This application is for secondary analyses to determine the long-term effect of treatment, clinical
and demographic factors on vision-related quality of life (VRQOL) in the Ocular Hypertension
Treatment Study (OHTS) cohort. This application is timely because the US Preventative
Services Task Force recently concluded there was “Inadequate evidence that treatment of
primary open-angle glaucoma improves health outcomes such as reduced visual impairment,
vision-related function, and quality of life” (JAMA Ophthal, May 2022).
OHTS is the only US study with 20-year clinical and VRQOL outcomes in a cohort of 1,636
participants with ocular hypertension. The 20 year follow-up is meaningful because it
approaches the life expectation of participants whose median age was 55 at baseline. Aim 1 will
report cross-sectional 20 year data from the National Eye Institute Visual Function Questionnaire
(NEI VFQ) and 15 item Glaucoma Quality Life survey (GQL-15). Aim 2 will focus on
longitudinal changes in clinical and VRQOL in the inception cohort of participants who
developed POAG in OHTS 1 or 2. Pre-POAG VRQOL data collected in the inception cohort will
allow statistical adjustment for individual differences on post-POAG VRQOL which will
increase precision of post-POAG impact on VRQOL. Accurate dates of POAG diagnosis in the
inception cohort will enable a rigorous test of the effect of duration and rate of change in clinical
parameters on VRQOL. We will analyze treatment, clinical and demographic factors affecting
VRQOL in the cross-sectional sample at 20 years of follow-up (Aim 1) and in the longitudinal
cohort sample (Aim 2).
Core tests and measures were completed per protocol at 6 month intervals for 13 years and at 1-3
visits after 20 years of follow-up. Tests and measures to be analyzed include indices from
Humphrey 30-2 SITA standard visual fields, best corrected acuity, Pelli-Robson contrast
sensitivity, and OCT (assessed at 20 years). VRQOL was assessed using the NEI-VFQ
administered every 2 years for 13 years and the GQL-15 administered at 20 years.