Abstract
Purpose
To assess vision-related quality of life (VRQoL) in Chinese glaucoma patients and explore its sociodemographic, clinical and psychological correlates, and determine which of them explain the largest variation.
Methods
This cross-sectional study included 508 Chinese glaucoma patients. Chinese-version Glaucoma Quality of Life-15 questionnaire (CHI-GQL-15) and Hospital Anxiety and Depression Scales were administered to all participants to evaluate their VRQoL and psychological distresses. Visual functions (habitual-corrected visual acuity (HCVA), intraocular pressure, and mean defect (MD) of visual field) were assessed through clinical examinations by professionals. Sociodemographic information and other treatment histories were collected via interviews and chart review. Stepwise multiple linear regression analyses were performed to identify sociodemographic, clinical, and psychological predictors of VRQoL.
Results
The mean summary score for CHI-GQL-15 was 28.79 ± 12.74. Patients exhibited the greatest difficulty in activities involving glare and dark adaptation (28.19 ± 22.86), followed by central and near vision (26.18 ± 26.56), peripheral vision (18.03 ± 21.37), and the least difficulty for outdoor mobility (15.06 ± 24.57). Moderate and heavy economic burden, HCVA and MD of both the better and the worse eyes, number of glaucoma surgeries in the treatment history and the presence of depression were independent predictors for VRQoL of glaucoma patients. Clinical factors explained the largest variation.
Conclusion
VRQoL of glaucoma patients is multifactorial and was primarily determined by clinical indices. VRQoL assessment could be informative when adopted as a complement to objective visual measures in clinical practice.
Similar content being viewed by others
References
Resnikoff, S., Pascolini, D., Etya’Ale, D., Kocur, I., Pararajasegaram, R., Pokharel, G. P., et al. (2004). Global data on visual impairment in the year 2002. Bulletin of the World Health Organization, 82(11), 844–851.
Quigley, H. A., & Broman, A. T. (2006). The number of people with glaucoma worldwide in 2010 and 2020. British Journal of Ophthalmology, 90(3), 262–267.
Guedes, R. A. P., Guedes, V. M. P., Freitas, S. M., & Chaoubah, A. (2012). Quality of life of medically versus surgically treated glaucoma patients. J Glaucoma, 22, 369–373.
van Gestel, A., Webers, C. A., Beckers, H. J., van Dongen, M. C., Severens, J. L., Hendrikse, F., et al. (2010). The relationship between visual field loss in glaucoma and health-related quality-of-life. Eye, 24(12), 1759–1769.
Mabuchi, F., Yoshimura, K., Kashiwagi, K., Shioe, K., Yamagata, Z., Kanba, S., et al. (2008). High prevalence of anxiety and depression in patients with primary open-angle glaucoma. Journal of Glaucoma, 17(7), 552–557.
Elliott, D. B., Pesudovs, K., & Mallinson, T. (2007). Vision-related quality of life. Optometry and Vision Science, 84(8), 656–658.
Nelson, P., Aspinall, P., Papasouliotis, O., Worton, B., & O’Brien, C. (2003). Quality of life in glaucoma and its relationship with visual function. Journal of Glaucoma, 12(2), 139–150.
Bechetoille, A., Arnould, B., Bron, A., Baudouin, C., Renard, J. P., Sellem, E., et al. (2008). Measurement of health-related quality of life with glaucoma: Validation of the Glau-QoL 36-item questionnaire. Acta Ophthalmologica, 86(1), 71–80.
Lee, B. L., Gutierrez, P., Gordon, M., Wilson, M. R., Cioffi, G. A., Ritch, R., et al. (1998). The Glaucoma Symptom Scale. A brief index of glaucoma-specific symptoms. Archives of Ophthalmology, 116(7), 861–866.
Nelson, P., Aspinall, P., & O’Brien, C. (1999). Patients’ perception of visual impairment in glaucoma: A pilot study. British Journal of Ophthalmology, 83(5), 546–552.
Onakoya, A. O., Mbadugha, C. A., Aribaba, O. T., & Ibidapo, O. O. (2012). Quality of life of primary open angle glaucoma patients in Lagos, Nigeria: Clinical and sociodemographic correlates. Journal of Glaucoma, 21(5), 287–295.
Goldberg, I., Clement, C. I., Chiang, T. H., Walt, J. G., Lee, L. J., Graham, S., et al. (2009). Assessing quality of life in patients with glaucoma using the Glaucoma Quality of Life-15 (GQL-15) questionnaire. Journal of Glaucoma, 18(1), 6–12.
Skalicky, S., & Goldberg, I. (2008). Depression and quality of life in patients with glaucoma: a cross-sectional analysis using the Geriatric Depression Scale-15, assessment of function related to vision, and the Glaucoma Quality of Life-15. Journal of Glaucoma, 17(7), 546–551.
Altangerel, U., Spaeth, G. L., & Rhee, D. J. (2003). Visual function, disability, and psychological impact of glaucoma. Current Opinion in Ophthalmology, 14(2), 100–105.
