Functional Testing and Quality of Life in Glaucoma

项目摘要/摘要 眼科临床管理的目标是保护患者的视力和相应的生活质量。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，而另一些任务则更依赖于 在周边视野的不同区域上。因此，两个疾病严重程度相同的人可能会有 对那次损失有非常不同的体验。这对于青光眼尤其如此，青光眼会导致局限性的青光眼 不同的人之间可能有很大的不同。在这个项目中，我们将确定视觉区域 对生活质量各方面影响最大的领域。我们将推导出可能真实的- 不依赖耗时获得的个体患者视野缺陷的世界效应 和可变问卷。这些以患者为中心的指标可以帮助临床医生确定护理的优先顺序和选择 适当的管理策略；以及向个别病人解释可能的后果 作为维持服药依从性的动力，也是为了使他们能够 调整他们的日常生活能力。在目标1中，我们将得出预测个人 根据临床标准将结果参数化后，不同患者报告的结果的视野损失 自动视野检查，以最大限度地提高与来自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 通过在青光眼诊所候诊室的平板电脑上执行的定制书写测试进行测量 考场。在目标3中，我们将预测个人视野丧失对视力贡献的影响 平衡和随后跌倒的风险，使用在高环境和低环境下的平衡的客观测量 灯光设置。总体而言，该项目将为我们理解本地化的影响提供实质性的进展 青光眼引起的视野损失，为临床医生和患者提供了宝贵的新信息。

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.