Evaluating Health Outcomes for Iraqi Patients with Glaucoma
Keywords:
Glaucoma, Quality of life, Complications, Diabetes Mellitus and Hypertension, Visual Field Defect (VFD)Abstract
This study evaluates the clinical outcomes of Iraqi patients with glaucoma, a leading cause of irreversible blindness globally. Despite its prevalence, knowledge gaps persist regarding its management and impact on patients' quality of life. We conducted a cross-sectional analysis involving 87 glaucoma patients aged 30-60 from various Iraqi hospitals between February 2023 and April 2024. Comprehensive examinations, including visual acuity and intraocular pressure tests, and the Glaucoma Quality of Life Questionnaire-15 (GQL-15) were employed to assess patients' vision and quality of life. Findings indicated significant visual impairment and quality of life reduction, particularly among older patients, highlighting the need for improved educational and therapeutic strategies to manage glaucoma effectively and enhance patients' life quality. The implications underscore the critical role of sustained visual function in maintaining independence and well-being in glaucoma patients.
References
F. A. Medeiros, C. P. Gracitelli, E. R. Boer, R. N. Weinreb, L. M. Zangwill, and P. N. Rosen, "Longitudinal Changes in Quality of Life and Rates of Progressive Visual Field Loss in Glaucoma Patients," Ophthalmology, vol. 122, pp. 293–301, 2015.
R. Varma, P. P. Lee, I. Goldberg, and S. Kotak, "An Assessment of the Health and Economic Burdens of Glaucoma," Am. J. Ophthalmol., vol. 152, pp. 515–522, 2011.
J. P. Nordmann, N. Auzanneau, S. Ricard, and G. Berdeaux, "Vision-Related Quality of Life and Topical Glaucoma Treatment Side Effects," Health Qual. Life Outcomes, vol. 1, p. 75, 2003.
P. Ramulu, "Glaucoma and Disability: Which Tasks Are Affected, and at What Stage of Disease?" Curr. Opin. Ophthalmol., vol. 20, pp. 92–98, 2009.
K. A. Turano, A. T. Broman, K. Bandeen-Roche, B. Munoz, G. S. Rubin, and S. West, "Association of Visual Field Loss and Mobility Performance in Older Adults: Salisbury Eye Evaluation Study," Optom. Vis. Sci., vol. 81, pp. 298–307, 2004.
S. W. van Landingham, C. Hochberg, R. W. Massof, E. Chan, D. S. Friedman, and P. Y. Ramulu, "Driving Patterns in Older Adults with Glaucoma," BMC Ophthalmol., vol. 13, p. 4, 2013.
S. A. Haymes, R. P. Leblanc, M. T. Nicolela, L. A. Chiasson, and B. C. Chauhan, "Risk of Falls and Motor Vehicle Collisions in Glaucoma," Invest. Ophthalmol. Vis. Sci., vol. 48, pp. 1149–1155, 2007.
S. E. Skalicky et al., "Activity Limitation in Glaucoma: Objective Assessment by the Cambridge Glaucoma Visual Function Test," Invest. Ophthalmol. Vis. Sci., vol. 57, pp. 6158–6166, 2016.
H. A. Quigley and A. T. Broman, "The Number of People with Glaucoma Worldwide in 2010 and 2020," Br. J. Ophthalmol., vol. 90, pp. 262–267, 2006.
G. Gazzard et al., "Selective Laser Trabeculoplasty Versus Eye Drops for First-Line Treatment of Ocular Hypertension and Glaucoma (LiGHT): A Multicentre Randomised Controlled Trial," Lancet (Lond, Engl), vol. 393, pp. 1505–1516, 2019.
A. J. King et al., "Primary Trabeculectomy for Advanced Glaucoma: Pragmatic Multicentre Randomised Controlled Trial (TAGS)," BMJ, vol. 373, p. n1014, 2021.
A. Rabiolo, K. Barton, and A. I. McNaught, "Patient-Reported Outcome Measures Should Not Be the Primary Outcome in Glaucoma Clinical Trials of Disease Modification," Br. J. Ophthalmol., vol. 107, pp. 3–5, 2023.
L. Jones, D. F. Garway-Heath, A. Azuara-Blanco, and D. P. Crabb, "Are Patient Self-Reported Outcome Measures Sensitive Enough to Be Used as Endpoints in Clinical Trials? Evidence from the United Kingdom Glaucoma Treatment Study," Ophthalmology, vol. 126, pp. 682–689, 2019.
EuroQol Group, "EuroQol-A New Facility for the Measurement of Health-Related Quality of Life," Health Policy, vol. 16, pp. 199–208, 1990.
C. M. Mangione et al., "Development of the 25-Item National Eye Institute Visual Function Questionnaire," Arch. Ophthalmol. (Chic, Ill: 1960), vol. 119, pp. 1050–1058, 2001.
B. B. Kulkarni, P. Leighton, and A. J. King, "Exploring Patients’ Expectations and Preferences of Glaucoma Surgery Outcomes to Facilitate Healthcare Delivery and Inform Future Glaucoma Research," Br. J. Oph-thalmol., vol. 103, pp. 1850–1855, 2019.
J. T. Le, K. Mohanty, A. K. Bicket, M. E. Tarver, M. B. Eydelman, and T. Li, "Identifying Outcomes That Are Important to Patients with Ocular Hypertension or Primary Open-Angle Glaucoma: A Qualitative Inter-view Study," Ophthalmol. Glaucoma, vol. 2, pp. 374–382, 2019.
