Threat to fixation and vision-related quality of life in patients with open-angle glaucoma

We aimed to investigate the association between overlapping threat to fixation (TTF) and vision-related quality of life (VRQoL) in patients with manifest open-angle glaucoma (OAG).

Overall, 316 patients with manifest OAG were recruited from the glaucoma outpatient department of Skåne University Hospital, Malmö, Sweden, between April and December 2018. VRQoL was assessed using the Swedish version of the National Eye Institute Visual Function Questionnaire-25 (VFQ-25). The results were analysed using Rasch analysis. Overlapping TTF was defined as glaucomatous visual field loss (VFL) involving at least one of the four most central points, depressed at p < 1% on the total deviation probability map of Humphrey visual fields, and present at corresponding points in both eyes. The relationship between VRQoL and overlapping TTF was examined using linear regression analysis.

In univariable linear regression analysis, overlapping TTF was significantly associated with VRQoL scores on the Visual Functioning Scale (VFS) and Socioemotional Scale (SES). However, this correlation was not significant in multivariable linear regression analysis after adjusting for potentially confounding factors (all p > 0.05). Integrated visual field mean deviation (IVF-MD) and best-corrected visual acuity in the better and worse eyes were significantly correlated with Rasch-calibrated VFQ-25 scores. Collectively, these factors accounted for 37% and 34% of the variance in VFS and SES scores, respectively.

Overlapping TTF was not an independent predictor of VRQoL after controlling for VFL severity. By contrast, IVF-MD emerged as the most significant predictor of VRQoL.