IOVS Journal of Clinical Microbiology
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(Investigative Ophthalmology and Visual Science. 2008;49:1907-1915.)
© 2008 by The Association for Research in Vision and Ophthalmology, Inc.
DOI:  10.1167/iovs.07-0559

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Evaluation of Quality of Life and Priorities of Patients with Glaucoma

Peter A. Aspinall,1,2 Zoe K. Johnson,3 Augusto Azuara-Blanco,3 Alicia Montarzino,1 Roger Brice,4 and Adrian Vickers4

1From the Visual Impairment Research Group, School of the Built Environment, Heriot-Watt University, and the 2Princess Alexandra Eye Pavilion, Edinburgh, Scotland, United Kingdom; the 3Department of Ophthalmology, University of Aberdeen, Scotland, United Kingdom; and 4Adelphi Group Ltd., Bollington, United Kingdom.

PURPOSE. To investigate the quality of life and priorities of patients with glaucoma.

METHODS. Patients diagnosed with glaucoma and no other ocular comorbidity were consecutively recruited. Clinical information was collected. Participants were asked to complete three questionnaires: EuroQuol (EQ-5D), time tradeoff (TTO), and choice-based conjoint analysis. The latter used five-attribute outcomes: (1) reading and seeing detail, (2) peripheral vision, (3) darkness and glare, (4) household chores, and (5) outdoor mobility. Visual field loss was estimated by using binocular integrated visual fields (IVFs).

RESULTS. Of 84 patients invited to participate, 72 were enrolled in the study. The conjoint utilities showed that the two main priorities were "reading and seeing detail" and "outdoor mobility." This rank order was stable across all segmentations of the data by demographic or visual state. However, the relative emphasis of these priorities changed with increasing visual field loss, with concerns for central vision increasing, whereas those for outdoor mobility decreased. Two subgroups of patients with differing priorities on the two main attributes were identified. Only 17% of patients (those with poorer visual acuity) were prepared to consider TTO. A principal component analysis revealed relatively independent components (i.e., low correlations) between the three different methodologies for assessing quality of life.

CONCLUSIONS. Assessments of quality of life using different methodologies have been shown to produce different outcomes with low intercorrelations between them. Only a minority of patients were prepared to trade time for a return to normal vision. Conjoint analysis showed two subgroups with different priorities. Severity of glaucoma influenced the relative importance of priorities.








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Copyright © 2008 by the Association for Research in Vision and Ophthalmology