Association of Fast Visual Field Loss With Risk of Falling in Patients With Glaucoma.
OBJECTIVE
Patients with glaucoma and a history of fast visual field loss might be at an increased risk for falls compared with those with a history of slow visual field loss, but, to date, this association has not been previously investigated in the literature.


OBJECTIVE
To evaluate the association between self-reported falls and past rate of visual field loss in a cohort of patients with glaucoma followed up over time.


METHODS
This observational cohort study included patients diagnosed as having glaucoma who had been followed up at the Visual Performance Laboratory, University of California, San Diego, at 6-month intervals for a mean (SD) of 7.5 (2.6) years from January 1, 2005, through December 31, 2015. Self-reported number of falls during the past year was obtained at the last follow-up visit. Integrated binocular fields were estimated from the monocular fields. Linear mixed models were used to calculate rates of change in binocular mean sensitivity over time. Poisson models were used to evaluate the association between the self-reported number of falls and rates of visual field loss. The models adjusted for the current level of visual field damage and other confounding variables.


METHODS
Association between rates of binocular visual field loss and self-reported number of falls.


RESULTS
The study included 116 patients with glaucoma with a mean (SD) age of 73.1 (10.7) years (55 women [47.4%], 84 white individuals [72.4%], and 32 black individuals [27.6%]). Of the 116 patients, 29 (25.0%) reported at least 1 fall in the previous year. The mean rate of change in binocular mean sensitivity was faster for patients who reported a history of falls vs those who did not (-0.36 vs -0.17 dB/y; mean difference, 0.20 dB/y; 95% CI, 0.09-0.31 dB/y; P < .001). History of fast visual field loss was significantly associated with falls (rate ratio, 2.28 per 0.5 dB/y faster; 95% CI, 1.15-4.52 db/y; P = .02), even after adjusting for confounding factors.


CONCLUSIONS
The rate of visual field loss was associated with a self-reported history of falls in the past year even after taking into account the magnitude of visual field defect. However, although a positive association was found, further studies are necessary to establish whether a cause-and-effect relationship exists between rate of visual field loss and self-reported history of falls.
Visual Performance Laboratory, Department of Ophthalmology, University of California, San Diego, La Jolla.
Saif
S
Baig
Visual Performance Laboratory, Department of Ophthalmology, University of California, San Diego, La Jolla.
Alberto
A
Diniz-Filho
Visual Performance Laboratory, Department of Ophthalmology, University of California, San Diego, La Jolla.
Zhichao
Z
Wu
Visual Performance Laboratory, Department of Ophthalmology, University of California, San Diego, La Jolla.
Ricardo Y
RY
Abe
Visual Performance Laboratory, Department of Ophthalmology, University of California, San Diego, La Jolla.
Carolina P B
CP
Gracitelli
Visual Performance Laboratory, Department of Ophthalmology, University of California, San Diego, La Jolla.
Eric
E
Cabezas
Visual Performance Laboratory, Department of Ophthalmology, University of California, San Diego, La Jolla.
Felipe A
FA
Medeiros
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D002140:California / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D006801:Humans; D015994:Incidence; D007429:Intraocular Pressure; D008297:Male; D011446:Prospective Studies; D012607:Scotoma / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D057566:Self Report; D018434:Sickness Impact Profile; D013997:Time Factors; D015348:Vision, Binocular / Q000502:physiology*; D014792:Visual Acuity; D058609:Visual Field Tests; D014794:Visual Fields / Q000502:physiology*