- Jul 17, 2001
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- Pennsylvania College of Optometry
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- Key Biscayne
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- FL
Binocular visual field loss is a risk factor for fractures in older women, according to a report in the October issue of the Journal of the American Geriatrics Society.
Using data from the Study for Osteoporotic Fractures (SOF) for 1997 to 2008, Dr. Anne L. Coleman, of the University of California, Los Angeles, and colleagues examined the associations between visual field loss and non-spine fractures in 4773 community-dwelling white and African-American women. All were at least 65 years old.
Based on age-adjusted screening tests of the peripheral and central vision of each eye, binocular visual field loss was classified as no loss (all 96 points of light detected), mild loss (1 to 9 points missed), moderate loss (10 to 19 points missed), and severe loss (>20 points missed).
Overall, 1773 women (37%) had no visual field loss, 2015 (42%) had mild loss, 485 (10%) had moderate loss, and 500 (11%) had severe loss.
For the analysis of hip fracture rates, 190 women with previous hip fractures were excluded. Among the remaining 4583 women, over a mean follow-up of 8.1 years, 424 (9.3%) suffered a first hip fracture, for an incidence rate of 11.4 per 1000 person-years. Women with a first hip fracture missed a mean of 8.3 points on the visual field test, compared to a mean of 6.1 missed points among those without any fractures (p < 0.001).
In covariate-adjusted analysis, the highest risk of hip fracture was in women with the most severe visual field loss (hazard ratio 1.66). Risks were lower among those with mild (HR 1.49) and moderate (HR 1.25) visual field loss.
The authors included 3869 women in their analysis of visual field loss and risks of non-spine, non-hip fracture. Over an average follow-up of 8.0 years, 770 (19.9%) had fractures. Women with non-spine, non-hip fractures missed a mean of 7.3 points on the visual field test, compared to 5.9 points among those without fractures (p = 0.30). Here again, the risk of fracture was highest in women with severe visual field loss (covariate-adjusted HR 1.59) and lower with mild and moderate loss (HR 0.88 and 1.18, respectively).
"Future guidelines for the care of older patients should consider recommending evaluations of the visual fields in patients at heightened risk of fractures by recommending that clinicians refer their patients who are recurrent fallers for visual field loss assessment or screen for visual field loss themselves using suprathreshold tests such as was done in the SOF," the researchers conclude.
Using data from the Study for Osteoporotic Fractures (SOF) for 1997 to 2008, Dr. Anne L. Coleman, of the University of California, Los Angeles, and colleagues examined the associations between visual field loss and non-spine fractures in 4773 community-dwelling white and African-American women. All were at least 65 years old.
Based on age-adjusted screening tests of the peripheral and central vision of each eye, binocular visual field loss was classified as no loss (all 96 points of light detected), mild loss (1 to 9 points missed), moderate loss (10 to 19 points missed), and severe loss (>20 points missed).
Overall, 1773 women (37%) had no visual field loss, 2015 (42%) had mild loss, 485 (10%) had moderate loss, and 500 (11%) had severe loss.
For the analysis of hip fracture rates, 190 women with previous hip fractures were excluded. Among the remaining 4583 women, over a mean follow-up of 8.1 years, 424 (9.3%) suffered a first hip fracture, for an incidence rate of 11.4 per 1000 person-years. Women with a first hip fracture missed a mean of 8.3 points on the visual field test, compared to a mean of 6.1 missed points among those without any fractures (p < 0.001).
In covariate-adjusted analysis, the highest risk of hip fracture was in women with the most severe visual field loss (hazard ratio 1.66). Risks were lower among those with mild (HR 1.49) and moderate (HR 1.25) visual field loss.
The authors included 3869 women in their analysis of visual field loss and risks of non-spine, non-hip fracture. Over an average follow-up of 8.0 years, 770 (19.9%) had fractures. Women with non-spine, non-hip fractures missed a mean of 7.3 points on the visual field test, compared to 5.9 points among those without fractures (p = 0.30). Here again, the risk of fracture was highest in women with severe visual field loss (covariate-adjusted HR 1.59) and lower with mild and moderate loss (HR 0.88 and 1.18, respectively).
"Future guidelines for the care of older patients should consider recommending evaluations of the visual fields in patients at heightened risk of fractures by recommending that clinicians refer their patients who are recurrent fallers for visual field loss assessment or screen for visual field loss themselves using suprathreshold tests such as was done in the SOF," the researchers conclude.
