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Factors associated with glaucoma-specific quality of life in a US glaucoma clinic in a pilot implementation of an online computerised adaptive test (GlauCAT)
  1. Omar A Halawa1,2,
  2. Ana M Roldan1,
  3. Ryan S Meshkin1,2,
  4. Nazlee Zebardast2,3,
  5. Eva K Fenwick4,5,
  6. Ecosse Luc Lamoureux6,7,
  7. David S Friedman8
  1. 1 Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
  2. 2 Harvard Medical School, Boston, Massachusetts, USA
  3. 3 Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
  4. 4 Singapore Eye Research Institute, Singapore
  5. 5 Duke-NUS Medical School, Singapore
  6. 6 HSSR, Duke-NUS Medical School, Singapore
  7. 7 Population Health, Singapore Eye Research Institute, Singapore
  8. 8 Glaucoma Center of Excellence, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
  1. Correspondence to Dr David S Friedman, Glaucoma Center of Excellence, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA; Friedman{at}meei.harvard.edu

Abstract

Objectives Measure quality of life (QoL) outcomes using a novel computerised adaptive test in a clinical setting, and determine the social and demographic factors associated with specific QoL domains in patients with glaucoma.

Design Cross-sectional study between July 2020 and April 2021.

Participants English-speaking adults presenting to glaucoma clinic. Patients with cognitive impairment on a six-item cognitive impairment screen or with intraocular surgery within 90 days prior to presentation were excluded.

Results Of 206 patients surveyed, mean age was 64.8 years (SD 15.2), 122 (56.7%) were female and 159 (74.7%) were white. On multivariable regression, visual acuity was associated with greater activity limitation (β=−2.8 points, 95% CI −3.8 to –1.8, p<0.001) and worse mobility (β=−2.1 points, 95% CI −3.2 to –0.9, p<0.001), while poorer visual field (VF) mean deviation was associated with lower scores on the emotional well-being domain (β=−2.4 points, 95% CI −4.6 to –0.3, p=0.03). Glaucoma suspects and those with early VF defects had higher QoL scores than those with severe glaucoma in the following domains: activity limitation (88.5±14.6 vs 74.3±21.9, respectively, p<0.001), mobility (91.0±12.5 vs 80.0±25.3, respectively, p=0.005) and concerns domains (82.2±13.9 vs 72.5 5±18.9, respectively, p=0.01).

Conclusions In a busy glaucoma clinic where QoL was measured with online adaptive tests for glaucoma, we found that several demographic and clinical variables are associated with lower domain scores, suggesting that patients with predisposing demographic and clinical factors are at a higher risk of worse QoL.

  • glaucoma

Data availability statement

Data are available on reasonable request.

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Data availability statement

Data are available on reasonable request.

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Footnotes

  • OAH and AMR are joint first authors.

  • Twitter @oahalawa, @anaroldanvasq, @Sameen_Meshkin

  • OAH and AMR contributed equally.

  • Presented at Association for Research in Vision and Ophthalmology Annual Meeting 2021, Oral Presentation.

  • Contributors OH and AMR have contributed to study design, data collection, extraction and analysis, and manuscript writing, preparation and revision. DSF has contributed to study design and manuscript writing, preparation and revision. RSM has contributed to data collection. NZ, EKF, ELL have contributed to study design, data analysis and manuscript writing, preparation and revision. DSF is guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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