Effect of Visual Crowding on Quality of Life in Glaucoma Patients.
- 1Bascom Palmer Eye Institute, University of Miami, Miami, Florida, United States.
- 2Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Universidade Federal de São Paulo, São Paulo, Brazil.
Abstract
Purpose
To investigate the association between visual crowding and vision-related quality of life (QoL) in patients with glaucoma.Methods
This cross-sectional study included 50 patients diagnosed with POAG. Visual crowding was quantified by measuring the critical spacing (Scritical). The Scritical was assessed in each visual field quadrant. For each eye, a global Scritical was calculated as the mean of the eligible quadrant-specific values. Vision-related QoL was assessed using the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25), scored using Rasch analysis. Associations between the Scritical and the NEI VFQ-25 Rasch-calibrated scores were examined using generalized estimating equations, with multivariable models adjusted for age and standard automated perimetry 24-2 mean deviation.Results
Among 50 patients with POAG (93 eyes; mean age, 67.9 ± 9.2 years), the mean Rasch-calibrated NEI VFQ-25 score was 59.9 ± 18.8. In univariable analyses, each 1-degree increase in the better-eye global Scritical was associated with a 5.69-point lower NEI VFQ-25 score (95% confidence interval, -10.43 to -0.96; P = 0.018), and each 1-degree increase in the worse-eye Scritical was associated with a 2.23-point lower score (95% confidence interval, -4.38 to -0.08; P = 0.042). In multivariable analysis adjusting for age and standard automated perimetry mean deviation, the better-eye Scritical remained independently associated with a worse QoL (-5.02 points per degree; 95% confidence interval, -9.59 to -0.45; P = 0.031).Conclusions
Visual crowding is independently associated with worse vision-related QoL in patients with glaucoma, even after adjustment for standard perimetric loss. These findings suggest that visual crowding captures clinically meaningful aspects of visual dysfunction beyond conventional perimetry.
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BibTeX
@article{guerreirofilho2026effect,
title = {{Effect of Visual Crowding on Quality of Life in Glaucoma Patients.}},
author = {Marcus Guerreiro-Filho and Davina A Malek and Ali Azizi and Ivan M Tavares and Felipe A Medeiros},
journal = {Investigative ophthalmology \& visual science},
year = {2026},
month = oct,
doi = {10.1167/iovs.67.12.13},
url = {https://europepmc.org/article/MED/42841590},
note = {CC BY},
}
RIS
TY - JOUR
TI - Effect of Visual Crowding on Quality of Life in Glaucoma Patients.
AU - Marcus Guerreiro-Filho
AU - Davina A Malek
AU - Ali Azizi
AU - Ivan M Tavares
AU - Felipe A Medeiros
PY - 2026
DA - 2026/10/01
JO - Investigative ophthalmology & visual science
DO - 10.1167/iovs.67.12.13
UR - https://europepmc.org/article/MED/42841590
AB - Purpose To investigate the association between visual crowding and vision-related quality of life (QoL) in patients with glaucoma.Methods This cross-sectional study included 50 patients diagnosed with POAG. Visual crowding was quantified by measuring the critical spacing (Scritical). The Scritical was assessed in each visual field quadrant. For each eye, a global Scritical was calculated as the mean of the eligible quadrant-specific values. Vision-related QoL was assessed using the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25), scored using Rasch analysis. Associations between the Scritical and the NEI VFQ-25 Rasch-calibrated scores were examined using generalized estimating equations, with multivariable models adjusted for age and standard automated perimetry 24-2 mean deviation.Results Among 50 patients with POAG (93 eyes; mean age, 67.9 ± 9.2 years), the mean Rasch-calibrated NEI VFQ-25 score was 59.9 ± 18.8. In univariable analyses, each 1-degree increase in the better-eye global Scritical was associated with a 5.69-point lower NEI VFQ-25 score (95% confidence interval, -10.43 to -0.96; P = 0.018), and each 1-degree increase in the worse-eye Scritical was associated with a 2.23-point lower score (95% confidence interval, -4.38 to -0.08; P = 0.042). In multivariable analysis adjusting for age and standard automated perimetry mean deviation, the better-eye Scritical remained independently associated with a worse QoL (-5.02 points per degree; 95% confidence interval, -9.59 to -0.45; P = 0.031).Conclusions Visual crowding is independently associated with worse vision-related QoL in patients with glaucoma, even after adjustment for standard perimetric loss. These findings suggest that visual crowding captures clinically meaningful aspects of visual dysfunction beyond conventional perimetry.
SN - 0146-0404
SN - 1552-5783
ER -