Functional Testing and Quality of Life in Glaucoma

青光眼的功能测试和生活质量

• 批准号: 10734431
• 负责人: Stuart Gardiner
• 金额: $ 62.8万
• 依托单位: LEGACY EMANUEL HOSPITAL AND HEALTH CENTER
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-30 至 2027-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10734431
• 关键词: Activities of Daily Living; Affect; Blindness; Caring; Cellular Phone; Central Scotomas; Clinic; Clinical; Clinical Management; Clinical Trials; Consumption; Contrast Sensitivity; Custom; Data; Devices; Disease; Electronics; Equilibrium; Eye; Fall prevention; Glaucoma; Goals; Health; Hospitalization; Impairment; Individual; Light; Light Adaptations; Lighting; Location; Longitudinal Studies; Measurement; Measures; Medical; Motivation; National Eye Institute; Ocular Hypertension; Outcome Measure; Participant; Patient Care; Patient Outcomes Assessments; Patient Self-Report; Patient-Focused Outcomes; Patients; Pattern; Perimetry; Peripheral; Persons; Quality of life; Questionnaires; Reporting; Research; Risk; Scotoma; Severities; Severity of illness; Tablet Computer; Tablets; Testing; Time; Trabeculectomy; Vision; Visit; Visual; Visual Fields; Visual System; Work; Writing; clinical care; equilibration disorder; experience; fall risk; falls; functional loss; hypertension treatment; improved; indexing; individual patient; medication compliance; novel; patient oriented; personalized medicine; preventive intervention; prospective; rate of change; research clinical testing; treatment adherence; visual search

Project Summary / Abstract The goal of clinical management in eye care is to protect patients’ vision and consequent quality of life. Yet, the impact of vision loss on an individual’s quality of life depends not only on its severity, but also on its location within the visual field. Some tasks are predominantly impacted by central visual field loss, while others rely more on differing regions of the peripheral visual field. Thus, two individuals with the same disease severity could have very different experiences of that loss. This is particularly true for glaucoma, which causes localized loss in locations that can differ greatly between individuals. In this project, we will determine the regions of the visual field that most influence different aspects of quality of life. We will derive quantitative metrics of the likely real- world effects of an individual patient’s visual field defect that can be obtained without relying on time-consuming and variable questionnaires. These patient-centered metrics can aid clinicians in prioritizing care and choosing appropriate management strategies; and in explaining to an individual patient what the likely consequences are of their disease, both as motivation to maintain medication adherence and so that they can make necessary adjustments to their activities of daily living. In Aim 1, we will derive indices predicting the effect of an individual’s visual field loss on different patient-reported outcome measures, by parameterizing results from clinical standard automated perimetry, to maximize correlations with results of patient questionnaires from four large studies of ocular hypertension and glaucoma. In Aim 2, we will use similar analyses to predict the impact on visual search as measured by a custom-written test, performed on a tablet computer in glaucoma clinic waiting rooms and testing rooms. In Aim 3, we will predict the impact of an individual’s visual field loss on the visual contribution to balance and subsequent risk of falling, using objective measurements of balance in both high and low ambient light settings. Overall, the project will provide substantial advances in our understanding of the effects of localized visual field loss as caused by glaucoma, and provide invaluable new information for clinicians and patients.

项目总结/摘要 眼科护理临床管理的目标是保护患者的视力和随之而来的生活质量。然而 视力丧失对个人生活质量的影响不仅取决于其严重程度，还取决于其位置 在视野范围内。一些任务主要受中央视野丧失的影响，而另一些任务则更多地依赖于中央视野丧失。 在周边视野的不同区域。因此，具有相同疾病严重程度的两个个体可能具有 有着截然不同的经历这对于青光眼尤其如此，青光眼导致局部的视网膜损害。 个体之间可能存在很大差异的位置。在这个项目中，我们将确定视觉的区域 这些领域对生活质量的不同方面影响最大。我们将得出可能的真实的量化指标- 个体患者的视野缺陷的世界效应，其可以在不依赖于耗时的 和变量问卷。这些以患者为中心的指标可以帮助临床医生优先考虑护理和选择 适当的管理策略;以及向个别病人解释可能产生的后果 他们的疾病，既作为动机，以保持药物治疗的依从性，使他们能够使必要的 调整他们的日常生活。在目标1中，我们将推导出预测个人行为影响的指数。 通过临床标准的参数化结果，不同患者报告结局指标的视野丧失 自动视野检查，以最大限度地提高与四项大型研究的患者问卷结果的相关性 高眼压和青光眼。在目标2中，我们将使用类似的分析来预测对视觉搜索的影响 如通过在青光眼诊所候诊室的平板电脑上进行的定制书面测试所测量的， 测试室。在目标3中，我们将预测个体视野丧失对视觉贡献的影响， 平衡和随后的跌倒风险，使用在高和低环境中的平衡的客观测量 灯光设置。总的来说，该项目将为我们理解本地化的影响提供实质性的进步。 青光眼引起的视野丧失，并为临床医生和患者提供了宝贵的新信息。