title: Impact of glaucoma severity and laterality on vision-specific functioning: the Singapore Malay eye study.
abstract: OBJECTIVE
  We determined the impact of glaucoma severity and laterality on vision-specific functioning (VF) in an Asian population.
  
  
  METHODS
  The Singapore Malay Eye Study (SiMES) was a population-based cross-sectional study of 3280 Malays aged 40 to 80 years. VF was assessed using the VF-11 questionnaire. Associations between VF-11 score and glaucoma clinical indices (glaucoma severity in better and worse eyes, and laterality) were determined by multivariate regression modeling. Glaucoma severity was defined as mild, moderate, advanced, and severe based on the Hodapp-Anderson-Parish system. Rasch analysis was used to validate the VF-11 and determine its psychometric properties.
  
  
  RESULTS
  Of 926 persons analyzed, 123 had glaucoma (13.3% glaucoma prevalence in analyzed sample). The mean ± SD VF score was 3.64 ± 1.05 log of odds units (Logits). In multivariate models adjusting for sociodemographic, ocular, and systemic variables, poorer VF was associated with increasingly worse eye visual field loss (β = 0.016, 95% confidence interval [CI] 0.004-0.029, P < 0.001), but not that of the better eye (P > 0.05). Compared to controls, VF was reduced in individuals with worse eye advanced and severe glaucoma (β = -0.65, 95% CI -1.03 to -0.28, P < 0.05), but not mild or moderate glaucoma (P > 0.05). Compared to controls, VF was reduced in unilateral (β = -0.29, 95% CI -0.54 to -0.04, P < 0.05), but not bilateral glaucoma (P > 0.05). These associations remained significant after adjusting for presenting and best-corrected visual acuity.
  
  
  CONCLUSIONS
  Among Singaporean Malays, unilateral, and advanced and severe glaucoma in the worse eye significantly impacts on VF. Identifying early-stage glaucoma, preventing progression, and visual rehabilitation in advanced glaucoma are important aspects of glaucoma management.
authors: Department of Ophthalmology, National University Hospital, National University Health System, Singapore, Republic of Singapore.
authors: Errol W
authors: EW
authors: Chan
authors: Peggy P C
authors: PP
authors: Chiang
authors: Tien Y
authors: TY
authors: Wong
authors: Seang M
authors: SM
authors: Saw
authors: Seng C
authors: SC
authors: Loon
authors: Tin
authors: T
authors: Aung
authors: Ecosse
authors: E
authors: Lamoureux
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000706:statistics & numerical data*; D001766:Blindness / Q000175:diagnosis / Q000208:ethnology / Q000503:physiopathology; D003430:Cross-Sectional Studies; D018450:Disease Progression; D042241:Early Diagnosis; D005260:Female; D005901:Glaucoma / Q000175:diagnosis / Q000208:ethnology* / Q000503:physiopathology*; D006801:Humans; D008296:Malaysia / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D011594:Psychometrics / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D012846:Singapore / Q000453:epidemiology; D011795:Surveys and Questionnaires; D015354:Vision, Low / Q000175:diagnosis / Q000208:ethnology / Q000503:physiopathology