Patients with early primary open-angle glaucoma may have reduced vision-related quality of life (VRQoL) associated with the amount of macular damage they have sustained, according to a new study. The findings add more weight to the ongoing call for earlier structure and function testing for glaucoma suspects to help mitigate negative outcomes.1

Researchers looked at 88 eyes of 44 glaucoma patients using spectral-domain optical coherence tomography optic disc and macular cube scans, as well as both 10-2 and 24-2 visual fields. They measured VRQoL using the National Eye Institute Visual Function Questionnaire (NEI VFQ-25).1

Results show 57% of the worse-seeing eyes and 31% of the better-seeing eyes had macular damage. While macular damage in either eye was associated with lower NEI VFQ-25 scores compared with unaffected eyes, macular damage in the worse-seeing eye led to a lower NEI VFQ-25 score (85.4 ±9.0 vs. 94.6 ±3.3) than that in the better-seeing eye compared with controls (84.8 ±11.1 vs. 91.3 ±6.3).1

“In comparing the overall fit of the data to VRQoL, we found that the presence or absence of macular damage in the worse eye was a better predictor of VRQoL than the presence or absence of macular damage in the better eye,” the researchers said.1

“Because this study shows that macular damage resulting in 10-2 defects correlates much higher with QoL surveys of impaired visual function, it seems time to acknowledge that this is an important screening test for any patient considered to be a glaucoma suspect,” added Leonard J. Press, OD, in a Practice Update commentary.2

1. Garg A, DC Hood, Pensec N, et al. Macular damage, as determined by structure-function staging, is associated with worse vision-related quality of life in early glaucoma. Am J Ophthalmol. July 24, 2018. [Epub ahead of print].

2. Macular damage, as determined by structure–function staging, is associated with worse vision-related quality of life in early glaucoma. PracticeUpdate. August 6, 2018.