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Ferrand N, Trauzettel-Klosinski S, Blumenstock G, Voykov B, Kuester-Gruber S. Benefits of Explorative Saccade Training in Patients with Advanced Glaucomatous Visual Field Defects-A Randomized, Placebo-Controlled Study. J Clin Med 2025; 14:2876. [PMID: 40363909 PMCID: PMC12073057 DOI: 10.3390/jcm14092876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2025] [Revised: 04/06/2025] [Accepted: 04/15/2025] [Indexed: 05/15/2025] Open
Abstract
Purpose: Patients with advanced glaucoma have visual field defects that impair mobility and quality of life (QoL). We aim to determine the effects of exploratory saccade training (EST) in such patients with bilateral overlapping scotomas that affect at least one visual field quadrant. Patients and Methods: This study was approved by the Ethics Committee of the Medical Faculty of the University of Tuebingen, Germany, and was registered in the German Clinical Trials Register (DRKS DRKS00031082, date of approval: 2 February 2023). We randomly assigned 27 patients to two groups, one of which trained with a computer-based EST (group 1). A control group (group 2) first used reading training (rapid serial visual presentation, RSVP, a single-word presentation to minimize eye movements) as placebo training (PRT) in regard to EST, which trains eye movements and, in a later phase, also used EST. Each training method required 6 weeks of home training. Main outcome variables were reaction time (RT) during the EST training sessions, RT during a natural search task (table test), reading speed (RS) during training on the screen, and during reading printed paragraphs aloud. QoL was assessed by a questionnaire. Results: Reaction times during EST and the table test improved significantly, which indicated transfer of the training effect to daily life. RS and QoL were reduced at baseline. Reading training improved RS significantly and reached normal median values. QoL improved significantly in the sub-categories regarding mobility problems in group 1. Patients with inferior field defects were more impaired and improved more than those without inferior field defects. Conclusions: As a supplement to the necessary treatment for glaucoma, EST is an effective home training method for rehabilitation by improving reaction time in daily living tasks for patients with advanced glaucoma. Reading training improved RS while reading from a screen as well as reading printed text.
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Affiliation(s)
- Nawfel Ferrand
- Centre for Ophthalmology, University of Tuebingen, 72076 Tuebingen, Germany;
- Vision Rehabilitation Research Unit, Centre for Ophthalmology, University of Tuebingen, 72076 Tuebingen, Germany; (S.T.-K.); (S.K.-G.)
| | - Susanne Trauzettel-Klosinski
- Vision Rehabilitation Research Unit, Centre for Ophthalmology, University of Tuebingen, 72076 Tuebingen, Germany; (S.T.-K.); (S.K.-G.)
| | - Gunnar Blumenstock
- Department of Clinical Epidemiology and Applied Biometry, University of Tuebingen, 72076 Tuebingen, Germany;
| | - Bogomil Voykov
- Centre for Ophthalmology, University of Tuebingen, 72076 Tuebingen, Germany;
| | - Stephan Kuester-Gruber
- Vision Rehabilitation Research Unit, Centre for Ophthalmology, University of Tuebingen, 72076 Tuebingen, Germany; (S.T.-K.); (S.K.-G.)
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Sen S, Mishra A, Das M, Iyer V, Sethi M. Assessment of quality of life in glaucoma patients in a tertiary care center in Eastern India. Indian J Ophthalmol 2023; 71:2767-2772. [PMID: 37417118 PMCID: PMC10491073 DOI: 10.4103/ijo.ijo_3050_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 04/11/2023] [Accepted: 05/26/2023] [Indexed: 07/08/2023] Open
Abstract
Purpose The aim of this study is to assess the quality of life (QOL) in glaucoma patients and find out the sociodemographic factors predicting QOL. Methods A cross-sectional study was conducted in a tertiary care center from August 2021 to February 2022. Subjects diagnosed with glaucoma for at least 6 months were enrolled. After taking informed consent, demographic details and detailed history were collected for all patients. Comprehensive eye examination (visual acuity, intraocular pressure, gonioscopy, fundoscopy, visual field assessment, ocular coherence tomogram assessment) was done for all and they were asked to fill the WHOQOL-BREF questionnaire. Data were collected and analyzed using SPSS 21. Results One hundred and ninety-nine patients were recruited. Mean age of participants was 57.99 ± 10.76 years. Based on various domains and subgroups, QOL values were significant with respect to income (P = 0.016). Gender-wise QOL in females was lower than that of males with respect to all the domains (P = 0.001). While marital status affected both environmental and social domain, literacy affected only the social domain. A variation in intraocular pressure affected the QOL in the psychological domain. QOL was not significantly associated with the severity of the disease. Gender was the most predominant predictor out of all sociodemographic factors. Conclusion Chronic diseases affect the QOL of individuals in many ways. Glaucoma being a chronic disease hampers patients' vision irreversibly and by extension the various physical, social, and psychological aspects of the patient's life as well. Hence, knowledge of the change in QOL it brings about can help plan the treatment, counseling, and management of these patients.
