Impact of Monocular and Binocular Visual Function Parameters on Vision-Related Quality of Life in Glaucoma

Abstract

Précis: This study describes the impact of monocular (M/O) and binocular (B/O) visual function decline, primarily the contrast sensitivity (CS) and visual field (VF) defect severity and its location, on the subjective perception of quality of life (QoL) among the Indian glaucoma population with spared central acuity. Aim: To investigate the influence of M/O and B/O visual function parameters on vision-related QoL (VRQoL) in glaucoma with spared central visual acuity. Materials and Methods: Glaucoma subjects underwent M/O and B/O visual acuity, CS assessment, followed by the M/O perimetry from which the integrated VF was estimated (B/O summation method). VRQoL was evaluated using the Glaucoma Quality Of Life-15 (GQL-15) and Visual Function Questionnaire–Utility Index (VFQ-UI) questionnaires. The relationship between CS and VF defect (VFD) with the composite VRQoL scores was analyzed. Results: A total of 154 glaucoma subjects with a median age of 61 (range: 24–83) years were enrolled. Subjects with severe VFD reported poor composite scores for GQL-15 and VFQ-UI when compared with unilateral and mild groups (P < 0.001, Dunn post hoc). Both the composite scores were negatively correlated with M/O and B/O CS and VF mean deviation (r range: −0.3 to −0.5, P < 0.001, Spearman rank correlation). B/O VFD in the inferior central zone contributed to poor GQL-15 score [odds ratio: 1.14 (95% CI: 1.10–1.29), P = 0.04] irrespective of sex, whereas females with increasing B/O VFD reported poor QoL score in VFQ-UI [odds ratio: 4.09 (95% CI: 1.77–9.43), p=0.003]. Conclusions: Poor GQL-15 and VFQ-UI scores were reported with increasing disease severity. B/O VFD in the inferior central region was found to contribute predominantly to the poor GQL-15 scores while both disease severity and sex influenced VFQ-UI scores.