Analysis of life quality of primary angle-closure glaucoma patients and its influencing factors in Baotou region, Inner Mongolia

Objective

To investigate vision-related quality of life, anxiety and depression in patients with primary angle-closure glaucoma (PACG) and the influencing factors in Baotou, Inner Mongolia.

Methods

A cross-sectional study was conducted.One hundred and eighty-two consecutive PACG patients (364 eyes) with intraocular pressure ≤20 mmHg (1 mmHg=0.133 kPa) at 3 random times after treatment were enrolled in Baotou Chaoju Ophthalmic Hospital from September 2018 to January 2020.Gender, age, marital status, education level, monthly income, total treatment cost, glaucoma treatment time, surgery and drug treatment history, best corrected visual acuity (BCVA), Humphrey visual field index (VFI) and scores of the National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25) and Hospital Anxiety and Depression Scale (HADS) of patients were recorded.Pearson correlation analysis was used to analyze the correlation between age and composite VFQ-25 score.Spearman rank correlation analysis was used to analyze the correlation between other statistical data.Stepwise multivariate linear regression was used to analyze the correlation between composite VFQ-25 score, HADS score and statistically significant influencing factors above.This study protocol adhered to the Declaration of Helsinki, and was approved by an Ethics Committee of Beijing Tongren Hospital, Capital Medical University (No.TRECKY2015-30). Written informed consent was obtained from each subject.

Results

The mean age of subjects was (59.75±8.43) years.The mean composite VFQ-25 score was (68.59±14.43) points.The mean HADS, HADS-Anxiety (HADS-A) and HADS-Depression (HADS-D) scores were 16.00 (12.00, 20.00), 8.00 (6.00, 10.00), 8.00 (6.00, 10.00) points, respectively.The proportion of anxious (HADS-A score>10 points) and depressd (HADS-D score >10 points) patients was 18.1% (33/182) and 13.7% (25/182), respectively.Age was positively correlated with BCVA in eyes with better and worse vision (r_s=0.36, 0.29; both at P<0.01), and it was negatively correlated with mean deviation (MD) of Humphrey visual field in the better-MD and worse-MD eyes, VFI of Humphrey visual field in the better-VFI and worse-VFI eyes (r_s=-0.21, -0.23, -0.30, -0.23; all at P<0.01). The composite VFQ-25 score was negatively correlated with age, BCVA in the eyes with better and worse vision (r_s=-0.32, -0.34, -0.48; all at P<0.01), and it was positively correlated with MD in the better-MD and worse-MD eyes, VFI in the better-VFI and worse-VFI eyes (r_s=0.37, 0.45, 0.38, 0.46; all at P<0.01). The HADS-A score was negatively correlated with MD in the better-MD eye (r_s=-0.20, P<0.01). The HADS-D score was positively correlated with BCVA in the eyes with worse vision (r_s=0.26, P<0.01) and negatively correlated with MD in the better-MD and worse-MD eyes, and VFI in the worse-VFI eyes (r_s=-0.21, -0.22, -0.22; all at P<0.01). The HADS score was positively correlated with BCVA in the eyes with worse vision (r_s=0.22, P<0.01), and negatively correlated with MD in the better-MD and worse-MD eyes, and VFI in the worse-VFI eyes (r_s=-0.20, -0.20, -0.21; all at P<0.01). The composite VFQ-25 score was negatively correlated with mean HADS-A, HADS-D and HADS scores (r_s=-0.41, -0.41, -0.45; all at P<0.01). According to the multivariate analysis, the composite VFQ-25 score was related to age (P<0.01), education level (P<0.01), total treatment cost (P<0.05), BCVA in the eyes with better vision (P<0.05) and MD in the worse-MD eyes (P<0.01). The HADS score was related to gender (P<0.05) and the composite VFQ-25 score (P<0.01).

Conclusions

The vision-related quality of life and incidence of anxiety and depression are low in patients with PACG in Baotou region, Inner Mongolia.With age increasing, PACG patients suffer from declined visual function, increased visual field damage, reduced vision-related quality of life and raised anxiety and depression.The vision-related quality of life is poorer in patients with lower education level and higher total treatment cost.Female glaucoma patients are more likely to suffer from anxiety and depression.