The impact of visual function on staircase use performance in glaucoma.

Objectives

This cross-sectional study aimed to investigate the relationship between visual function and staircase use in glaucoma.

Methods

Overall, 181 patients with glaucoma with a best-corrected visual acuity ≥20/400 were classified into mild to moderate (mean deviation [MD] ≥ -12 dB) and advanced (MD < -12 dB) groups, according to 24-2 VF of the worse eye. Staircase use evaluation included stair descent and ascent time (SDT/SAT) and self-reported stair difficulty. Correlations between staircase use and visual function were analysed, including binocular visual acuity, integrated visual field (IVF), and binocular contrast sensitivity (CS). Linear and logistic regression adjusted by age, sex, and comorbidities inspected the effect of visual parameters on SDT/ SAT and stair difficulty.

Results

Visual function best correlated with SDT among staircase use. In mild to moderate glaucoma, area under the log CS function (AULCSF) (β = -1.648, P = 0.031) was the only visual factor significant for SDT (adjusted R 2  = 0.106), whereas AULCSF (β = -1.641, P = 0.048) and MD of IVF INF0-24 (β = -0.089, P = 0.013) were associated with SDT in advanced glaucoma (adjusted R 2  = 0.589). The AULCSF was the only significant visual parameter related to SAT (β = -1.125, P = 0.019) and stair difficulty (adjusted odds ratio = 0.003; 95% confidence interval, 0-0.302; P = 0.013).

Conclusions

SDT provides a higher correlation with visual function than self-reported stair difficulty. Patients with impaired CS or inferior IVF defects should be advised on stair safety and referred to low-vision services.