Impact of age-related macular degeneration in patients with glaucoma: understanding the patients' perspective.
Simon E Skalicky, Eva Fenwick, Keith R Martin, Jonathan Crowston, Ivan Goldberg, Peter McCluskey
Summary
Vision-related activity limitation and preference-based status are negatively impacted by severe glaucoma and age-related macular degeneration. Patients with both conditions perceive increased difficulty walking safely compared with patients with glaucoma alone.
Abstract
BACKGROUND
The aim of the study is to measure the impact of age-related macular degeneration on vision-related activity limitation and preference-based status for glaucoma patients.
DESIGN
This was a cross-sectional study.
PARTICIPANTS
Two-hundred glaucoma patients of whom 73 had age-related macular degeneration were included in the research.
METHODS
Sociodemographic information, visual field parameters and visual acuity were collected. Age-related macular degeneration was scored using the Age-Related Eye Disease Study system.
MAIN OUTCOME MEASURES
The Rasch-analysed Glaucoma Activity Limitation-9 and the Visual Function Questionnaire Utility Index measured vision-related activity limitation and preference-based status, respectively. Regression models determined factors predictive of vision-related activity limitation and preference-based status. Differential item functioning compared Glaucoma Activity Limitation-9 item difficulty for those with and without age-related macular degeneration.
RESULTS
Mean age was 73.7 (±10.1) years. Lower better eye mean deviation (β: 1.42, 95% confidence interval: 1.24-1.63, P < 0.001) and age-related macular degeneration (β: 1.26 95% confidence interval: 1.10-1.44, P = 0.001) were independently associated with worse vision-related activity limitation. Worse eye visual acuity (β: 0.978, 95% confidence interval: 0.961-0.996, P = 0.018), high risk age-related macular degeneration (β: 0.981, 95% confidence interval: 0.965-0.998, P = 0.028) and severe glaucoma (β: 0.982, 95% confidence interval: 0.966-0.998, P = 0.032) were independently associated with worse preference-based status. Glaucoma patients with age-related macular degeneration found using stairs, walking on uneven ground and judging distances of foot to step/curb significantly more difficult than those without age-related macular degeneration.
CONCLUSIONS
Vision-related activity limitation and preference-based status are negatively impacted by severe glaucoma and age-related macular degeneration. Patients with both conditions perceive increased difficulty walking safely compared with patients with glaucoma alone.
Keywords
More by Simon E Skalicky
View full profile →Objective Assessment of Activity Limitation in Glaucoma with Smartphone Virtual Reality Goggles: A Pilot Study.
Glaucoma Australia educational impact study: a randomized short-term clinical trial evaluating the association between glaucoma education and patient knowledge, anxiety and treatment satisfaction.
Patient-reported Outcomes, Functional Assessment, and Utility Values in Glaucoma.
Top Research in Visual Field
Browse all →Optical coherence tomography angiography: A comprehensive review of current methods and clinical applications.
Relationship between Optical Coherence Tomography Angiography Vessel Density and Severity of Visual Field Loss in Glaucoma.
Improving our understanding, and detection, of glaucomatous damage: An approach based upon optical coherence tomography (OCT).
Discussion
Comments and discussion will appear here in a future update.