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Affiliation(s)
- Saswati Sen
- Department of Ophthalmology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Alpana Mishra
- Department of Community Medicine, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Matuli Das
- Department of Ophthalmology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Vanaja Iyer
- Department of Ophthalmology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Mehak Sethi
- Department of Ophthalmology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Mamtani NH, Mamtani HG, Chaturvedi SK. Psychiatric aspects of ophthalmic disorders: A narrative review. Indian J Ophthalmol 2023; 71:1810-1815. [PMID: 37203034 PMCID: PMC10391518 DOI: 10.4103/ijo.ijo_2101_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Abstract
Ophthalmic disorders have psychiatric aspects associated with them at various levels. Psychological factors have a well-documented role in the causation, aggravation, and maintenance of various ophthalmic conditions, including glaucoma, central serous retinopathy, dry eye disease, and retinitis pigmentosa. Many ophthalmic conditions, including blindness, have psychological manifestations as well, which need to be addressed, in addition to the ophthalmic pathology. There is also significant overlap in the treatment of the two disciplines in many ways. For instance, many ophthalmic drugs have psychiatric side effects. Even ophthalmological surgeries have psychiatric aspects associated with them, which primarily include black patch psychosis and anxiety in the operation theater. This review will be useful for psychiatrists and ophthalmologists, for their clinical practice and research. Future research should focus on this interface to give it its well-deserved attention.
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Affiliation(s)
- Nidhi H Mamtani
- Department of Glaucoma, Vision Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Harkishan Gurmukh Mamtani
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Santosh K Chaturvedi
- Department of Psychiatry, Leicestershire Partnership, NHS Trust, Leicester, United Kingdom
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Kumar M, Parveen S, Chauhan L. Quality of life in patients with glaucoma using the Glaucoma Quality of Life-15 Questionnaire. JOURNAL OF CLINICAL OPHTHALMOLOGY AND RESEARCH 2023. [DOI: 10.4103/jcor.jcor_88_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
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Kapinga IK, Kayembe DL, Mwanza JC. Vision-related Quality of Life in Congolese Patients with Glaucoma. J Curr Glaucoma Pract 2022; 16:24-30. [PMID: 36060036 PMCID: PMC9385387 DOI: 10.5005/jp-journals-10078-1360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose Methods Results Conclusion How to cite this article
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Affiliation(s)
- Isis K Kapinga
- Department of Ophthalmology, University of Kinshasa, Kinshasa, The Democratic Republic of the Congo
| | - David L Kayembe
- Department of Ophthalmology, University of Kinshasa, Kinshasa, The Democratic Republic of the Congo
| | - Jean-Claude Mwanza
- Department of Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
- Jean-Claude Mwanza, Department of Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States, Phone: +1 9198434917, e-mail:
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Nayyar S, Kumar S, Rehman O, Ichhpujani P, Singla E. Impact of moderate and severe primary open-angle glaucoma on quality of life due to activity limitation. Indian J Ophthalmol 2022; 70:552-557. [PMID: 35086236 PMCID: PMC9023973 DOI: 10.4103/ijo.ijo_1687_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Purpose: To study the impact of moderate and severe primary open-angle glaucoma (POAG) on the quality of life (QoL) due to activity limitation using glaucoma-specific questionnaires. Methods: This cross-sectional study enrolled 122 participants, 50% (n = 61) being controls and 50% were diagnosed cases of moderate/severe POAG. Three orally administered glaucoma-specific QoL instruments were used: Glaucoma Activity Limitation (GAL-9), Glaucoma Quality of Life (GQL-15), and Viswanathan questionnaires. The questions related to activity limitation were identified and analyzed for each questionnaire separately. Results: The mean age of the participants was 61.04 ± 9.88 years and a majority were males (64.8%, n = 79). The mean scores in