Quality of life (QoL) in patients (pts) with primary open-angle glaucoma (POAG). An Italian multicenter observational study

Abstract Purpose:As a chronic and progressive condition, glaucoma can hardly affect QoL. Distress caused by diagnosis, increasing problems with daily activities from visual dysfunction and adverse reactions to glaucoma therapies are only some of the more frequently reported concerns. This study was aimed at evaluating QoL in a large cohort of POAG pts and at assessing the association between glaucoma-related QoL and socio-demographic and clinical characteristics. Methods:Italian multicenter observational study. Pts already diagnosed or at first diagnosis underwent a comprehensive ocular examination in which QoL was assessed using the Italian validated versions of National Eye Institute Visual Function Questionnaire (NEI-VFQ-25), which measures dimensions of self-reported vision-targeted health status, and Glaucoma Symptom Scale (GSS) Questionnaire, a glaucoma specific tool. Only newly diagnosed pts were asked to enter a 1-year longitudinal phase with two subsequent questionnaire administrations. Results:From March 2012 to July 2013, out of 3225 pts enrolled at 21 centres 3171 were eligible, whereas less than 2% were excluded due to QoL questionnaire unavailability. 99% pts were caucasian, 50% were female, mean age was 66.9 years (SD 12.2). Most pts (73%) were married, and only 17% lived alone. 93% had a previous POAG diagnosis from a median time of 8 years and 95% pts had a bilateral eye involvement. Mean values of mean defect (MD), of pattern standard deviation (PSD) and visual field index (VFI) were -6.19 dB (SD 6.24), 4.62 dB (SD 3.34) and 84.9 (SD 19.1), respectively. As for QoL, overall mean total score of NEI-VFQ-25 and GSS questionnaires were 86.9 (SD 11.9) and 74.9 (SD 19.2), respectively. PSD>2.5 dB, MD <-2 dB, (VFI) <90% and longer time from diagnosis negatively affect QoL as assessed by both questionnaires. Female sex has a lower total score of GSS, while older pts have a lower NEI-VFQ-25 total score. Glaucoma treatment seems to have no impact on QoL. Conclusions:This is a large-scale, not-for-profit study providing a reliable description of current Italian situation. Considering that the maximum total score value for both questionnaires is 100, results suggest an overall good QoL. More refined analyses are being conducted to examine in depth pts profiles and questionnaire sub-scales. Longitudinal phase on 207 pts is still ongoing.