青光眼患者小梁切除术后生存质量的评价

目的:评价青光眼患者小梁切除术后的生存质量及其影响因素。方法:采用视功能损害患者生存质量量表对123例青光眼患者小梁切除术后的生存质量进行评价。结果:青光眼患者小梁切除术后的生活质量得分较低,视力损害严重影响着患者的生存质量得分,多因素逐步直线回归显示:影响总分的主要因素是视力损伤程度(β=-10.139,P=0.000)、健康教育(β=2.576,P=0.000)、手术次数(β=-3.598,P=0.002)及性别(β=3.807,P=0.013)。结论:青光眼患者小梁切除术后的生存质量得分较低,因此不仅要重视患者的临床治疗,在保护青光眼患者视功能的同时,根据患者的职业、经济状况等进行综合治疗,给予必要的健康教育和心理治疗,解除患者的心理问题,对提高患者的生存质量有重要的意义。     

白内障患者视力改变与生存质量的关系

目的:了解白内障病人视力损害及康复与生存质量的关系,探讨影响白内障患者生存质量的因素。方法:应用视功能损害眼病生存质量量表测量142例不同视力损害的白内障患者生存质量及33例白内障摘除 人工晶体植入术前后的生存质量情况。结果:白内障患者视力改变与生存质量的总得分及各方面的得分有相关关系。白内障患者术前后生存质量得分差异有显著性,影响白内障患者生存质量的主要因素为视力损害、年龄和职业。结论:白内障的视力损害将降低患者的生存质量,适当时机进行白内障手术将有助于患者生存质量的提高,生存质量的测量为我们对白内障视力损害的评价提供了新的指标。眼科学报1997;13:85～89。     

原发性急性闭角型青光眼高眼压水平及持续时间对视力影响

为了探讨原发性急性闭角型青光眼高眼压对视功能的损害程度及影响视功能恢复的因素, 我们对 １０１ 例原发性急性闭角型青光眼急性发作期患者进行研究。结果表明急性发作期患者的视力损害程度与年龄、眼压水平, 高眼压持续时间呈线性关系, 眼压越高、持续时间越长、年龄越大、视力损害越严重。视盘凹陷的形成与高眼压持续时间成正相关。患者术后视力的恢复受术前高眼压的持续时间、年龄、术前视力、术后眼压、 Ｃ／ Ｄ等综合因素的影响。结果提示对急性闭角型青光眼患者应进行紧急降眼压治疗, 缩短高眼压的持续时间以挽救和保护患者的视功能。     

原发性开角型青光眼血液流变学改变及其对视功能的影响

对正常人和原发性开角型青光眼患者进行血液流变学参数测定的结果表明原发性开角型青光眼患者全血表观粘度、血浆粘度、全血粘弹性、红细胞聚集指数、红细胞压积，平均红细胞容积、血液相对粘度均比正常人增加。计算机多因素逐步回归分析结果提示低切变率下全血表观粘度与开角青光眼视野缺损率关系最密切。讨论了原发性开角型青光眼视功能损害的多因素性和血液粘度对视功能损害的机理。     

青光眼患者的生存质量及其影响因素研究

目的：评价青光眼患者的生存质量并探讨影响其生存质量的因素。 方法：采用国家眼科研究所视功能问卷-25,对126例青光眼患者的生活质量进行评价。 结果：青光眼患者的生存质量普遍下降,不同程度的视力损害明显影响着患者的生存质量得分（P＜0.01）。多因素逐步直线回归显示：生存质量的得分与年龄、经济收入、遵医行为有密切关系（P＜0.05）。 结论：在保护青光眼患者视功能的同时,要重视其社会、心理等因素,给予其必要的健康教育和心理辅导,以期提高其生存质量。     

青光眼患者生存质量的研究进展

青光眼是当今世界范围内不可逆盲的主要病因,同时也是导致视力丧失的主要原因之一。青光眼的症状、视功能的损害以及各种对症的治疗方式、不良反应使患者的日常生活、社会活动受到不同程度的限制,使患者的心理、社会和经济等方面受到影响,极大地影响患者的健康。就青光眼患者生存质量（QOL）测评的意义及工具、影响青光眼患者QOL的因素以及如何提高他们的QOL进行综述。     

24 h眼灌注压与原发性开角型青光眼和正常眼压性青光眼的相关性研究

目的 深入探究原发性开角型青光眼(POAG)及正常眼压性青光眼(NTG)患者24 h眼内灌注压的昼夜变化及其与视功能损害的关系.方法 选择眼科门诊筛选患者162例,分为2组:原发性开角型青光眼组(71例)、正常眼压性青光眼组(91例).采集年龄、性别、屈光度、最佳矫正视力、眼轴、中央角膜厚度、杯盘比、中心视野等基本信息...     

