Importance Faster structural changes may be associated with worse vision-related quality of life in patients with glaucoma. Objectives To evaluate the association between the rate of ganglion cell complex thinning and the Vision Function Questionnaire in glaucoma. Design, Setting, and Participants This retrospective analysis of a longitudinal cohort was designed in October 2021. Patients were enrolled from the Diagnostic Innovations in Glaucoma Study and the African Descent and Glaucoma Evaluation Study. Two hundred thirty-six eyes of 118 patients with diagnosed or suspected glaucoma were followed up with imaging for a mean of 4.1 years from September 2014 to March 2020. Main Outcomes and Measures The Vision Function Questionnaire was evaluated using the 25-item National Eye Institute Visual Function at the last follow-up visit. Ganglion cell complex thickness was derived from macular optical coherence tomography scans and averaged within 3 circular areas (3.4°, 5.6°, and 6.8° from the fovea) and superior and inferior hemiregions. Linear mixed-effects models were used to investigate the association between the rate of ganglion cell complex thinning and Rasch-calibrated Vision Function Questionnaire score. Results The mean (SD) age was 73.2 (8.7) years, 65 participants (55.1%) were female, and 53 participants (44.9%) were African American. Race was self-reported by the participants. Mean composite Rasch-calibrated National Eye Institute Visual Function Questionnaire score was 50.3 (95% CI, 45.9-54.6). A faster annual rate of global ganglion cell complex thinning in the better eye was associated with a higher disability reflected by the composite National Eye Institute Visual Function Questionnaire score (-15.0 [95% CI, -28.4 to -1.7] per 1 μm faster; P = .03). When stratified by degrees from the fovea, the 5.6° and 6.8° areas were associated with the composite National Eye Institute Visual Function Questionnaire Rasch-calibrated score (-14.5 [95% CI, -27.0 to -2.0] per 1 μm faster; R2 = 0.201; P = .03; and -23.7 [95% CI, -45.5 to -1.9] per 1 μm faster; R2 = 0.196; P = .02, respectively), and -8.0 (95% CI, -16.8 to 0.8) per 1 μm faster for the 3.4° area (R2 = 0.184; P = .07) after adjusting for confounding factors. Conclusions and Relevance These findings suggest that faster and sectoral central location of ganglion cell complex thinning provides useful information in determining the risk of vision-related quality of life in glaucoma. Monitoring macular structure may be useful for determining the risk of functional impairment in glaucoma.

中文翻译：

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青光眼神经节细胞复合体变薄与视力相关生活质量之间的关联。

重要性 青光眼患者更快的结构变化可能与视力相关的生活质量较差有关。目的 评估青光眼神经节细胞复合体变薄率与视功能问卷之间的关联。设计、背景和参与者 这项纵向队列回顾性分析于 2021 年 10 月设计。患者是从青光眼诊断创新研究和非洲人后裔和青光眼评估研究中入组的。从2014年9月至2020年3月，对118名确诊或疑似青光眼患者的236只眼睛进行了平均4.1年的影像学随访。 主要结果和措施 使用25项国家眼科研究所对视功能问卷进行评估最后一次随访时的视觉功能。神经节细胞复合体厚度源自黄斑光学相干断层扫描，并在 3 个圆形区域（距中央凹 3.4°、5.6° 和 6.8°）以及上半区域和下半区域内取平均值。线性混合效应模型用于研究神经节细胞复合体变薄率与 Rasch 校准的视觉功能问卷评分之间的关​​联。结果平均 (SD) 年龄为 73.2 (8.7) 岁，65 名参与者 (55.1%) 为女性，53 名参与者 (44.9%) 为非裔美国人。比赛由参与者自行报告。Rasch 校准的国家眼科研究所视觉功能问卷平均综合评分为 50.3（95% CI，45.9-54.6）。较好的眼睛中整体神经节细胞复合体每年变薄的速度越快，与国家眼科研究所视觉功能问卷综合评分反映出的残疾程度越高（每快 1 μm，-15.0 [95% CI，-28.4 至 -1.7]； P = .03)。当按照中央凹的度数进行分层时，5.6°和6.8°区域与国家眼科研究所视觉功能问卷Rasch校准综合评分相关（每快1微米-14.5 [95% CI，-27.0至-2.0]；R2每快 1 μm，分别为 -201；P = .03；和 -23.7 [95% CI，-45.5 至 -1.9]；R2 = 0.196；P = .02）和 -8.0（95% CI，-16.8 至 -1.9）调整混杂因素后，3.4° 区域的速度每 1 μm 加快 0.8）（R2 = 0.184；P = .07）。结论和相关性这些研究结果表明，神经节细胞复合体变薄的更快和扇形中心位置为确定青光眼视力相关生活质量的风险提供了有用的信息。监测黄斑结构可能有助于确定青光眼功能障碍的风险。