Vision Parameters Most Important to Functionality in Glaucoma

Abstract

PurposeTo determine the importance of various vision parameters to functionality in glaucoma.MethodsVision was measured using seven parameters: visual acuity (VA), contrast sensitivity (CS), integrated visual field (IVF), area under the log CS function (AULCSF), color vision, stereoacuity, and VA with noise (ViN). Likelihood ratio testing (LRT) determined if the full set of visual parameters significantly explained variability in 10 functional outcomes. For outcomes where the visual contribution was significant, dominance analysis determined the relative importance of the various visual parameters.ResultsThe analysis included 151 glaucoma patients. Mean age was 70 ± 6.8 years, and 47% were men. Significant visual contributions (LRT P < 0.05) were noted for glaucoma quality of life (GQL-15), reading speed, driving cessation, daily steps, and base of support while walking, but not for fear of falling, balance, gait velocity, stride velocity, and stride length while walking (LRT P > 0.05). The most important parameter (and percent contribution) to vision-explained variability were AULCSF for daily steps (45%), IVF for base of support (35%), VA for reading speed (34%), CS for GQL-15 (30%), and VA for driving cessation (26%).ConclusionsMeasures of visual ability are important for several aspects of quality of life and functionality. The most important vision parameter for functionality differs depending on the domain studied. Reading and driving were explained by VA and IVF sensitivity. On the other hand, GQL-15 and daily steps were more heavily influenced by CS and AULCSF, which are rarely performed clinically.

Neuroprotection of the Inner Retina Also Prevents Secondary Outer Retinal Pathology in a Mouse Model of Glaucoma

“…Many parameters subserved by BCs and HCs are altered in glaucoma, consistent with functional deficits in outer retina. 19 – 24 …”

“…Many parameters subserved by BCs and HCs are altered in glaucoma, consistent with functional deficits in outer retina. [19][20][21][22][23][24] Structural changes localized to the outer retina are temporally correlated with inner retinal pathology in glaucoma patients and therefore appear dependent on the state of disease progression. 8,25 However, it is unclear whether these abnormalities result directly from glaucomatous insult or are a secondary consequence of inner retina damage.…”

The Association of Vision, Hearing, and Dual-Sensory Loss with Walking Speed and Incident Slow Walking: Longitudinal and Time to Event Analyses in the Health and Retirement Study

“…One potential limitation of this study is its use of self-reported measures of sensory function; however, this may also be viewed as a strength, as measuring vision using a single objective measure may not capture the full dimensionality of the effect of vision on function. 38 Another limitation is the older age of the population and the fact that a majority of participants walked slowly at baseline; future studies should examine the association between sensory function and walking speed in a younger cohort, where a difference in the rate of decline of walking speed by sensory function may be more apparent.…”

O impacto do glaucoma na qualidade de vida: uma revisão sistemática

“…O glaucoma vai progressivamente reduzindo o campo visual o que acarreta mais dificuldade para enxergar os objetos com clareza, limitando a realização das AVDs, como se alimentar, se vestir, ler, escrever e até tomar banho 5,7,11,19,23 . A falta de autonomia aumenta com o avanço da severidade da doença, de modo que quanto maior deficiência visual, mais dependência de outras pessoas, afetando as relações sociais de pacientes glaucomatosos 24,25 .…”

“…O domínio do meio ambiente é afetado principalmente na habilidade de transporte. A capacidade de dirigir é afetada pela dificuldade de adaptação à diferentes luminosidades,em especial no período da noite pelo prejuízo na visão noturna e em dias nublados 2,15,19,24,26 .…”