A. K. Bicket, J. T. Le, C. Yorkgitis, and T. Li, "Priorities and Treatment Preferences Among Surgery-Naive Patients with Moderate to Severe Open-Angle Glaucoma," Ophthalmol. Glaucoma, vol. 3, pp. 377–383, 2020.
B. C. Stagg, A. Granger, T. C. Guetterman, R. Hess, and P. P. Lee, "The Burden of Caring for and Treating Glaucoma: The Patient Perspective," Ophthalmol. Glaucoma, vol. 5, pp. 32–39, 2022.
A. Tong, P. Sainsbury, and J. Craig, "Consolidated Criteria for Reporting Qualitative Research (COREQ): A 32-Item Checklist for Interviews and Focus Groups," Int. J. Qual. Health Care, vol. 19, pp. 349–357, 2007.
C. Hirneiss, "The Impact of a Better-Seeing Eye and a Worse-Seeing Eye on Vision-Related Quality of Life," Clin. Ophthalmol., vol. 8, pp. 1703–1709, 2014.
E. A. Hodapp, R. K. Parrish, and D. R. Anderson, Clinical Decisions in Glaucoma. St Louis, USA: Mosby, 1993.
R. Asaoka, D. P. Crabb, T. Yamashita, R. A. Russell, Y. X. Wang, and D. F. Garway-Heath, "Patients Have Two Eyes! Binocular Versus Better Eye Visual Field Indices," Invest. Ophthalmol. Vis. Sci., vol. 52, pp. 7007–7011, 2011.
N. Mays and C. Pope, Qualitative Research in Health Care, 4th ed. Wiley-Blackwell, 2020, pp. 211–233.
European Glaucoma Society, Terminology and Guidelines for Glaucoma, 5th ed., 2020. [Online]. Available: https://www.eugs.org/eng/guidelines.asp
M. Dempster, N. K. McCorry, M. Donnelly, K. Barton, and A. Azuara-Blanco, "Individualisation of Glau-coma Quality of Life Measures: A Way Forward?" Br. J. Ophthalmol., vol. 103, pp. 293–295, 2019.
J. T. Le et al., "Prioritizing Outcome Preferences in Patients with Ocular Hypertension and Open-Angle Glaucoma Using Best-Worst Scaling," Ophthalmol. Glaucoma, vol. 2, pp. 367–373, 2019.
T. Li et al., "Patient-Reported Outcomes Measures and Patient Preferences for Minimally Invasive Glaucoma Surgical Devices," Eye (Lond), vol. 34, pp. 205–210, 2020.
M. Okamoto et al., "Impact of Better and Worse Eye Damage on Quality of Life in Advanced Glaucoma," Sci. Rep., vol. 4, p. 4144, 2014.
S. Nickels et al., "Vision-Related Quality of Life Considering Both Eyes: Results from the German Popula-tion-Based Gutenberg Health Study (GHS)," Health Qual. Life Outcomes, vol. 17, p. 98, 2019.
I. T. Coyne, "Sampling in Qualitative Research. Purposeful and Theoretical Sampling; Merging or Clear Boundaries?" J. Adv. Nurs., vol. 26, pp. 623–630, 1997.
L. Quaranta, I. Riva, C. Gerardi, F. Oddone, I. Floriani, and A. G. Konstas, "Quality of Life in Glaucoma: A Review of the Literature," Adv. Ther., vol. 33, pp. 959–981, 2016.
J. Lacey, H. Cate, and D. Broadway, "Barriers to Adherence with Glaucoma Medications: A Qualitative Re-search Study," Eye (Lond), vol. 23, pp. 924–932, 2009.
L. Jones, D. J. Taylor, F. Sii, I. Masood, D. P. Crabb, and P. Shah, "Only Eye Study 2 (OnES 2): ‘Am I Going to Be Able to See When the Patch Comes Off?’ A Qualitative Study of Patient Experiences of Undergoing High-Stakes Only Eye Surgery," BMJ Open, vol. 10, p. e038916, 2020.
L. Bonomi et al., "Vascular Risk Factors for Primary Open-Angle Glaucoma: The Egna–Neumarkt Study," Ophthalmology, vol. 107, no. 7, pp. 1287–1293, 2000.
N. Orzalesi, L. Rossetti, and S. Omboni, "Vascular Risk Factors in Glaucoma: The Results of a National Survey," Graefes Arch. Clin. Exp. Ophthalmol., vol. 245, no. 6, pp. 795–802, 2007. doi: https://doi.org/10.1007/s00417-006-0457-5
R. Varma et al., "Four-Year Incidence of Open-Angle Glaucoma and Ocular Hypertension: The Los Angeles Latino Eye Study," Am. J. Ophthalmol., vol. 154, no. 2, pp. 315–325.e1, 2012. doi: https://doi.org/10.1016/j.ajo.2012.02.014
A. Khatri, J. K. Shrestha, M. Thapa, B. K. Khatri, and M. Kharel, "Severity of Primary Open-Angle Glaucoma in Patients with Hypertension and Diabetes," Diabetes Metab. Syndr. Obes., vol. 11, pp. 209–215, 2018.
P. Garg, L. Singh, R. Malhotra, and M. Lisa, "A Study on Systemic Risk Factors for Primary Open-Angle Glaucoma," Int. J. Life Sci. Pharma Rev., vol. 4, no. 2, ISSN 2250-0480, 2014.
