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青光眼患者行小梁切除术前后的与视觉相关的生活质量。

Vision-related quality of life in patients with glaucoma before and after trabeculectomy.

机构信息

Department of Ophthalmology, Copenhagen University Hospital-Rigshospitalet Copenhagen, Glostrup, Denmark.

Department of Physics, Technical University of Denmark, Kongens Lyngby, Denmark.

出版信息

Acta Ophthalmol. 2024 Nov;102(7):779-789. doi: 10.1111/aos.16697. Epub 2024 Apr 24.

Abstract

PURPOSE

To determine vision-related quality of life (VR-QoL) and functional and structural parameters associated with VR-QoL in patients with glaucoma before and 12 months after trabeculectomy.

METHODS

Fifty-eight patients undergoing trabeculectomy were included. Participants completed the 25-item National Eye Institute Visual Function Questionnaire (VFQ-25) prior to and 12 months after trabeculectomy. Functional (visual acuity and visual fields) and structural (ganglion cell layer volume) parameters were evaluated for their association with VR-QoL using multiple linear regression of VFQ-25 subscale scores. Intraocular pressure and the number of glaucoma medications were also included in the analyses.

RESULTS

The VFQ-25 composite score did not change after trabeculectomy (before: 74.9; 12 months: 74.0; p = 0.512). The subscale mental health had a significantly higher score 12 months after trabeculectomy (before: 65.6; 12 months: 71.4; p = 0.017). The VFQ-25 scores for general health (before: 68.5; 12 months: 62.5; p = 0.009) and role difficulties (before: 78.9; 12 months: 53.7; p < 0.001) were significantly lower 12 months after trabeculectomy. No functional or structural parameters were associated with VFQ-25 composite score.

CONCLUSION

Overall, VR-QoL in glaucoma patients was similar before and after trabeculectomy, reflecting the procedure's stabilizing effect on both objective and subjective visual function. The absence of correlations between VR-QoL and clinical parameters emphasizes the multifaceted nature of VR-QoL and highlights the limitations of depending solely on objective clinical metrics to evaluate patients' subjective experiences. Using both objective measures and VR-QoL, clinicians can better understand the challenges patients face due to glaucoma and trabeculectomy, potentially leading to better solutions.

摘要

目的

在小梁切除术前后,确定青光眼患者的视力相关生活质量(VR-QoL)以及与 VR-QoL 相关的功能和结构参数。

方法

纳入 58 名接受小梁切除术的患者。参与者在小梁切除术前后完成了 25 项国家眼科研究所视觉功能问卷(VFQ-25)。使用 VFQ-25 子量表评分的多元线性回归评估功能(视力和视野)和结构(神经节细胞层体积)参数与 VR-QoL 的相关性。分析中还包括眼内压和青光眼药物的数量。

结果

小梁切除术后 VFQ-25 综合评分没有变化(术前:74.9;12 个月:74.0;p=0.512)。心理健康子量表术后 12 个月的得分明显较高(术前:65.6;12 个月:71.4;p=0.017)。一般健康(术前:68.5;12 个月:62.5;p=0.009)和角色困难(术前:78.9;12 个月:53.7;p<0.001)的 VFQ-25 评分在术后 12 个月明显降低。没有功能或结构参数与 VFQ-25 综合评分相关。

结论

总体而言,小梁切除术后青光眼患者的 VR-QoL 相似,反映了该手术对客观和主观视觉功能的稳定作用。VR-QoL 与临床参数之间没有相关性,这强调了 VR-QoL 的多面性,并突出了仅依赖客观临床指标评估患者主观体验的局限性。临床医生可以同时使用客观测量和 VR-QoL,更好地理解患者因青光眼和小梁切除术而面临的挑战,从而可能提供更好的解决方案。

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