Prevalence and causes of visual field loss in the elderly and associations with impairment in daily functioning: the Rotterdam Study.
OBJECTIVE
To determine the prevalence and causes of visual field loss (VFL) and the association between VFL and indicators of impairment in daily functioning.


METHODS
Population-based cohort study.


METHODS
Suburb of Rotterdam, the Netherlands.


METHODS
Community-dwelling elderly residents (n = 6250).


METHODS
Visual field loss on suprathreshold static, Goldmann kinetic perimetry, or both.


METHODS
Suprathreshold testing of the central visual field was performed on both eyes and repeated if results were abnormal or unreliable. Goldmann perimetry was performed to confirm defects. Causes were determined using ophthalmologic and neurologic examination data and medical records. Impairment was assessed using data from interviews and medical records on disability in daily life, falling, and fractures.


RESULTS
The overall prevalence of VFL was 5.6% (3.0% in those aged 55-64 years to 17.0% in those > or =85 years); glaucoma was the leading cause in all age groups. Before age 75 years, other optic nerve diseases and stroke ranked second and third, respectively, as did age-related macular degeneration and retinal vascular occlusive disease, respectively, after this age. Also, after adjustment for visual acuity, VFL was associated with disability, diminished enjoyment of reading and watching television, and a higher risk of incident falling. Risk of incident hip fracture was not increased.


CONCLUSIONS
Visual field loss is present in 1 of every 20 community-dwelling elderly people and is associated with impaired daily functioning. Glaucoma is the leading cause in all age groups. Other high-ranking causes, some of which are partly preventable, vary by age.
Ramrattan
R S
RS
Department of Epidemiology, Erasmus University Medical School, Rotterdam, The Netherlands.
Wolfs
R C
RC
Panda-Jonas
S
S
Jonas
J B
JB
Bakker
D
D
Pols
H A
HA
Hofman
A
A
de Jong
P T
PT
D000203:Activities of Daily Living; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005901:Glaucoma / Q000150:complications; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D009901:Optic Nerve Diseases / Q000150:complications; D015995:Prevalence; D011446:Prospective Studies; D012164:Retinal Diseases / Q000150:complications; D012307:Risk Factors; D017678:Sex Distribution; D014786:Vision Disorders / Q000453:epidemiology* / Q000209:etiology*; D014792:Visual Acuity; D058609:Visual Field Tests; D014794:Visual Fields