Longitudinal changes in quality of life and rates of progressive visual field loss in glaucoma patients.
Longitudinal changes in quality of life and rates of progressive visual field loss in glaucoma patients.
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DOI：
10.1016/j.ophtha.2014.08.014
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发表时间：
2015-02
期刊：
影响因子：
13.7
通讯作者：
Rosen, Peter N.
中科院分区：
文献类型：
--
作者：
Medeiros, Felipe A.;Gracitelli, Carolina P. B.;Boer, Erwin R.;Weinreb, Robert N.;Zangwill, Linda M.;Rosen, Peter N.
评价青光眼患者生活质量的纵向变化与进行性视野丧失率之间的关系。前瞻性观察性队列研究。从诊断创新青光眼研究（DIGS）中招募的161例青光眼性视野丧失患者的322只眼，平均随访3.5 ± 0.7年。所有受试者每年进行一次NEI VFQ-25检查，每6个月进行一次标准自动视野检查（SAP）。如果受试者在随访期间至少有2次NEI VFQ-25和至少5次标准自动视野检查（SAP），则纳入受试者。使用综合双眼视野的平均灵敏度（MS）评价视野变化率。进行Rasch分析以获得NEI VFQ-25测量的残疾最终评分。采用联合纵向多变量混合模型研究NEI VFQ-25 Rasch校准评分变化与双眼视野敏感度变化之间的相关性。还分析了潜在混杂的社会经济和临床变量。NEI VFQ-25 Rasch校准评分变化与双眼SAP MS变化之间的关系。随访期间NEI VFQ-25 Rasch评分变化与双眼SAP敏感性变化之间存在统计学显著相关性。在随访期间，双眼SAP MS每年每变化1dB，NEI VFQ-25 Rasch评分每年变化2.9个单位（R2=26%; P<0.001）。基线时病情更严重的眼睛在随访期间NEI VFQ-25评分也更有可能下降（P<0.001）。对于SAP敏感性变化量相同的受试者，随访时间较短的受试者NEI VFQ-25评分变化较大（P=0.005）。一个包含基线和双眼MS变化率的多变量模型在预测NEI VFQ-25评分变化方面的调整R2为50%。双眼视野敏感度的基线严重程度、幅度和变化率与青光眼患者生活质量的纵向变化相关。纵向视野变化的评估可能有助于确定患者在发展残疾的疾病的风险较高。
To evaluate the association between longitudinal changes in quality of life and rates of progressive visual field loss in glaucoma. Prospective observational cohort study. 322 eyes of 161 patients with glaucomatous visual field loss recruited from the Diagnostic Innovations Glaucoma Study (DIGS) followed for an average of 3.5 ± 0.7 years. All subjects had NEI VFQ-25 performed annually and standard automated perimetry (SAP) at 6-month intervals. Subjects were included if they had a minimum of 2 NEI VFQ-25 and at least 5 standard automated perimetry (SAP) during follow up. Evaluation of rates of visual field change was performed using the mean sensitivity (MS) of the integrated binocular visual field. Rasch analysis was performed to obtain final scores of disability as measured by the NEI VFQ-25. A joint longitudinal multivariate mixed model was used to investigate the association between change in NEI VFQ-25 Rasch-calibrated scores and change in binocular visual field sensitivity. Potentially confounding socio-economic and clinical variables were also analyzed. The relationship between change in NEI VFQ-25 Rasch-calibrated scores and change in binocular SAP MS. There was a statistically significant correlation between change in the NEI VFQ-25 Rasch scores during follow-up and change in binocular SAP sensitivity. Each 1db change in binocular SAP MS per year was associated with a change of 2.9 units per year in the NEI VFQ-25 Rasch scores during the follow-up period (R2=26%; P<0.001). Eyes with more severe disease at baseline were also more likely to have a decrease in NEI VFQ-25 scores during follow-up (P<0.001). For subjects with the same amount of change in SAP sensitivity, those with shorter follow-up times had larger changes in NEI VFQ-25 scores (P=0.005). A multivariable model containing baseline and rate of change in binocular MS had an adjusted-R2 of 50% in predicting change in NEI VFQ-25 scores. Baseline severity, magnitude and rates of change in binocular visual field sensitivity were associated with longitudinal changes in quality of life of glaucoma patients. Assessment of longitudinal visual field changes may help identify patients at higher risk for developing disability from the disease.
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