Article
Quality of life in glaucoma patients: results of a meta analysis in 1996 - 2002
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Authors
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K. Brauer
- Department of Medical Biometry, Epidemiology and Informatics, University of Mainz
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O. Schwenn
- Department of Ophthalmology, Bürgerhospital Frankfurt/Main
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F. Krummenauer
- Department of Medical Biometry, Epidemiology and Informatics, University of Mainz
| Published: | September 22, 2004 |
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Outline
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Objective
Despite objective clinical endpoints like visual field loss, quality of life has become an important aspect of both clinical and health economic evaluation of glaucoma therapy. To both estimate quality of life in glaucoma patients and its putative association with medical and surgical treatment, a meta analysis of corresponding publications during 1996 to 2002 was implemented.
Methods
Publications were screened via MedLine alongside searching criteria such as "quality of life & glaucoma" or "glaucoma & patient satisfaction"; the use of psychometrically validated questionnaires for quality of life assessment was an inclusion criterion for the meta analysis. Study publications were re-analysed according to the following primary meta endpoints: clinically relevant association between subjective quality of life and visual field loss (progression); clinically relevant loss in quality of life compared to probands without ophthalmological disorder; clinically relevant association between quality of life and medical or surgical treatment.
Results
The meta analysis comprised 13 international study reports, which were based on validated quality of life questionnaires; 2 further reports were based on instruments derived by the authors. 8 of the 13 trials considered visual field loss and quality of life simuntaneously, among which 5 did not find a clinically relevant association (based on SF-36 or VF-14). 3 of 4 studies reported a clinically relevant quality of life loss in glaucoma patients when compared to probands without ophthalmological disorder (based on SF-36 or VF-14). Three investigations considered the putative loss in quality of life due to medical glaucoma treatment, where two of them did not report a clinically relevant association (SF-36). Only one clinical trial (based on VAQ / SIP) on the effect of glaucoma surgery on quality of life could be included in this meta analysis; this study could not show a clinically relevant gain in quality of life after surgery. Two additional reports (both based on questionnaires, which could not be considered validated), however, showed a significant gain in subjective quality of life after glaucoma surgery.
Conclusions
This meta analysis did neither provide evidence for a clinically relevant gain in quality of life after glaucoma surgery, nor for a loss due to medical glaucoma treatment. In summary, the subjective quality of life of glaucoma patients was found reduced when contrasted to that of healthy probands, where a clinically relevant association with visual field loss (progression) could not be confirmed.