心理干预对青光眼患者生存质量影响的临床研究

目的 探讨心理干预对青光眼患者生存质量的影响,为青光眼的护理干预提供科学依据和对策.方法 采用视功能损害眼病患者生存质量量表、健康促进生活方式量表和自行设计的焦虑相关因素调查问卷对患者分别在人院前、手术前后、出院前进行评估.结果 实验组和对照组比较,心理干预后实验组与对照组焦虑评分、生存质量总评分、精神与心理方面评分、症状与视功能方面评分以及医患顺应性有显著差异(P<0.01).身体机能、社会活动方面评分无显著差异(P>0.05).健康行为与婚姻家庭状况、文化教育程度、心理干预、经济状况、社会支持、青光眼症状发作显著相关(P<0.01).结论 心理干预可以明显缓解青光眼患者住院期间情绪波动所造成的发作性症状,改善焦虑情绪及心理状态,提高住院期间视功能及相关生存质量.     

青光眼视功能损害及药物治疗研究进展

青光眼是一类以特异性视神经损害和视野缺损为特征的眼病,严重危害患者的视力和生存质量,对青光眼视功能保护的研究对防盲治盲工作具有深远意义,我们就青光眼视功能损害及药物治疗进展进行综述。     

白内障患者视功能损害和生存质量分析

目的:观察白内障患者视功能损害生存质量下降情况。方法:应用视功能损害患者生存质量量表对不同视力损害的256例双眼白内障患者进行测量分析。结果:白内障患者生存质量总分以及各指标分数下降。重度视力下降组生存质量分数下降更加明显。结论:白内障患者由于视功能下降而生存质量受损害。生存质量的研究使医师更加全面了解患者的需求。     

Prevalence of end‐of‐life visual impairment in patients followed for glaucoma

Purpose: To assess the prevalence of end‐of‐life visual impairment in patients followed for glaucoma. Methods: Data of 122 patients followed for glaucoma who had died between July 2008 and July 2010 and who had visited the ophthalmology outpatient department of a large non‐academic Dutch hospital were collected from the medical files. Sixty‐one patients had open‐angle glaucoma (OAG), and 61 patients were suspect for glaucoma or had ocular hypertension (OHT). Visual impairment was defined as a mean deviation value <?15 dB or a Snellen visual acuity <0.3 (20/60) of the better eye. We determined the number of patients with visual impairment on the last patient visit before death and investigated its main explanations. Results: Overall, the mean age at death was 81.8 years after a mean follow‐up period of 9.2 years. Seventy‐three per cent of all patients had their last visit in the year preceding death. In OAG, 16 patients (26%) had an end‐of‐life visual impairment. In nine patients (15%), this was caused by glaucoma. Eight of them had substantial visual loss at the initial visit. Six (10%) impaired OAG cases were mainly explained by ocular comorbidity, and there was an equal contribution of comorbidity and glaucoma in one case. Five glaucoma suspects or patients with OHT (8%) were visually impaired at death and these were all caused by ocular comorbidity. Conclusion: The prevalence of end‐of‐life visual impairment is considerable in patients with OAG. Substantial visual loss at baseline is an important contributing factor. In glaucoma suspects or patients with OHT, the prevalence is lower and can be attributed to ocular comorbidity.     

