Is utility-based quality of life in adults affected by glaucoma?

We evaluated the utility values (UVs), using the time trade off (TTO) technique, associated with primary glaucoma and varying degrees of visual field (VF) loss.

In this cross-sectional study, 198 adults (mean age, 59.8 years) with primary glaucoma were recruited from the glaucoma clinic of a tertiary center in Hyderabad, South India. Each patient underwent comprehensive glaucoma evaluation, and completed the utility (TTO) and Glaucoma Quality of Life-15 questionnaires (Rasch version, Glaucoma Activity Limitation [GAL]-10). Better mean deviation (MD, using Humphrey Field Analyzer program 24-2) between two eyes was used to classify participants into mild, moderate, and severe VF loss groups. Utilities (range, 0.0-1.0) derived by TTO technique (lifetime traded against perfect vision) and interval level Rasch scores of GAL-10 were used for analyses.

Mean UV was 0.81 (95% confidence interval [CI], 0.78-0.84); that is, a decrease in quality of life (QoL) of 19%. Of the subjects, 59% were willing to trade lifetime in return of perfect vision; those willing to trade were significantly younger with poorer acuity in the worse-seeing eye. In univariate and multivariate analysis, severe VF loss in the worse eye was associated with lower UV (β = -0.108; 95% CI, -0.201 to -0.014; P = 0.02).

Our results show that primary glaucoma in adults causes substantial decrease in UVs (and QoL thereof), and is highly dependent on the severity of VF loss in the worse eye.