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The Collaborative Initial Glaucoma Treatment Study: interim quality of life findings after initial medical or surgical treatment of glaucoma.

Abstract

OBJECTIVE

To present interim quality of life (QOL) findings in the Collaborative Initial Glaucoma Treatment Study (CIGTS) using all available follow-up through 5 years from treatment initiation.

DESIGN

Randomized controlled clinical trial.

PARTICIPANTS

Six hundred seven newly diagnosed patients with open-angle glaucoma from 14 clinical centers.

INTERVENTION

Patients were randomly assigned to either initial medical therapy or initial trabeculectomy. After treatment initiation and early follow-up, patients received clinical and QOL evaluations at 6-month intervals. QOL assessments were administered by telephone at a centralized interviewing center.

MAIN OUTCOME MEASURES

The CIGTS collected comprehensive QOL information that included both generic and vision-specific QOL measures. This article focuses on initial treatment group differences related to symptom reporting, as measured by a Symptom and Health Problem Checklist, and changes in daily visual functioning, as measured by the Visual Activities Questionnaire (VAQ).

RESULTS

Across both treatment groups, there was an overall decline in the percent of participants reporting symptoms over time. Of 43 possible symptoms, 12 symptoms were reported with greater frequency by the surgically treated group and 7 symptoms more frequently by the medically-treated group. The surgical patients reported more total Symptom Impact Glaucoma (P = 0.005) and, in particular, more bother related to local eye symptoms. Very few treatment group differences were noted in visual functioning, although surgical patients reported more problems with activities related to their visual acuity (P = 0.024). The percentage of patients across treatment groups reporting worry about blindness was 50% at baseline but declined to approximately 25% over time.

CONCLUSIONS

Overall, the QOL impact reported by the two treatment groups as measured by instruments used in this study is remarkably similar, with relatively few significant study group differences observed after up to 5 years of follow-up in the CIGTS. When significant differences in visual function have been detected using the VAQ, they are consistent with the clinical outcomes. To date, the most persistent QOL finding is the increased impact of local eye symptoms reported by the surgical group compared with the medical group. Although no changes are recommended in the treatment of newly diagnosed glaucoma patients at the time of this interim report, further follow-up will allow for more definitive answers to the QOL impact of these two treatment approaches.

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  • Authors+Show Affiliations

    ,

    Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan 48109-2029, USA.

    , , , , , ,

    Source

    Ophthalmology 108:11 2001 Nov pg 1954-65

    MeSH

    Adrenergic beta-Antagonists
    Adult
    Aged
    Female
    Follow-Up Studies
    Glaucoma, Open-Angle
    Humans
    Intraocular Pressure
    Male
    Middle Aged
    Ophthalmic Solutions
    Prospective Studies
    Quality of Life
    Sickness Impact Profile
    Trabeculectomy
    Treatment Outcome
    Visual Acuity
    Visual Fields

    Pub Type(s)

    Clinical Trial
    Comparative Study
    Journal Article
    Multicenter Study
    Randomized Controlled Trial
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    11713062

    Citation

    Janz, N K., et al. "The Collaborative Initial Glaucoma Treatment Study: Interim Quality of Life Findings After Initial Medical or Surgical Treatment of Glaucoma." Ophthalmology, vol. 108, no. 11, 2001, pp. 1954-65.
    Janz NK, Wren PA, Lichter PR, et al. The Collaborative Initial Glaucoma Treatment Study: interim quality of life findings after initial medical or surgical treatment of glaucoma. Ophthalmology. 2001;108(11):1954-65.
    Janz, N. K., Wren, P. A., Lichter, P. R., Musch, D. C., Gillespie, B. W., Guire, K. E., & Mills, R. P. (2001). The Collaborative Initial Glaucoma Treatment Study: interim quality of life findings after initial medical or surgical treatment of glaucoma. Ophthalmology, 108(11), pp. 1954-65.
    Janz NK, et al. The Collaborative Initial Glaucoma Treatment Study: Interim Quality of Life Findings After Initial Medical or Surgical Treatment of Glaucoma. Ophthalmology. 2001;108(11):1954-65. PubMed PMID: 11713062.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - The Collaborative Initial Glaucoma Treatment Study: interim quality of life findings after initial medical or surgical treatment of glaucoma. AU - Janz,N K, AU - Wren,P A, AU - Lichter,P R, AU - Musch,D C, AU - Gillespie,B W, AU - Guire,K E, AU - Mills,R P, AU - ,, PY - 2001/11/20/pubmed PY - 2002/1/5/medline PY - 2001/11/20/entrez SP - 1954 EP - 65 JF - Ophthalmology JO - Ophthalmology VL - 108 IS - 11 N2 - OBJECTIVE: To present interim quality of life (QOL) findings in the Collaborative Initial Glaucoma Treatment Study (CIGTS) using all available follow-up through 5 years from treatment initiation. DESIGN: Randomized controlled clinical trial. PARTICIPANTS: Six hundred seven newly diagnosed patients with open-angle glaucoma from 14 clinical centers. INTERVENTION: Patients were randomly assigned to either initial medical therapy or initial trabeculectomy. After treatment initiation and early follow-up, patients received clinical and QOL evaluations at 6-month intervals. QOL assessments were administered by telephone at a centralized interviewing center. MAIN OUTCOME MEASURES: The CIGTS collected comprehensive QOL information that included both generic and vision-specific QOL measures. This article focuses on initial treatment group differences related to symptom reporting, as measured by a Symptom and Health Problem Checklist, and changes in daily visual functioning, as measured by the Visual Activities Questionnaire (VAQ). RESULTS: Across both treatment groups, there was an overall decline in the percent of participants reporting symptoms over time. Of 43 possible symptoms, 12 symptoms were reported with greater frequency by the surgically treated group and 7 symptoms more frequently by the medically-treated group. The surgical patients reported more total Symptom Impact Glaucoma (P = 0.005) and, in particular, more bother related to local eye symptoms. Very few treatment group differences were noted in visual functioning, although surgical patients reported more problems with activities related to their visual acuity (P = 0.024). The percentage of patients across treatment groups reporting worry about blindness was 50% at baseline but declined to approximately 25% over time. CONCLUSIONS: Overall, the QOL impact reported by the two treatment groups as measured by instruments used in this study is remarkably similar, with relatively few significant study group differences observed after up to 5 years of follow-up in the CIGTS. When significant differences in visual function have been detected using the VAQ, they are consistent with the clinical outcomes. To date, the most persistent QOL finding is the increased impact of local eye symptoms reported by the surgical group compared with the medical group. Although no changes are recommended in the treatment of newly diagnosed glaucoma patients at the time of this interim report, further follow-up will allow for more definitive answers to the QOL impact of these two treatment approaches. SN - 0161-6420 UR - https://www.unboundmedicine.com/medline/citation/11713062/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(01)00874-0 DB - PRIME DP - Unbound Medicine ER -