Academic Journal
Longitudinal Visual Field and Quality-of-Life Change in the Treatment for Advanced Glaucoma Study.
| Τίτλος: | Longitudinal Visual Field and Quality-of-Life Change in the Treatment for Advanced Glaucoma Study. |
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| Συγγραφείς: | Montesano G; NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom; Optometry and Visual Sciences, City St George's, University of London, London, United Kingdom. Electronic address: g.montesano@ucl.ac.uk., Ometto G; NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom; Optometry and Visual Sciences, City St George's, University of London, London, United Kingdom., Cheloni R; NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom; Optometry and Visual Sciences, City St George's, University of London, London, United Kingdom; School of Pharmacy, Optometry & Medical Sciences, University of Bradford, Bradford, United Kingdom., Garway-Heath DF; NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom., Higgins BE; Optometry and Visual Sciences, City St George's, University of London, London, United Kingdom., Crabb DP; Optometry and Visual Sciences, City St George's, University of London, London, United Kingdom., King AJ; Nottingham University Hospital, Nottingham, United Kingdom. |
| Συλλογικό Έργο: | Treatment of Advanced Glaucoma Study (TAGS) Group |
| Πηγή: | Ophthalmology [Ophthalmology] 2026 Aug; Vol. 133 (8), pp. 996-1005. Date of Electronic Publication: 2026 Apr 24. |
| Τύπος έκδοσης: | Journal Article; Multicenter Study; Randomized Controlled Trial; Comparative Study |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Elsevier Country of Publication: United States NLM ID: 7802443 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1549-4713 (Electronic) Linking ISSN: 01616420 NLM ISO Abbreviation: Ophthalmology Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2000- : New York : Elsevier Original Publication: Rochester, Minn., American Academy of Ophthalmology. |
| Ιατρικοί όροι (MeSH): | Quality of Life*/psychology , Visual Fields*/physiology , Glaucoma, Open-Angle*/physiopathology , Glaucoma, Open-Angle*/therapy , Glaucoma, Open-Angle*/psychology , Glaucoma, Open-Angle*/surgery , Antihypertensive Agents*/therapeutic use , Vision Disorders*/physiopathology , Vision Disorders*/psychology , Trabeculectomy*, Intraocular Pressure/physiology ; Visual Acuity/physiology ; Humans ; Female ; Aged ; Male ; Surveys and Questionnaires ; Middle Aged ; Sickness Impact Profile ; Visual Field Tests |
| Περίληψη: | Purpose: Progressive visual field (VF) loss resulting from glaucoma affects quality of life (QoL). Although treatments aim to preserve vision, the extent to which slowing VF loss translates into QoL changes in advanced disease is not understood fully. We compare the 5-year rate of VF and QoL change and examined their correlation in the Treatment for Advanced Glaucoma Study. Design: Multicenter randomized clinical trial (27 secondary care glaucoma departments in the UK). Participants: Adults (n = 453) with newly diagnosed advanced open-angle glaucoma in at least 1 eye were randomized to trabeculectomy (n = 227) or medical management (n = 226) as initial treatment. One eligible index eye was identified per participant. Main Outcome Measures: Mean difference in rate of change in monocular index eye VF (24-2 SITA Standard), binocular integrated (BI) VF, and the 25-item Visual Function Questionnaire (VFQ-25) composite score over 5 years (intention to treat) using a Bayesian longitudinal hierarchical model. Results: Data from 442 patients with reliable VF (false-positive rate ≤15%) or VFQ-25 data from >2 time points were included (221 patients in the trabeculectomy-first arm). Baseline characteristics were similar between arms. The rate of index eye VF loss was faster in the medications-first arm (-0.75 [95% credible interval (CrI), -0.90 to -0.59] dB/year) compared with the trabeculectomy-first arm (-0.37 [95% CrI, -0.53 to -0.22] dB/year; P = 0.002). Differences between groups were not statistically significant for BI VF decline (P = 0.062) or VFQ-25 change (P = 0.392). Correlations between VF and QoL were stronger for BI VF for baseline (0.41 [95% CrI, 0.32-0.49]; P < 0.001) and rate of change (0.56 [95% CrI, 0.41-0.70]; P < 0.001) than for index eye VF (0.22 [95% CrI, 0.12-0.32]; P < 0.001 and 0.43 [95% CrI, 0.26-0.58]; P < 0.001, respectively). Conclusions: Trabeculectomy more effectively reduced the rate of VF loss compared with medical treatment in advanced glaucoma. Despite a moderately strong correlation with the BI VF, no difference was found in the measured QoL, suggesting that the VFQ-25 might not be reactive or sensitive enough to monocular glaucoma interventions. Financial Disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article. (Copyright © 2026 American Academy of Ophthalmology, Inc. Published by Elsevier Inc. All rights reserved.) |
| Contributed Indexing: | Investigator: A King; P Agrawal; DC Broadway; N Strouthidis; S Chew; C Sng; M Toth; G Gazzard; A Elkarmouty; E Nikita; G Triolo; S Aguilar-Munoa; S Goyal; S Lim; V Sung; I Masood; N Wride; A Sandhu; E Hill; J Sparrow; F Grey; R Bourne; G Nithyanandarajah; C Willshire; P Bloom; F Ahmed; F Cordeiro; L Crawley; E Normando; S Ameen; J Tryfinopoulou; A Porteous; G Jutley; D Bessinis; J Kirwan; S Begum; A Sepetis; E Rule; R Thornton; A McNaught; N Anand; A Negi; O Kousha; M Hovan; R Sanders; PK Agarwal; A Tatham; L Au; E Nikita; C Fenerty; T Karaconji; B Drury; D Penmol; E Ansari; A Dardzhikova; R Moosavi; R Imonikhe; P Kontovourikis; L Membrey; G Almeida; J Tildsley; A Azuara-Blanco; A Knox; S Rankin; S Wilson; A Prabhu; S Mukherji; A Datta; A Fern; J Liput; T Manners; J Pilling; C Stemp; K Martin; T Nixon; C Cobb; A Rotchford; S Sidiki; A Bansal; O Kousha; G Auger; M Freeman Keywords: Glaucoma; Quality of life; Trabeculectomy; VFQ-25; Visual field |
| Substance Nomenclature: | 0 (Antihypertensive Agents) |
| Entry Date(s): | Date Created: 20260426 Date Completed: 20260720 Latest Revision: 20260821 |
| Update Code: | 20260822 |
| DOI: | 10.1016/j.ophtha.2026.04.020 |
| PMID: | 42036075 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1549-4713 |
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| DOI: | 10.1016/j.ophtha.2026.04.020 |