Impact of primary glaucoma on health-related quality of life in China: the handan eye study

Di Song; Sujie Fan; Qiang Zhou; Xiaohui Yang; Sizhen Li; Lynne Lohfeld; Weihe Zhou; Nathan Congdon; Yuanbo Liang; Ningli Wang

doi:10.1186/s12886-023-03106-w

Impact of primary glaucoma on health-related quality of life in China: the handan eye study

BMC Ophthalmol. 2023 Sep 14;23(1):377. doi: 10.1186/s12886-023-03106-w.

Authors

Di Song^{1

2}, Sujie Fan³, Qiang Zhou⁴, Xiaohui Yang⁵, Sizhen Li^{5

6}, Lynne Lohfeld⁷, Weihe Zhou^{1

8}, Nathan Congdon^{7

9}, Yuanbo Liang^{10

11}, Ningli Wang⁵

Affiliations

¹ National Clinical Research Center for Eye Diseases, The Eye Hospital, School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, China.
² The First People's Hospital of Huzhou, The First Affiliated Hospital of Huzhou Teacher College, Huzhou, Zhejiang, China.
³ Handan Eye Hospital, Handan, Hebei, China.
⁴ Beijing Chaoyang Hospital, Beijing, China.
⁵ Beijing Tongren Hospital, Capital Medical University, Beijing, China.
⁶ Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.
⁷ Centre for Public Health, Queen's University, Belfast, UK.
⁸ Glaucoma Institute, Wenzhou Medical University, Wenzhou, Zhejiang, China.
⁹ Orbis International, New York, NY, USA.
¹⁰ National Clinical Research Center for Eye Diseases, The Eye Hospital, School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, China. yuanboliang@wmu.edu.cn.
¹¹ Glaucoma Institute, Wenzhou Medical University, Wenzhou, Zhejiang, China. yuanboliang@wmu.edu.cn.

Abstract

Background: We assessed health-related quality of life (HRQOL) and its determinants among rural glaucoma participants compared to age-matched normal controls in the population-based Handan Eye Study (HES), in rural Yongnian County, northern China.

Methods: We enrolled 99 adults with glaucoma (mean age 63.0 ± 11.0 years), including primary open-angle glaucoma (POAG, n = 67) and primary angle-closure glaucoma (PACG, n = 32) and 102 controls (mean age 58.5 ± 5.3 years) with normal visual acuity and visual field and no history of glaucoma. Results of ophthalmic examinations and socioeconomic data were recorded. HRQOL was measured using the EQ-5D (converted to utility valves, UVs), and visual function (VF) and vision-related quality of life (VRQOL) were evaluated using the visual function-quality of life (VF-QOL) instrument.

Primary and secondary outcome measures: EQ-5D and VF-QOL scores.

Results: The mean UVs, VF, and VRQOL scores for glaucoma cases were 0.98 ± 0.04, 87.9 ± 15.2, and 95.5 ± 12.8, respectively, significantly worse than VF (94.4 ± 4.4) and VRQOL (100.0 ± 0.0) among controls, even after adjusting for age, gender, educational level, and family income (P = 0.015, P = 0.033). UVs were significantly lower among glaucoma participants with impaired VRQOL (55.4 ± 11.5) compared to those with normal VRQOL scores (99.1 ± 2.8) (UVs: 0.92 ± 0.08 vs. 0.99 ± 0.03, P = 0.036), also after adjustment for age and family income (P = 0.006). Participants with PACG had significantly lower VF and VRQOL scores compared to POAG (77.8 ± 21.4 vs. 92.9 ± 6.8, P < 0.001; 89.0 ± 18.1 vs. 98.7 ± 7.5, P < 0.001).

Conclusion: Participants with glaucoma have worse visual function and related quality of life compared to age-matched normal population controls. Participants with PACG have lower VF and VRQOL compared to those with POAG. UVs can be used for cost-effectiveness research and to support public health strategies for glaucoma in rural China.

Keywords: EQ-5D; Glaucoma; Health-Related Quality of Life; Visual function quality of life.

MeSH terms

Adult
Aged
China / epidemiology
Glaucoma*
Glaucoma, Open-Angle*
Humans
Middle Aged
Quality of Life
Vision, Low*
Visual Fields

Abstract

MeSH terms

Grants and funding