Threat to fixation and vision-related quality of life in early open-angle glaucoma — results from the Glaucoma Intensive Treatment Study

Dorothea Peters*, Anders Heijl, Sabina Andersson-Geimer, Johan Aspberg, Christina Lindén, Gauti Jóhannesson, Boel Bengtsson

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Purpose: To determine the effect of glaucomatous visual field (VF) damage close to the point of fixation, called threat-to-fixation (TTF), on vision-related quality of life (VRQoL) in open-angle glaucoma. Methods: A total of 239 patients from the Glaucoma Intensive Treatment Study (GITS) were included in this analysis. The second VF of patients with newly diagnosed primarily early glaucoma was evaluated for the presence or absence of TTF. TTF was defined as VF loss including one or more of the four innermost test points depressed at p < 1% in the total deviation probability map of Humphrey 24–2 SITA Standard visual fields. VRQoL was evaluated using Rasch-analysed National Eye Institute Visual Function Questionnaire 25 (NEI VFQ-25) scores. The correlation between VRQoL and TTF was evaluated using uni- and multivariable regression analyses. Results: TTF was present in at least one eye in 115 patients (48%); located in the superior hemifield alone in 47% (54 of 115), in the inferior hemifield alone in 23% (27 of 115), and in 30% (34 of 115) in both hemifields. The median Rasch-calibrated NEI VFQ-25 scores were identical when comparing patients with TTF (VRQoL score 66, 95% CI: 23–100) and those with no-TTF (VRQoL score 66, 95% CI: 21–100) (p = 0.925). Neither the presence of TTF (R2 = −0.004, p = 0.968) nor the location of TTF (R2 = 0.023, p = 0.103) was significantly correlated to Rasch-calibrated NEI VFQ-25 scores. Conclusion: The presence of TTF did not influence VRQoL, as measured by the NEI-VFQ-25, in this relatively large group of patients with mainly early glaucoma.

Original languageEnglish
JournalActa Ophthalmologica
Publication statusAccepted/In press - 2022

Bibliographical note

Funding Information:
Financial support was provided through regional agreements between Lund University and Skåne Regional Council (ALF), and between Umeå University and Västerbotten County Council, and also by grants from the Swedish Society for Medical Research, Knut and Alice Wallenbergs Foundation, Cronqvist Foundation, Ögonfonden, Swedish Medical Society Foundation, Foundation for visually impaired in former Malmöhus county, King Gustav V and Queen Victoria's Freemason Foundation, foundations and donations administered by Skåne University Hospital, Crown Princess Margareta's Foundation, Margit and Kjell Stolz Foundation, Herman Järnhardt Foundation, Ingrid Nordmark's Foundation, Medical Research in the North Foundation at Umeå university. None of the supporting organisations had any role in the design or conduct of the research. Open access funding enabled and organized by ProjektDEAL.

Publisher Copyright:
© 2022 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.

Other keywords

  • Glaucoma
  • Threat to fixation
  • Vision-related Quality of Life
  • Visual field defect


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