controls, moderate glaucoma, and severe POAG patients for GAL-9 questionnaire were 9.77 ± 1.36 (P = 0.44), 13.75 ± 4.76 (P < 0.001), and 23.45 ± 5.62 (P < 0.001), for GQL-15, these were 16.39 ± 2.18 (P = 0.5), 22.75 ± 7.89 (P < 0.001), and 39.34 ± 9.42 (P < 0.001), respectively, while for the Viswanathan questionnaire, they were 9.49 ± 0.94 (P = 0.38), 7.91 ± 1.59 (P < 0.001), and 4.41 ± 2.20 (P < 0.001), respectively. The GQL-15 and GAL-9 questionnaires concluded that activity limitation pertaining to dark adaptation-related tasks affected the QoL the most in moderate as well as severe POAG (P < 0.001). Using the Viswanathan questionnaire, it was observed that the peripheral vision-related activity limitation was most significant for the decrease in QoL in moderate POAG while near vision-related activity limitation affected the QoL the most in severe POAG (P < 0.001). Conclusion: All three questionnaires concluded that the activity limitation due to moderate and severe glaucoma has a negative impact on the QoL. The limitation of the tasks involving dark adaptation/glare and peripheral vision has the most significant impact on the QoL in moderate glaucoma. As the disease progresses to a severe category, the limitation of activities requiring central and near vision causes the most significant worsening in QoL.
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Affiliation(s)
- Shifali Nayyar
- Department of Ophthalmology, Government Medical College and Hospital, Chandigarh, India
| | - Suresh Kumar
- Department of Ophthalmology, Government Medical College and Hospital, Chandigarh, India
| | - Obaidur Rehman
- Department of Ophthalmology, Government Medical College and Hospital, Chandigarh, India
| | - Parul Ichhpujani
- Department of Ophthalmology, Government Medical College and Hospital, Chandigarh, India
| | - Ekta Singla
- Department of Ophthalmology, Government Medical College and Hospital, Chandigarh, India
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Ajith BS, Najeeb N, John A, Anima VN. Cross sectional study of depression, anxiety and quality of life in glaucoma patients at a tertiary centre in North Kerala. Indian J Ophthalmol 2022; 70:546-551. [PMID: 35086235 PMCID: PMC9023908 DOI: 10.4103/ijo.ijo_1389_21] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 08/21/2021] [Accepted: 09/21/2021] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To determine the magnitude and direction of association of anxiety and depression and the quality of life (QoL) in persons with glaucoma. METHODS This prospective cross-sectional study in conducted in a tertiary eye center in north Kerala included glaucoma patients and normal subjects aged 40-80 years. The Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7), Glaucoma Quality of Life (GQOL), and glaucoma evaluation were performed for all participants. One-way analysis of variance was used for statistical analysis. RESULTS The study included 148 subjects with glaucoma and 150 subjects without glaucoma. The prevalence of depression (35.81%) and anxiety (25.0%) was significantly higher in glaucoma patients. In a multivariate regression model, PHQ-9 (adjusted OR: 2.39, 95% CI: 1.31-4.38, P < 0.001), GAD-7 (adjusted OR: 2.06, 95% CI: 1.01-4.19, P = 0.01) and GQOL (coefficient: 6.92, 95% CI: 4.52-9.31, P = < 0.001) was significantly associated with glaucoma. The GAD-7 score was significantly higher (P = 0.02) in PACG compared to POAG in moderate and severe anxiety. ADL scores (one-way ANOVA, P = 0.001) and GQOL scores (one-way ANOVA, P < 0.001) were significantly associated with vision impairment and blindness. CONCLUSION Depression and anxiety are common in glaucoma patients, indicating the need for screening protocols using PHQ and GAD scales to identify persons at risk. The lack of ophthalmic risk factors associated with depression and anxiety emphasizes the importance of psychological evaluation and combined management with a psychiatrist in glaucoma management.
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Affiliation(s)
- Bindu S Ajith
- Department of Glaucoma, Comtrust Eye Hospital, Kozhikode, Kerala, India
| | - Nimitha Najeeb
- Department of Glaucoma, Comtrust Eye Hospital, Kozhikode, Kerala, India
| | - Arino John
- Department of Glaucoma, Comtrust Eye Hospital, Kozhikode, Kerala, India
| | - V N Anima
- Department of Glaucoma, Comtrust Eye Hospital, Kozhikode, Kerala, India
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