Gradually then suddenly? Decline in vision-related quality of life as glaucoma worsens

Purpose. to evaluate the relationship between self-reported vision-related quality of life (vrql) and visual field (vf) loss in people from glaucoma clinics. methods. a postal survey using the national eye institute visual function questionnaire (nei vfq-25) was administered to people with a range of vf loss identified from a uk hospital-based glaucoma service database. trends were assessed in a composite score from nei vfq-25 against better-eye mean deviation (bemd) using linear regression and a spline-fitting method that can highlight where a monotonic relationship may have different stages. results. a total of 636 patients (median [interquartile range] bemd -2.1 [-5.2,-0.4] db,median age 70 [60,77] years) were analysed. analysis of trends in the data revealed an average patient loses approximately 2 units (out of 100) on nei vfq-25 for every loss of 1 db (bemd) as vf defects first become bilateral,up to bemd -5 db. nei vfq-25 deterioration then appears to slow before a more rapid phase of change (4-5 units per 1 db loss) after bemd worsens beyond -15 db. conclusions. relationship between decline in vrql and vf worsening in glaucoma is unlikely to be linear; it more likely has different phases,and these should be further explored in longitudinal studies. © 2017 lee jones et al.