The quality of life impact of peripheral versus central vision loss with a focus on glaucoma versus age-related macular degeneration

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Authors: Keith Evans, Simon K Law, John Walt, et al

Published Date July 2009 , Volume 2009:3 Pages 433 - 445 DOI 10.2147/OPTH.S6024

Keith Evans¹, Simon K Law², John Walt³, Patricia Buchholz⁴, Jan Hansen³

¹Global Health Outcomes, Wolters Kluwer Health, Chester, United Kingdom; ²Jules Stein Eye Institute, Los Angeles, CA, USA; ³Global Health Outcomes Strategy and Research, Allergan Inc., Irvine, CA, USA; ⁴Health Economics, Pricing, and Reimbursement, Allergan GmbH, Ettlingen, Germany

Purpose: It is well accepted that conditions that cause central vision loss (CVL) have a negative impact on functional ability and quality of life (QoL), but the impact of diseases that cause peripheral vision loss (PVL) is less well understood. Focusing on glaucoma and age-related macular degeneration (ARMD), the effects of CVL and PVL on QoL were compared.

Methods: A systematic literature review of publications reporting QoL in patients with CVL or PVL identified 87 publications using four generic (Short-Form Health Survey-36 and -12, EuroQoL EQ-5D and Sickness Impact Profile) and five vision-specific (National Eye Institute Visual Function Questionnaire-51, -39, and -25, Impact of Vision Impairment and Visual Function-14) QoL instruments; 33 and 15 publications reported QoL in ARMD and glaucoma, respectively.

Results: QoL was impaired to a similar extent by diseases associated with PVL and CVL, but different domains were affected. In contrast to ARMD, mental aspects appeared to be affected more than physical aspects in patients with glaucoma.

Conclusions: The differential impact upon QoL might be a function of the pathology of the diseases, for example potential for blindness and better ability to perform physical tasks due to retention of central vision may explain these observations in glaucoma.

Keywords: vision loss, quality of life, glaucoma, age-related macular degeneration, diabetic macular edema, cataracts