青光眼患者生活质量的研究进展

青光眼以其不可逆转的视神经损害、视野缺损及视力丧失为特征.其疾病本身和各种治疗都会明显限制青光眼患者的日常生活和社会活动,从而严重影响患者的生活质量.为此,有必要就目前有关青光眼患者的生活质量及其影响因素的研究资料予以综述,以供同道参考.(中华眼科杂志,2009,45:88-92)     

Modified Bahasa Malaysia version of VF-14 questionnaire: assessing the impact of glaucoma in rural area of Malaysia

Purpose: To evaluate the functional impairment of glaucoma patients, using a modified Bahasa Malaysia version of VF‐14 questionnaire, and to correlate the score with the severity of the disease. Methods: One‐to‐one interview by trained interviewers was conducted on glaucoma patients seen in the eye clinic of Hospital Universiti Sains Malaysia, using a modified validated Bahasa Malaysia version of VF‐14 questionnaire. The severity of glaucoma was determined based on the better‐eye Advanced Glaucoma Intervention Study Scale (AGIS) score of visual field analysis on the latest most reliable visual field. The literacy rate, living situation, better‐eye visual acuity and lens status were also documented. Results: A total of 110 glaucoma patients were recruited (54.5% primary open‐angle glaucoma, 21.8% primary angle‐closure glaucoma, 19.2% normotensive glaucoma and 4.5% pseudoexfoliative glaucoma) and majority with bilateral involvement. Based on the better‐eye AGIS score, 41.5% were in advanced stage, 29.1% moderate and 29.1% mild. There was a significant association between VF‐14 scoring with the better‐eye AGIS score (r =?0. 579, P < 0.001), age (r = ?0.313, P = 0.000) and better‐eye visual acuity (r = ?0.752, P = 0.000). Based on the multivariate analysis, there was a significant association of the questionnaire score and better‐eye AGIS score (P < 0.001). Conclusion: The Bahasa Malaysia version of modified VF‐14 questionnaire is a useful tool in quantifying quality of life among glaucoma patients in rural area with high illiteracy rate and provides moderate correlation with severity of the disease. Customization of quality of life questionnaire according to custom and culture of the community will provide better insight to the functional impairment of glaucoma patients.     

Evaluation of quality of life characteristics and grade of legal visual impairment

PURPOSE: To evaluate the possible correlation between quality of life (QOL) characteristics and grades of legal visual impairment. MATERIALS AND METHODS: Quality of life characteristics associated with various causes of visual loss were investigated in 237 Japanese patients in the low-vision care clinic at Tokyo University Hospital, who had been issued the official ID and handbook for the physically handicapped. The main causes of vision loss were glaucoma (87 patients), macular degeneration (35) and diabetic retinopathy (34). Using a previously developed questionnaire, we assessed the correlation between the disability index (DI) as a quality of life characteristic, and the grade of legal visual impairment. RESULTS: Total DI was 1.24 +/- 0.43, showing a very significant correlation with Handicapped Handbook grades (r = -0.44, p < .0001). The correlation coefficients were -0.63 (p < 0.0001) for diabetic retinopathy, -0.50 (p = 0.002) for macular degeneration, and -0.16 (p = 0.14) for glaucoma patients. CONCLUSION: The needs of low-vision patients correlate with the grade of legal visual impairment and it is important to understand that the needs of low vision patients differ for each disease.     

Contributing ocular comorbidity to end-of-life visual acuity in medically treated glaucoma patients,ocular hypertension and glaucoma suspect patients

AimTo assess the visual acuity at the end of life in glaucoma suspect patients, ocular hypertension, and patients treated for glaucoma and to find factors contributing to a reduced visual acuity in this cohort of deceased patients.MethodsIn a cohort of 3883 medically treated glaucoma patients, glaucoma suspect, or patients with ocular hypertension assembled in 2001–2004, 1639 were deceased. Patient data were collected from electronic and paper patient files. The files of 1378 patients were studied and the last measured visual acuity and ocular comorbidities influencing the visual acuity were extracted.ResultsOur results show that only 37.2% of patients had no visual impairment in either eye, 30.5% was visually impaired or blind in both eyes and 4.1% was blind in both eyes, all based on VA. The most common contributing factors for severe visual impairment or blindness (prevalence ≥ 1%) were: glaucoma, retinal vein occlusion, dry and exudative age-related macular degeneration, past retinal detachment, amblyopia, diabetic retinopathy, anterior ischemic optic neuropathy, trauma, decompensated cornea, past keratitis, enucleation, corneal transplantation, and macular hole.ConclusionsDespite the current advanced treatment modalities for glaucoma, 30.5% of patients had a VA < 0.5 in both eyes and 4.1% was blind in both eyes. However, this disability cannot be confidently attributed only to glaucoma. Besides glaucoma, most common contributing factors were among others retinal and macular diseases. Patient management in glaucoma should be based on more than lowering the intraocular pressure to prevent blindness at the end of life.Subject terms: Optic nerve diseases, Pattern vision     

