Association of Vision Loss in Glaucoma and Age-Related Macular Degeneration with IADL Disability
Association of Vision Loss in Glaucoma and Age-Related Macular Degeneration with IADL Disability
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DOI：
10.1167/iovs.12-9469
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发表时间：
2012-05-01
影响因子：
4.4
通讯作者：
Ramulu, Pradeep Y.
中科院分区：
文献类型：
--
作者：
Hochberg, Chad;Maul, Eugenio;Ramulu, Pradeep Y.
目的.目的探讨青光眼和/或年龄相关性黄斑变性（AMD）是否与工具性日常生活活动能力（IADL）障碍有关。将伴有双侧视野（VF）丧失的青光眼受试者（n = 84）和伴有双侧或严重单侧视力（VA）丧失的AMD受试者（n = 47）与60名视力正常的受试者（对照组）进行比较。受试者完成了标准的IADL残疾问卷，残疾定义为无法执行一个或多个IADL。18.3%的对照组患者存在一种或多种IADL功能障碍，而青光眼组患者为25.0%（P = 0.34），AMD组患者为44.7%（P = 0.003）。在AMD和青光眼受试者中更频繁发生的特定IADL残疾是准备膳食，杂货店购物和外出旅行在校正年龄、性别、精神状态、合并症和受教育年限后的多变量logistic回归模型中，（比值比[OR]= 3.4，P = 0.02）而非青光眼（OR = 1.4，P = 0.45）与IADL残疾相关。然而，在青光眼和对照组患者中，视力较好的眼睛中VF每损失5 dB，IADL残疾的几率增加1.6倍（P = 0.001）。此外，严重青光眼受试者（好眼MD低于-13.5 dB）IADL残疾的几率更高（OR = 4.2，P = 0.02）。在AMD和对照组中，糖尿病视网膜病变早期治疗研究中视力越差，IADL残疾的可能性越大（OR = 1.3）。AMD患者的VA损失和青光眼患者的严重VF损失与自我报告的IADL困难相关。随着VA或VF损失幅度的增加，这些限制变得更有可能。（Invest Ophthalmol维斯科学。2012; 53：3201 - 3206）DOI：10.1167/iovs.12 - 9469
PURPOSE. To determine if glaucoma and/or age-related macular degeneration (AMD) are associated with disability in instrumental activities of daily living (IADLs).METHODS. Glaucoma subjects (n = 84) with bilateral visual field (VF) loss and AMD subjects (n = 47) with bilateral or severe unilateral visual acuity (VA) loss were compared with 60 subjects with normal vision (controls). Subjects completed a standard IADL disability questionnaire, with disability defined as an inability to perform one or more IADLs unassisted.RESULTS. Disability in one or more IADLs was present in 18.3% of controls as compared with 25.0% of glaucoma subjects (P = 0.34) and 44.7% of AMD subjects (P = 0.003). The specific IADL disabilities occurring more frequently in both AMD and glaucoma subjects were preparing meals, grocery shopping, and out-of-home travelling (P < 0.05 for both).In multivariate logistic regression models run adjusting for age, sex, mental status, comorbidity, and years of education, AMD (odds ratio [OR] = 3.4, P = 0.02) but not glaucoma (OR = 1.4, P = 0.45) was associated with IADL disability. However, among glaucoma and control patients, the odds of IADL disability increased 1.6-fold with every 5 dB of VF loss in the better-seeing eye (P = 0.001). Additionally, severe glaucoma subjects (better-eye MD worse than -13.5 dB) had higher odds of IADL disability (OR = 4.2, P = 0.02). Among AMD and control subjects, every Early Treatment of Diabetic Retinopathy Study line of worse acuity was associated with a greater likelihood of IADL disability (OR = 1.3).CONCLUSIONS. VA loss in AMD and severe VF loss in glaucoma are associated with self-reported difficulties with IADLs. These limitations become more likely with increasing magnitude of VA or VF loss. (Invest Ophthalmol Vis Sci. 2012;53:3201-3206) DOI:10.1167/iovs.12-9469