan University Hospital Jin-Shan Branch, New Taipei City, Taiwan.
Department of Ophthalmology, National Taiwan University Hospital, No. 7, Chung-Shan S. Rd., Taipei, Taiwan.
Graefes Arch Clin Exp Ophthalmol. 2022 Sep;260(9):2971-2980. doi: 10.1007/s00417-022-05593-x. Epub 2022 Feb 22.
This study aimed to investigate the factors associated with disability glare in patients with advanced glaucoma and evaluate the impact of disability glare on the vision-related quality of life.
We prospectively studied 225 eyes (225 patients) with advanced glaucoma. The visual function was evaluated using the 10-2 and 24-2 Humphrey visual field (VF) (Dublin, California) and contrast sensitivity test. Structural parameters were obtained using RTVue optical coherence tomography and angiography (Fremont, California). Significant loss of macular vessel density (mVD) was defined as VD < 30%. Each participant completed the National Eye Institute Visual Function Questionnaire 25 (NEI-VFQ-25) and questions regarding subjective symptoms of glare.
Fifty-six patients (24.9%) experienced glare and had a lower NEI-VFQ-25 composite score (P = 0.017). The average retinal nerve fiber layer and ganglion cell complex thickness and mean deviation (MD) in the 24-2 VF test were not associated with glare. Significant superior or inferior mVD loss (P < 0.001; odds ratio [OR], 3.45; and 95% confidence interval [CI], 1.83-6.55), lower logarithmic contrast sensitivity at 0.75 cycles/degree (P < 0.001; OR, 0.27; and 95% CI, 0.13-0.56), and worse MD in the 10-2 VF test (P < 0.001; OR, 0.93; and 95% CI, 0.89-0.97) showed an association with glare.
In advanced glaucoma, central VF defect and mVD loss are associated with disability glare, which negatively impacts vision-related quality of life.
本研究旨在探讨与晚期青光眼患者视功能障碍性眩光相关的因素，并评估视功能障碍性眩光对视觉相关生活质量的影响。
前瞻性研究了 225 只眼（225 例患者）的晚期青光眼患者。使用 10-2 和 24-2 Humphrey 视野（加利福尼亚州都柏林）和对比敏感度测试评估视觉功能。使用 RTVue 光学相干断层扫描和血管造影（加利福尼亚州弗里蒙特）获得结构参数。显著的黄斑血管密度（mVD）损失定义为 VD<30%。每位参与者完成了国家眼科研究所视觉功能问卷 25（NEI-VFQ-25）和关于眩光主观症状的问题。
56 例（24.9%）患者出现眩光，且 NEI-VFQ-25 综合评分较低（P=0.017）。24-2 VF 测试中的平均视网膜神经纤维层和节细胞复合体厚度以及平均偏差（MD）与眩光无关。显著的上或下 mVD 损失（P<0.001；优势比[OR]，3.45；95%置信区间[CI]，1.83-6.55），较低的对数对比敏感度（0.75 周期/度）（P<0.001；OR，0.27；95% CI，0.13-0.56）和 10-2 VF 测试中更差的 MD（P<0.001；OR，0.93；95% CI，0.89-0.97）与眩光有关。
在晚期青光眼患者中，中央视野缺损和 mVD 损失与视功能障碍性眩光相关，对视觉相关生活质量产生负面影响。
