دورية أكاديمية
أعرض في EDS

Patient-Reported Symptoms Demonstrating an Association with Severity of Visual Field Damage in Glaucoma.

التفاصيل البيبلوغرافية
العنوان: Patient-Reported Symptoms Demonstrating an Association with Severity of Visual Field Damage in Glaucoma.
المؤلفون: Shah YS; Johns Hopkins Wilmer Eye Institute, Baltimore, Maryland., Cheng M; Johns Hopkins Wilmer Eye Institute, Baltimore, Maryland., Mihailovic A; Johns Hopkins Wilmer Eye Institute, Baltimore, Maryland., Fenwick E; Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Duke-NUS Medical School, Singapore., Lamoureux E; Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Duke-NUS Medical School, Singapore; The University of Melbourne, Melbourne, Australia., Ramulu PY; Johns Hopkins Wilmer Eye Institute, Baltimore, Maryland. Electronic address: pramulu@jhmi.edu.
المصدر: Ophthalmology [Ophthalmology] 2022 Apr; Vol. 129 (4), pp. 388-396. Date of Electronic Publication: 2021 Oct 28.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: United States NLM ID: 7802443 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1549-4713 (Electronic) Linking ISSN: 01616420 NLM ISO Abbreviation: Ophthalmology Subsets: MEDLINE
أسماء مطبوعة: Publication: 2000- : New York : Elsevier
Original Publication: Rochester, Minn., American Academy of Ophthalmology.
مواضيع طبية MeSH: Glaucoma*/complications , Glaucoma*/diagnosis , Ocular Hypertension* , Optic Nerve Diseases*/diagnosis, Adult ; Cross-Sectional Studies ; Female ; Humans ; Intraocular Pressure ; Male ; Middle Aged ; Nerve Fibers ; Patient Reported Outcome Measures ; Retinal Ganglion Cells ; Tomography, Optical Coherence/methods ; Vision Disorders/diagnosis ; Visual Field Tests/methods ; Visual Fields
مستخلص: Purpose: To determine which patient-reported symptoms best distinguish patients with and without glaucoma and explain the most variance in visual field (VF) damage and to compare the amount of variance that can be explained by symptoms versus retinal nerve fiber layer (RNFL) thickness.
Design: Cross-sectional study.
Participants: Adults diagnosed with glaucoma or suspicion of glaucoma (controls).
Methods: Worse-eye VF damage was defined on the basis of perimetric testing. Thickness of RNFL was defined by OCT imaging. Patients rated their visual symptoms on questions collated from several published questionnaires, rating the frequency and severity of 28 symptoms on a scale of 1 (never/not at all) to 4 (very often/severe). Multivariable regression models identified patient-reported symptoms that contributed the highest variance in VF damage.
Main Outcome Measures: Patient-reported symptoms that explained the most variance in VF damage and amount of variance in VF damage explained by patient-reported symptoms and RNFL.
Results: A total of 170 patients (mean age: 64 years; 58% female; 47% employed) completed testing, including 95 glaucoma suspects and 75 glaucoma patients. In glaucoma patients, median mean deviation of VF damage in the worse eye was -19.3 and ranged from -5.3 to -34.7 decibels. Symptoms more common among glaucoma patients compared with glaucoma suspects included better vision in 1 eye, blurry vision, glare, sensitivity to light, cloudy vision, missing patches of vision, and little peripheral vision. Worse severity ratings for the symptom "little peripheral vision" explained the most variance in VF damage (43%). A multivariable model including the frequency of cloudy vision, severity of having little peripheral vision, missing patches, 1 eye having better vision, and vision worsening, plus sociodemographic features, explained 62% of the variance in VF damage. Comparatively, a multivariable model of worse-eye RNFL thickness and sociodemographic features explained 42% of the variance in VF damage, whereas a model including only sociodemographic features explained 8% of the variance in VF damage.
Conclusions: Five patient-reported symptoms explain a significant amount of the variance in VF damage. Asking patients about their symptoms may optimize patient-physician communication and be a useful adjunct to clinical testing in some patients to estimate disease severity.
(Copyright © 2021 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)
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معلومات مُعتمدة: R01 EY022976 United States EY NEI NIH HHS
فهرسة مساهمة: Keywords: RNFL; patient-reported symptoms; predict visual field; severe glaucoma; variance in visual field; visual field damage
تواريخ الأحداث: Date Created: 20211110 Date Completed: 20220502 Latest Revision: 20230402
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC9357267
DOI: 10.1016/j.ophtha.2021.10.023
PMID: 34756939
قاعدة البيانات: MEDLINE
الوصف
تدمد:1549-4713
DOI:10.1016/j.ophtha.2021.10.023