Hyphantis, T., Tomenson, B., Paika, V., Almyroudi, A., Pappa, C., Tsifetaki, N., et al. (2009). Somatization is associated with physical health-related quality of life independent of anxiety and depression in cancer, glaucoma and rheumatological disorders. Quality of Life Research, 18(8), 1029–1042.
Avorn, J., Everitt, D. E., & Weiss, S. (1986). Increased antidepressant use in patients prescribed beta-blockers. JAMA, 255(3), 357–360.
Chylack, L. J., Wolfe, J. K., Singer, D. M., Leske, M. C., Bullimore, M. A., Bailey, I. L., et al. (1993). The lens opacities classification system III. The longitudinal study of Cataract Study Group. Archives of Ophthalmology, 111(6), 831–836.
Geoffrey, R. N., & David, L. S. (2003). Pretty darned quick (PDQ) statistics (3rd ed.). Shelton CT: People’s Medical Publishing House-USA.
Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67(6), 361–370.
Leung, C. M., Ho, S., Kan, C. S., Hung, C. H., & Chen, C. N. (1993). Evaluation of the Chinese version of the Hospital Anxiety and Depression Scale. A cross-cultural perspective. International Journal of Psychosomatics, 40(1–4), 29–34.
Globe, D. R., Varma, R., Torres, M., Wu, J., Klein, R., & Azen, S. P. (2005). Self-reported comorbidities and visual function in a population-based study: the Los Angeles Latino Eye Study. Archives of Ophthalmology, 123(6), 815–821.
Varma, R., Wu, J., Chong, K., Azen, S. P., & Hays, R. D. (2006). Impact of severity and bilaterality of visual impairment on health-related quality of life. Ophthalmology, 113(10), 1846–1853.
Sawada, H., Fukuchi, T., & Abe, H. (2011). Evaluation of the relationship between quality of vision and the visual function index in Japanese glaucoma patients. Graefes Archive for Clinical and Experimental Ophthalmology, 249(11), 1721–1727.
Kulkarni, K. M., Mayer, J. R., Lorenzana, L. L., Myers, J. S., & Spaeth, G. L. (2012). Visual field staging systems in glaucoma and the activities of daily living. American Journal of Ophthalmology, 154(3), 445–451.
Gutierrez, P., Wilson, M. R., Johnson, C., Gordon, M., Cioffi, G. A., Ritch, R., et al. (1997). Influence of glaucomatous visual field loss on health-related quality of life. Archives of Ophthalmology, 115(6), 777–784.
Burr, J., Azuara-Blanco, A., & Avenell, A. (2005). Medical versus surgical interventions for open angle glaucoma. Cochrane Database of Systematic Reviews, 18, CD004399.
Janz, N. K., Wren, P. A., Lichter, P. R., Musch, D. C., Gillespie, B. W., Guire, K. E., et al. (2001). The Collaborative Initial Glaucoma Treatment Study: interim quality of life findings after initial medical or surgical treatment of glaucoma. Ophthalmology, 108(11), 1954–1965.
Bramley, T., Peeples, P., Walt, J. G., Juhasz, M., & Hansen, J. E. (2008). Impact of vision loss on costs and outcomes in medicare beneficiaries with glaucoma. Archives of Ophthalmology, 126(6), 849–856.
Varma, R., Lee, P. P., Goldberg, I., & Kotak, S. (2011). An assessment of the health and economic burdens of glaucoma. American Journal of Ophthalmology, 152(4), 515–522.
Mabuchi, F., Yoshimura, K., Kashiwagi, K., Yamagata, Z., Kanba, S., Iijima, H., et al. (2012). Risk factors for anxiety and depression in patients with glaucoma. British Journal of Ophthalmology, 96(6), 821–825.
Wang, S. Y., Singh, K., & Lin, S. C. (2012). Prevalence and predictors of depression among participants with glaucoma in a nationally representative population sample. American Journal of Ophthalmology, 154(3), 436–444.
Owsley, C., & McGwin, G., Jr. (2004). Depression and the 25-item National Eye Institute Visual Function Questionnaire in older adults. Ophthalmology, 111(12), 2259–2264.
Avorn, J., Everitt, D. E., & Weiss, S. (1986). Increased antidepressant use in patients prescribed beta-blockers. JAMA, 255(3), 357–360.
Jayawant, S. S., Bhosle, M. J., Anderson, R. T., & Balkrishnan, R. (2007). Depressive symptomatology, medication persistence, and associated healthcare costs in older adults with glaucoma. Journal of Glaucoma, 16(6), 513–520.
Acknowledgments
We wish to thank Mr. Wenlin Zhou and Dr. Jinjing Xie for their outstanding contribution to data interpretation and logistical help, and all participants for their time and invaluable devotion.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Zhou, C., Qian, S., Wu, P. et al. Quality of life of glaucoma patients in China: sociodemographic, clinical, and psychological correlates—a cross-sectional study. Qual Life Res 23, 999–1008 (2014). https://doi.org/10.1007/s11136-013-0518-2
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11136-013-0518-2