Impatto del glaucoma sulle attività quotidiane in correlazione con i deficit cognitivi

Introduction: Glaucoma leads to accelerated apoptosis of RGC (Retinal Glanglion Cells) and consequently to progressive constriction of the visual field and eventually to vision loss in the terminal stages. The 52.6% of patients with glaucoma are suffering of ocular discomfort. In contrast, among individuals with Dry Eye disease, glaucoma was identified in 21.2, compared to 7.4% of those without Dry Eye. The 40 %Patients with Dry Eye have also depression while DED patients are 1.81 times more likely to have depression. On the other hand, prevalence of depressive symptoms was observed in 10-20 % of patients with glaucoma. Our objectives of the study were to evaluate the correlation between the various features of the VFQ-39 questionnaire and glaucoma, the correlation of the VFQ-39 with the OSDI in relation to cognitive functions. Materials and methods: This is a cross-sectional, comparative observational study on patients with glaucoma. The following questionnaires were administered: OSDI Ocular Surface Index (OSDI) The National Institute 39 item Visual Function Questionnaire (VFQ-39), Clinical Dementia Rating (CDR) Patient Health Questionnaire (PHQ-2) Mini-Mental State Examination (MMSE). Results: The total number of patients was 42 individuals. Divided into three groups: patients with glaucoma and on therapy (GLA) (n=21), patients with glaucoma but not therapy (GLA_NT) (n=9), patients on therapy but without glaucoma (TP_NG) (n=12). We highlighted a correlation between VFI (Visual Field Index) in the three groups: in GLA patients the mean VFI was 65.10, in GLA_NT patients 78.78 instead in TP_NG patients it was 98 (p-value <0.001). The mean value of MD was also significant in the three groups in GLA patients was -12.44 db, GLA_NT was -7.82 db, TP_NG was -1.19 db, also the PSD in GLA patients was 6.92 db, in GLA_NT patients was 6.72 db, in TP_NG patients was 1.92 db. The risk of falling was also significant among the three groups. None of the patients in the GLA_NT and TP_NG groups had fallen in the past two years unlike 33% of the glaucoma patient. (p value <0.015) We found a significance of the VFQ-39 General Vision: in the GLA group it was 52.02 points, in the GLA_NT group it was 56.11 points while in the TP_NG group it was 70.25 (p value 0.045). We found similar significance in the VFQ-39 Distance Activity: in the GLA group it was 71.53 points, in the GLA_NT group it was 83.72 points while in the TP_NG group it was 93.37 (p-value 0.033). The VFQ-39 Mental Health subscale was also significant: in the GLA group it was 62.44 points, in the GLA_NT group it was 74.44 points while in the TP_NG group it was 91.67 (p-value 0.008). We found significance in the VFQ-39 Peripheral Vision: in the GLA group it was 64.29 points, in the GLA_NT group it was 83.33 points while in the TP_NG group it was 97.92 (p-value <0.001). No significant correlations were found with the other subscales of VFQ-39 Conclusions: In conclusion, glaucoma tends to have a significant impact on some daily activities and this can also be aggravated by dry eyes in glaucoma patients.