RNFL loss linked to loss in quality of life in glaucoma

This is the first study to show that rates of structural change on OCT are valid markers for the degree of patient-reported disability from glaucoma.

The authors followed 130 patients (260 eyes) for a mean of 3.5 years. SD-OCT and standard automated perimetry were performed every 6 months, and the 25-item NEI Visual Function Questionnaire was performed annually.

Progressive binocular RNFL thickness loss was associated with reduced quality of life, even after adjustment for the degree of visual field loss as measured by standard perimetry.  

Importantly, the change in binocular RNFL thickness corresponded to the change seen when using the thickest measurements between the 2 eyes of the same patient over time. Therefore, substantial loss of RNFL had to occur in the better eye or in both eyes to produce meaningful changes in quality of life.