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Citation
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Baig S, Diniz-Filho A, Wu Z, Abe RY, Gracitelli CP, Cabezas E, Medeiros FA. JAMA Ophthalmol. 2016; 134(8): 880-886. |
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Affiliation
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Visual Performance Laboratory, Department of Ophthalmology, University of California, San Diego, La Jolla. |
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Abstract
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IMPORTANCE: Patients with glaucoma and a history of fast visual field loss might be at an increased risk for falls compared with those with a history of slow visual field loss, but, to date, this association has not been previously investigated in the literature.
OBJECTIVE: To evaluate the association between self-reported falls and past rate of visual field loss in a cohort of patients with glaucoma followed up over time. DESIGN, SETTING, AND PARTICIPANTS: This observational cohort study included patients diagnosed as having glaucoma who had been followed up at the Visual Performance Laboratory, University of California, San Diego, at 6-month intervals for a mean (SD) of 7.5 DESIGN, SETTING, AND PARTICIPANTS: (2.6) years from January 1, 2005, through December 31, 2015. Self-reported number of falls during the past year was obtained at the last follow-up visit. Integrated binocular fields were estimated from the monocular fields. Linear mixed models were used to calculate rates of change in binocular m DESIGN, SETTING, AND PARTICIPANTS: ean sensitivity over time. Poisson models were used to evaluate the association between the self-reported number of falls and rates of visual field loss. The models adjusted for the current level of visual field damage and other confounding variables. MAIN OUTCOMES AND MEASURES: Association between rates of binocular visual field loss and self-reported number of falls.
RESULTS: The study included 116 patients with glaucoma with a mean (SD) age of 73.1 RESULTS: (10.7) years (55 women [47.4%], 84 white individuals [72.4%], and 32 black individuals [27.6%]). Of the 116 patients, 29 (25.0%) reported at least 1 fall in the previous year. The mean rate of change in binocular mean sensitivity was faster for patients who reported a history of falls vs those wh RESULTS: o did not (-0.36 vs -0.17 dB/y; mean difference, 0.20 dB/y; 95% CI, 0.09-0.31 dB/y; P RESULTS: < RESULTS: .001). History of fast visual field loss was significantly associated with falls (rate ratio, 2.28 per 0.5 dB/y faster; 95% CI, 1.15-4.52 db/y; P = .02), even after adjusting for confounding factors.
CONCLUSIONS AND RELEVANCE: The rate of visual field loss was associated with a self-reported history of falls in the past year even after taking into account the magnitude of visual field defect. However, although a positive association was found, further studies are necessary to establish whether a cause-and-effect relationship exists between rate of visual field loss and self-reported history of falls.
Language: en |