緑内障患者のゴールドマン視野検査による視野障害別quality of lifeの評価

Evaluation of QOL classified by the visual field defects by Goldmann perimetry in patients with glaucoma

要約　目的：緑内障患者の生活の質quality of life（QOL）の評価をゴールドマン視野計による視野障害別にVFQ-25を用いて行う。

対象および方法：原発開放隅角緑内障129例を対象とした。自己記入式VFQ-25を患者に評価してもらった。25項目とコンポ7，コンポ11の点数を算出した。ゴールドマン視野検査の視野障害を湖崎分類に従い，視野良好眼の視野障害を早期症例（Ⅱa，Ⅱb），中期症例（Ⅲa，Ⅲb），晩期症例（Ⅳ，Ⅴb，Ⅴb）の3群に分けた。3群間の患者背景とVFQ-25の点数を比較した。

結果：視力は晩期症例で有意に低下していた。使用点眼薬数は中期症例で有意に多かった。VFQ-25の一般的見え方，近見視力による行動，遠見視力による行動，社会生活機能，心の健康，役割機能，自立，色覚，周辺視野，コンポ7，コンポ11は，晩期症例が早期症例，中期症例よりも，中期症例が早期症例よりも点数が有意に低かった（p＜0.01）。一般的健康感，目の痛みは中期症例，晩期症例が早期症例よりも点数が有意に低かった（p＜0.01）。

結論：緑内障患者ではVFQ-25の一般的健康感，目の痛みはゴールドマン視野検査による視野障害中期まで低下するが，それ以外の項目は視野障害が進行するに伴い，徐々にQOLが低下する。

Abstract　Purpose：To evaluate the quality of life（QOL）in patients with glaucoma using the National Eye Institute Visual Function Questionnaire（VFQ-25）by visual field defects classified by Goldmann perimetry.

Methods：Subjects were 129 patients with primary open-angle glaucoma. Patients answered a self-administered questionnaire of VFQ-25. Scores of the 25 items of VFQ-25 and total scores（composite 7 and composite 11）were calculated. Results of Goldmann perimetry were classified as the early-stage（Ⅱa and Ⅱb）, the middle-stage（Ⅲa and Ⅲb）, and the late-stage（Ⅳ, Ⅴa, and Ⅴb）after Kosaki classification. The characteristics of patients and the scores of VFQ-25 were compared between three-stage groups.

Results：Visual acuity decreased significantly in the late-stage. The number of medications was significantly larger in the middle-stage. The late-stage group had significantly lower score than the early and the middle stage groups and the middle-stage group had significantly lower score than the early-stage group in general vision, near vision, distance vision, social function, mental health, role limitations, dependency, color vision, peripheral vision, composite 11, and composite 7（p＜0.01）. The scores of general health and ocular pain in the middle and the late stage were significantly lower than the score in the early-stage（p＜0.01）.

Conclusions：Glaucoma patients showed decreased QOL. General health and eye pain progressed by the middle stage of visual field defects by Goldmann perimetry. Regarding the other items of VFQ-25, QOL gradually decreased as visual field defects progressed.