Vision-related Performance and Quality of Life of Patients With Rapid Glaucoma Progression

The purpose of this study was to determine how clinical measures, performance-based measures and subjective assessments of vision-related quality of life (VRQoL) are affected in patients with rapid glaucoma progression.

Prospective longitudinal study that included 153 patients diagnosed with moderate glaucoma. A subset of patients that presented with rapid glaucoma progression (n=22), defined as visual field (VF) mean deviation (MD) loss >2.0 dB/y, were compared with patients with nonrapid progression (n=131). Groups were compared using t tests, χ, or Fisher exact test. Main outcome measures were visual acuity (VA), VF MD, retinal nerve fiber layer thickness (RNFL), contrast sensitivity (CS), Compressed Assessment of Ability Related to Vision (CAARV), and Rasch calibrated National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) scores.

At baseline, patients who progressed rapidly had lower measurements of VA (P=0.041), VF MD (P<0.001), Pelli-Robson score (P=0.004), Spaeth/Richman Contrast Sensitivity (SPARCS) score (P=0.001), RNFL thickness (P=0.009), CAARV total score (P<0.001), and NEI-VFQ-25 composite score (P=0.03). A multivariable logistic regression was performed and showed VF MD to be the only baseline independent predictor of rapid progression. After 1 year, patients who progressed rapidly also had a significant decrease in SPARCS score (P=0.04).

Factors associated with rapid glaucoma progression included worse VF MD decreased scores of performance-based measures and subjectively worse VRQoL. After 1 year, rapid progressors had a significant reduction in contrast sensitivity as measured by SPARCS.