The impact of inferior visual field on frail status in glaucoma patients.

Purpose: To elucidate the association between frail status and regions of visual field (VF) defect in glaucoma patients, and assess the cut-off threshold of VF defect and visual acuity that should give attention to frailty.

Methods: In this cross-sectional study, we recruited 52 glaucoma patients aged 70 to 89 years. We utilized the Fried frailty criteria to evaluate frailty status. We divided the binocular-integrated VF into four regions and analyzed the association between those divided VF and frail status. The receiver operating characteristic (ROC) analysis was performed to assess the cut-off threshold of VF and visual acuity (LogMAR) to be prefrailty.

Results: Twenty-three were defined as robust, 24 were prefrail, three were frail, and two patients missed a questionnaire to determine frailty. All four regions of VF were significantly associated with the number of frailty criteria met. The results of structural equation modeling for frailty indicated a larger standardized factor loading in inferior VF than in superior VF. The ROC curve for detection of the combined prefrailty and frailty showed the cut-off threshold of the inferior central VF total deviation was - 3.75 (AUC: 0.825), and that of the worse eye's LogMAR was 0.22 (AUC: 0.810).

Conclusions: The impact of the inferior VF on frailty was evident in glaucoma patients. Even minor inferior visual field defects and mild visual acuity loss in the worse eye suggest the need for interventions not to develop frailty in glaucoma patients.