The relationship between visual disability and visual field in patients with glaucoma☆
Section snippets
Subjects
We evaluated visual disability in 147 patients (75 male and 72 female) with glaucoma (69 patients with primary open-angle glaucoma [POAG], 56 patients with normal tension glaucoma [NTG], and 22 patients with primary angle-closure glaucoma). All patients involved in the study fulfilled the following criteria: (1) glaucoma was the only disease leading to visual field damage and/or visual acuity impairment; (2) patients were followed for more than 6 months at either Tokyo Teishin Hospital or
Relationship between visual disability assessed by the revised questionnaire and visual acuity
Visual disability in the 147 glaucoma patients was assessed using the revised questionnaire. The questionnaire, originally written in Japanese, contained 30 questions addressing 7 items: legibility of letters (letters), sentences, walking, using public transportation (going out), dining, dressing, and additional miscellaneous activities (miscellaneous) (Table 1, excluding the questions, written with italics). Each question had three possible responses, scored as follows, greatly disabled, 2
Relationship between visual disability assessed by the revised questionnaire and visual acuity
Visual acuity in the better and worse eye correlated significantly with all the disability indices (r = 0.46 to 0.74) (Table 2). Visual acuity in the better eye demonstrated the highest correlation with the item and total DIs (r = 0.63 to 0.74).
Using stepwise variable selection, the visual acuities in both the better and worse eyes were found to be significant predictors of total DI (P < 0.0001, P < 0.001). The standardized partial regression coefficients for visual acuity in the better and
Discussion
Previous questionnaires5, 6, 7, 8, 9, 10, 11, 12 assessing visual disability in patients with visual acuity or field impairment unanimously covered the seven items examined in our questionnaire: letters, sentences, walking, going out, dining, dressing, and miscellaneous. Driving, however, an important section in questionnaires developed in Western countries, was not included in this questionnaire. None of the patients involved in this study complained of any inconvenience in driving. In Japan,
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2022, OphthalmologyCitation Excerpt :The criteria for judging VF deterioration using HFA have been reported in the literature, but most are based on the results of HFA 24-2 or 30-2 tests in eyes with mild or moderate glaucomatous damage30–34; however, in an eye with severely advanced damage, such as the eyes of the present participants, the accuracy of the evaluation of thresholds of test points with very low sensitivities is likely to be low.35 The central 10° VF covered by HFA 10-2 is more related to vision-related quality of life,21–23 and quite a few test points are relatively well spared in this subfield, even at the advancement of glaucomatous damage28,29; however, no criteria have been established for judging significant deterioration of the HFA 10-2 VF in eyes with advanced glaucoma. The specificity of the current criteria (the same 3 points with TD slope ≤–1.0 dB/year at P < 0.01 at 3 consecutive HFA 10-2 tests) was assessed in the simulated nonprogressing HFA 10-2 VF series, whose mean MD was very similar to that of the participants of the current study, and the assessed specificity was 99.99%.
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2021, Ophthalmology GlaucomaCitation Excerpt :Recent studies have revealed that the HFA 24-2 test is not sufficient to assess damage in the central VF, and therefore, it is recommended also to measure the HFA 10-2 VF.62-67 In addition, damage to this area of the VF is associated more directly with patients’ vision related to the quality of life.68,69 A future study should be attempted to shed light on the usefulness of VF augmentation in the HFA 10-2 test.
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Manuscript no. 210734.