采用效用分析方法测量中国人青光眼患者的视觉相关生活质量

背景近年来关于青光眼对患者生活质量的影响日益受到临床工作者的关注,但调查结果表明各种视功能量表均存在一定的不足,准确、全面地评价影响青光眼患者生活质量的主观和客观因素值得深入研究。目的利用效用分析的方法测量青光眼患者视觉相关生活质量并初步分析其相关因素。方法收集北京同仁医院门诊确诊的青光眼患者,采用效用分析中的线性等级尺度（RS）法和时间交易（TTO）法进行问卷调查以获得反映青光眼患者疾病相关生活质量的效用值,比较RS法和TTO法所得效用值的差异和相关性,分析不同性别、年龄、受教育程度、工作状态、青光眼家族史、青光眼手术史、不同视功能损害程度以及不同青光眼类型对患者效用值的影响。结果研究共纳入青光眼患者86例,其中男62例,女24例;平均年龄44．67岁。RS法和TTO法测得青光眼患者的效用值分别为0．62±0．19和0．77±0．12,两种方法获得的效用值之间无显著相关关系（r=0．074,P=0．499）。RS法计算所得的效用值受日常生活视力、视野缺损程度以及青光眼手术史的影响,而TTO法测得的效用值主要与患者的年龄、工作状态以及受教育程度有关,与患者视力和视野损害的严重程度无相关性。校正了年龄、工作状态和受教育程度以后,较差眼视力≥0．3的青光眼患者其TTO效用值显著高于较差眼视力〈O．3者（P=0．029）。结论效用分析的方法简单、灵敏,可较好地被患者所接受。RS法所得效用值受日常生活视力、视野缺损程度以及青光眼手术史的影响,反映了患者对自身视觉状态的主观评价。TTO法测得的效用值主要与患者的年龄、工作状态以及受教育程度有关,反映了不同患病个体对自身视觉相关生活质量的主观评价。视功能的损害程度在青光眼患者的总体生活质量中不起决定性作用。     

Quality of life in glaucoma patients: regression analysis and correlation with possible modifiers

PURPOSE: To verify the quality of life in a Brazilian glaucoma population and the influence of possible modifiers (e.g., visual acuity, visual field impairment). METHODS: Forty-five consecutive patients from CEROF - Federal University of Goias, Brazil were included prospectively in the study. The quality of life was assessed using the Portuguese version of the VFQ. Possible modifiers were evaluated, initially separately with the Spearman's Correlation and then together in a regression model. RESULTS: The mean age was 59.6 +/- 12.4 years. The mean quality of life score was 79 +/- 15 (range 45-100). Age (r = -0.402, p = 0.006), visual acuity in the better eye (r = -0.497, p = 0.001) and in the worse eye (r = -0.608, p < 0.001), Hodapp-Parrish-Anderson visual field grading scale in the better (r = -0.353, p = 0.01) and worse eye (r = -0.387, p = 0.009), visual field Mean Deviation (MD) in the better (r = 0.355, p = 0.01) and worse eye (r = 0.320, p = 0.04) and ability to perform a visual field test in both eyes (r = -0.397, p = 0.007) were significantly correlated with the quality of life scores. However, only age (younger, better quality of life, p = 0.008) and visual acuity in the better eye (direct relation, p = 0.04) were significant in the regression model (r = 0.633, r(2) = 0.401). CONCLUSIONS: The VFQ may be a useful tool to assess the quality of life in glaucoma patients. The preliminary results indicate that age and visual acuity in the better eye are the main factors related to the quality of life in these patients.     

Visual function,disability, and psychological impact of glaucoma

PURPOSE OF REVIEW: This report briefly reviews recent instruments designed to test the visual function and quality of life of patients with glaucoma. RECENT FINDINGS: Several investigators have examined the functional status and vision-related quality of life among patients with glaucoma. These studies have shown that patients with glaucoma experience diminished visual function and poorer quality of life. SUMMARY: Because glaucoma and its treatment, either medical or surgical, can affect global quality of life as well as vision-related functioning, the assessment of both general and visual system health status is relevant.