Utility values in Singapore Chinese adults with primary open-angle and primary angle-closure glaucoma

J Glaucoma. 2005 Dec;14(6):455-62. doi: 10.1097/01.ijg.0000185434.08051.82.

Abstract

Purpose: To evaluate utility values in Chinese glaucoma patients.

Patient and methods: Singapore Chinese residents (n = 213) with primary open-angle glaucoma or primary angle-closure glaucoma were recruited from a single tertiary ophthalmic center. Standard face-to-face interviews were conducted to ask about utility values (time trade-off and standard gamble for both death and blindness). Ocular information, including current visual acuity, intraocular pressure, visual field defect, and cup-disc ratio were also obtained.

Results: The mean time trade-off utility value was 0.88 (95% confidence interval 0.85, 0.91), and standard gamble for death and blindness were 0.94 (95% confidence interval 0.93, 0.96) and 0.95 (95% confidence interval 0.93, 0.97), respectively. Only 35.7% of patients were willing to trade time, and 34.3% willing to risk blindness in return for perfect vision. Both primary angle-closure glaucoma and primary open-angle glaucoma patients had similar utility values. After adjusting for age, gender, language spoken, educational level, and diagnosis, patients with better eye visual field PSD > 10 were 2.52 times (95% confidence interval 1.13, 5.61) more willing to trade time. In a multivariate model, the odds ratio of willingness to risk blindness for a complete hypothetical glaucoma cure was 9.88 (95% confidence interval 1.65, 59.23) for patients who had only visited an ophthalmologist 15 years or more ago, and 0.53 (95% confidence interval 0.27, 1.02) for patients who had previous trabeculectomy.

Conclusion: Most Chinese glaucoma patients in Singapore are not willing to trade time or risk blindness. Patients with worse visual fields in the better-seeing eye are more willing to trade time; whereas patients who have not seen an ophthalmologist for at least 15 years or who had no history of a previous trabeculectomy are more willing to risk blindness.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Asian People / ethnology
  • Female
  • Glaucoma, Angle-Closure / ethnology
  • Glaucoma, Angle-Closure / psychology*
  • Glaucoma, Open-Angle / ethnology
  • Glaucoma, Open-Angle / psychology*
  • Health Status Indicators*
  • Humans
  • Intraocular Pressure
  • Male
  • Middle Aged
  • Quality of Life*
  • Quality-Adjusted Life Years
  • Singapore / epidemiology
  • Surveys and Questionnaires
  • Visual Acuity