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Editors Selection IGR 10-3
Quality of life: Binocular visual function
Comment by Clive Migdal on:
19498 Depression and mood indicators in newly diagnosed glaucoma patients, Jampel HD; Frick KD; Janz NK et al., American Journal of Ophthalmology, 2007; 144: 238-244
Jampel et al. (823) performed a cross-sectional study of data from newly diagnosed glaucoma patients enrolled in the Collaborative Initial Glaucoma Treatment Study (CIGTS), a randomized controlled clinical trial, investigated the responses, at baseline, to Quality of Life telephone interviews. The focus of this study was limited to psychological wellbeing. The interviews included questions from the Visual Activities Questionaire (VAQ), a disease-specific Health Perceptions Index (HPI) and the Center for Epidmiologic Studies Depression Scale (CES-D). Responses to the HPI and CES-D were correlated with the visual acuity (VA) and CIGTS visual fields (VF). At the time of the first Quality of Life questionnaire, patients were not aware of which treatment they would receive. The results showed that VAQ was correlated with better VA, better VF, worse VA and worse VF. However, none of the clinical vision measures were associated with any of the CES-D items, i.e., there was a lack of association between either VA or VF and most mood and all depression indicators. In contract, there were correlations between patient perception of their vision (total VAQ score) and each item on the HPI and CES-D. The strongest correlation between a clinical measure and an item from the HPI was between worse VF and worrying about the possibility of blindness. The odds ratio of reporting mood indicators and symptoms of depression increased with patient perception of worsening visual function (VAQ), but not objective visual function (VA and VF).
The importance of assessing binocular visual function and its potential effect on quality of life in glaucoma patients must be emphasized
In this study, which is limited by selection bias imposed by the inclusion/exclusion criteria of CIGTS (where, amongst others, only patients with reasonable VA and VF were included), the symptoms of depression and altered mood in these newly diagnosed patients were related to worse self-reported visual function but not to monocular clinical measures of visual function. Although the outcomes of this study might differ from those in a more general population sample of glaucoma patients, the importance of assessing binocular visual function and its potential effect on quality of life in glaucoma patients must be emphasized.
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