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Editors Selection IGR 11-4

Quality of life

Henry Jampel

Comment by Henry Jampel on:

13133 Treatment and vision-related quality of life in the early manifest glaucoma trial, Hyman LG; Komaroff E; Heijl A et al., Ophthalmology, 2005; 112: 1505-1513


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Hyman et al. (753) report results from the administration of a Swedish translation of the 25 item National Eye Institute Visual Function Questionnaire (NEI-VFQ) to subjects in the Early Manifest Glaucoma Trial. Unfortunately, the authors were unable to administer the NEI-VFQ to the subjects before randomization (baseline), but only once the subjects had been enrolled in the study for at least three years.

The authors find that the composite score for the NEI-VFQ was on average high (good visual-targeted quality of life) at the three-year visit. They also found, that there was no difference between subjects randomized to observation or treatment with betaxolol and laser trabeculoplasty. Not surprisingly, worse NEI-VFQ scores were modestly associated with worse visual acuity and visual field.

Not knowing that the treated and untreated groups were similar at baseline in terms of NEI-VFQ scores hampers interpretation of those scores when first collected at the three-year visit. Furthermore, separating out the effect of treatment (or no treatment) from the effect of worsening of visual function on NEI-VFQ responses was not possible. In spite of these limitations, the study offers valuable insight into the state of vision-related quality of life in subjects, both treated and untreated, with early glaucomatous visual field loss. The results can be interpreted in the context of other randomized treatment trials, i.e., Collaborative Initial Glaucoma Treatment Study and the Ocular Hypertension Treatment Trial, with a quality of life assessment tool.



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