Visual Field Staging Systems in Glaucoma and the Activities of Daily Living

Abstract

To compare 8 clinically relevant methods of staging visual field (VF) damage in glaucoma with a performance-based measure of the activities of daily living and self-reported quality of life. Prospective cross-sectional study. One hundred ninety-two patients with various types of glaucoma were evaluated at the Wills Eye Institute using standard monocular and binocular VF testing, as well as an objective, performance-based measure of visual function (the Assessment of Disability Related to Vision), and a subjective, standardized measure of quality of life (the 25-item National Eye Institute Visual Function Questionnaire). Binocular VFs were scored according to the Esterman and Integrated VF Systems. Monocular VFs were scored according to the mean defect, pattern standard deviation, Hodapp-Parrish-Anderson method, glaucoma staging system, glaucoma staging system 2, and the field damage likelihood scale. Partial Spearman correlations between VF staging systems, Assessment of Disability Related to Vision scores, and 25-item National Eye Institute Visual Function Questionnaire scores were calculated. Assessment of Disability Related to Vision scores and 25-item National Eye Institute Visual Function Questionnaire scores were associated most closely with the VF score in the better eye and the binocular VF scoring systems. The amount of binocular VF loss and the status of the better eye most accurately predict functional ability and quality of life in glaucoma.