title: The Impact of Location of Progressive Visual Field Loss on Longitudinal Changes in Quality of Life of Patients with Glaucoma.
abstract: OBJECTIVE
  To evaluate the association between rates of progressive loss in different regions of the visual field and longitudinal changes in quality of life (QoL).
  
  
  METHODS
  Prospective, observational cohort study.
  
  
  METHODS
  The study included 236 patients with glaucomatous visual field loss followed for an average of 4.3±1.5 years.
  
  
  METHODS
  All subjects had the 25-item National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25) performed annually and standard automated perimetry (SAP) at 6-month intervals. Subjects were included if they had a minimum of 2 NEI VFQ-25 and 5 SAP tests during follow-up. Evaluation of rates of visual field change was performed using 4 different regions (central inferior, central superior, peripheral inferior, and peripheral superior) of the integrated binocular visual field. The association between change in NEI VFQ-25 Rasch-calibrated scores and change in different regions of the visual field was investigated with a joint multivariable longitudinal linear mixed model.
  
  
  METHODS
  The relationship between change in QoL scores and change of mean sensitivity in different regions of the visual field.
  
  
  RESULTS
  There was a significant correlation between change in the NEI VFQ-25 Rasch scores during follow-up and change in different regions of the visual field. Each 1 decibel (dB)/year change in binocular mean sensitivity of the central inferior area was associated with a decline of 2.6 units/year in the NEI VFQ-25 scores (R(2) = 35%; P < 0.001). Corresponding associations with change in QoL scores for the peripheral inferior, central superior, and peripheral superior areas of the visual field had R(2) values of 30%, 24%, and 19%, respectively. The association for the central inferior visual field area was statistically significantly stronger than those of the central superior area (P = 0.011) and peripheral superior area (P = 0.001), but not the peripheral inferior area (P = 0.171). Greater declines in NEI VFQ-25 scores were also seen in patients who had worse visual field sensitivity at baseline.
  
  
  CONCLUSIONS
  Progressive decline in sensitivity in the central inferior area of the visual field had the strongest association with longitudinal decline in QoL of patients with glaucoma.
authors.affiliation: Visual Performance Laboratory, Department of Ophthalmology, University of California San Diego, La Jolla, California; Department of Ophthalmology, University of Campinas, Campinas, Brazil.
authors.forename: Ricardo Y
authors.initials: RY
authors.lastname: Abe
authors.affiliation: Visual Performance Laboratory, Department of Ophthalmology, University of California San Diego, La Jolla, California.
authors.forename: Alberto
authors.initials: A
authors.lastname: Diniz-Filho
authors.affiliation: Department of Ophthalmology, University of Campinas, Campinas, Brazil.
authors.forename: Vital P
authors.initials: VP
authors.lastname: Costa
authors.affiliation: Visual Performance Laboratory, Department of Ophthalmology, University of California San Diego, La Jolla, California.
authors.forename: Carolina P B
authors.initials: CP
authors.lastname: Gracitelli
authors.affiliation: Visual Performance Laboratory, Department of Ophthalmology, University of California San Diego, La Jolla, California.
authors.forename: Saif
authors.initials: S
authors.lastname: Baig
authors.affiliation: Visual Performance Laboratory, Department of Ophthalmology, University of California San Diego, La Jolla, California. Electronic address: fmedeiros@ucsd.edu.
authors.forename: Felipe A
authors.initials: FA
authors.lastname: Medeiros
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D005260:Female; D005901:Glaucoma / Q000523:psychology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D012680:Sensitivity and Specificity; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D014786:Vision Disorders / Q000175:diagnosis*; D058609:Visual Field Tests; D014794:Visual Fields