Quality of life in glaucoma and its relationship with visual function
Quality of life in glaucoma and its relationship with visual function
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DOI：
10.1097/00061198-200304000-00009
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发表时间：
2003-04-01
影响因子：
2
通讯作者：
O'Brien, C
中科院分区：
文献类型：
--
作者：
Nelson, P;Aspinall, P;O'Brien, C
目的：本研究的目的是（a）通过为此目的开发的问卷调查来探索患者自我报告的青光眼导致的视觉残疾;（B）识别与视野丧失的测量强烈相关的活动;（c）量化视觉功能的不同心理物理方面;（d）评估视觉功能的客观测量与患者对其视觉相关生活质量的感知之间的关系。三组青光眼患者（n = 47）（轻度（n = 18），中度（n = 19）和重度视野丧失（n = 10））和一组正常对照（n = 19）进行了全面的临床检查，完成了问卷调查，并在单独的访问中，进行了一些视觉功能的心理物理测试。主要结果测量：问卷答复（视觉相关的生活质量、一般健康和心理社会变量）、视敏度、视野、Esterman双眼残疾评分、对比敏感度、临界闪烁频率、色觉，暗适应，眩光残疾（亮度敏锐度），和立体视锐度scoresmeasured.Results：15的50个问题被指出有很强的显着关系，与视野损失的措施，并被列入一个新的问卷量表，青光眼生活质量-15（GQL-15）。量表的效度与周长平均差（MD）呈显著相关（r = -0.6; P < 0.0001），信度较高（Cronbach α = 0.95），重测信度较强（r = 0.87）。在正常受试者和所有青光眼患者组之间，与性能相关的生活质量总体上有统计学显著性下降。在量表问卷摘要性能测量和一些心理物理测试之间发现了显著的关系：佩利-罗布森对比灵敏度（r =-0.45，P < 0.001），眩光失能（r =-0.41，P < 0.001），Esterman双眼视野检查（r =-0.39，P < 0.001），暗适应（r = 0.34，P = 0.007），立体视（r = 0.26，P = 0.04）。与某些任务相关的视觉残疾（特别是涉及暗适应和失能眩光，需要功能性周边视觉的活动，如绊倒和撞到物体以及户外活动任务）与双眼视野丧失的严重程度显著相关。因此，本研究提出一个新的具有良好绩效特征的乳癌专用问卷量表。患者在日常生活中遇到的困难（用问卷测量）也反映在他们在一些心理物理测试中的表现，特别是对比敏感度，眩光残疾，Esterman双眼视野测试和暗适应。
Purpose: The aims of this study were (a) to explore patients self-reported visual disability resulting from glaucoma by means of a questionnaire developed for this purpose; (b) identify activities strongly associated with a measure of visual field loss, (c) to quantify different psychophysical aspects of visual function; (d) to assess the relationship between objective measures of visual function and patients' perception of their vision-related quality of life.Patients and Methods: Three groups of glaucoma patients (n = 47) with mild (n = 18), moderate (n = 19), and severe visual field loss (n = 10) and a group of normal controls (n = 19) underwent a comprehensive clinical examination, completed a questionnaire and, on a separate visit, performed a number of psychophysical tests of visual function.Main Outcome Measures: Questionnaire responses (vision-related quality of life, general health and psychosocial variables), visual acuity, visual fields, Esterman binocular disability scores, contrast sensitivity, critical flicker frequency, color vision, dark adaptation, glare disability (brightness acuity), and stereoacuity scores were measured.Results: Fifteen of the 50 questions were noted to have a strong significant relationship with a measure of visual field loss and were included in a new questionnaire scale, the Glaucoma Quality of Life - 15 (GQL-15). The scale validity showed a significant correlation with perimetric mean deviation (MD) values (r = -0.6; P < 0.0001), the reliability of the scale was high (Cronbach alpha = 0.95), and test-retest reliability of the questionnaire was strong (r = 0.87). An overall statistically significant decrease in performance-related quality of life was noted between normal subjects and all groups of glaucoma patients. A significant relationship was found between the scale questionnaire summary performance measure and a number of psychophysical tests: Pelli-Robson contrast sensitivity (r = -0.45, P < 0.001), glare disability (r = -0.41, P < 0.001), Esterman binocular visual field test (r = -0.39, P < 0.001), dark adaptation (r = 0.34, P = 0.007), and stereopsis (r = 0.26, P = 0.04).Conclusion: Perceived visual disability relating to certain tasks (particularly involving dark adaptation and disability glare, activities demanding functional peripheral vision such us tripping over and bumping into objects and outdoor mobility tasks) was significantly associated with the, severity of binocular visual field loss. As a result, a new glaucoma-specific questionnaire scale with, good performance characteristics is presented in this study. The difficulties encountered by patients in everyday life (as measured with the questionnaire) were also mirrored in their performance on a number of psychophysical tests, especially contrast sensitivity, glare disability, Esterman binocular visual field test, and dark adaptation.