The longitudinal link between visual acuity and health-related quality of life in patients with diabetic retinopathy

Objective: To establish if there is a difference in health-related quality of life and vision-related quality of life in patients with a confirmed diagnosis of giant cell arteritis compared with those with clinical features suspicious for the disease at initial presentation but in whom giant cell arteritis is ultimately excluded. Methods: A cross-sectional study of 116 patients who presented to two tertiary referral hospitals in Ireland with symptoms suspicious for giant cell arteritis was performed between August 2011 and June 2017. The Vision Core Measurement 1 and Short Form-36 questionnaires were used as assessment tools. Results: The mean (standard deviation) age of all 116 participants was 69.4 (9.3) years of whom 74 (63.8%) were female. In the giant cell arteritis group, 19.7% had permanent loss of vision and 54.7% had non-permanent visual disturbance. Vision Core Measurement 1 score in the giant cell arteritis group correlated with worse eye visual acuity (r = 0.4233, p = 0.0002). The Short Form-36 subscales of role physical (p = 0.0002), role emotional (p = 0.024), and the mental composite score (p = 0.012) were significantly worse in patients with giant cell arteritis. A significant correlation was found between vision-related quality of life scores and all Short Form-36 subscale scores except bodily pain (r = −0.215 to −0.399, p < 0.05 for all), and between social functioning and visual acuity in the better eye (r = −0.242, p = 0.038). Conclusion: Vision-related quality of life is an important subjective concern for both patients presenting with a suspicion of giant cell arteritis and those with a definite diagnosis of giant cell arteritis. Features of giant cell arteritis impact on patients’ physical and emotional states and vision influences global quality of life in giant cell arteritis. A long-term multidisciplinary approach is warranted for clinical, physical, and psychological treatment and support.

Download Full-text

Health-related quality of life in patients with uveitis

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-312882 ◽

2018 ◽

Vol 103 (9) ◽

pp. 1284-1288 ◽

Cited By ~ 4

Author(s):

Mohith Shamdas ◽

Kerolos Bassilious ◽

Philip Ian Murray

Keyword(s):

Quality Of Life ◽

Visual Acuity ◽

Vision Loss ◽

Glaucomatous Optic Neuropathy ◽

Health Related Quality ◽

Poor Vision ◽

Five Dimensions ◽

Related Quality ◽

Health Related

Background/aimsTo measure health-related quality of life (HRQOL) in patients with uveitis using time trade-off (TTO) and standard gamble (SG) methods of direct utility analysis.MethodsConsecutive patients attending a tertiary referral uveitis clinic were administered standardised, interview-delivered TTO and SG questionnaires and completed the European Quality of Life Five Dimensions Five Level (EQ5D-5L) questionnaire. Clinical data recorded included best-corrected visual acuity, uveitis anatomical and clinical classifications, duration since diagnosis, disease activity, current medication and any ocular or systemic comorbidities.ResultsTwo hundred patients with uveitis (124 female, 76 male, median age 54 years) were included. Overall mean TTO utility was 0.831 (95% CI 0.802 to 0.860); mean SG utility was 0.868 (95% CI 0.840 to 0.896) and mean EQ5D-5L utility was 0.742 (95% CI 0.702 to 0.782). There was a negative correlation between visual acuity and mean HRQOL (6/12 or better: TTO 0.86, SG 0.893; 6/15–6/60: TTO 0.662, SG 0.742; worse than 6/60: TTO 0.608, SG 0.712). Poor vision in the better- seeing eye (p=0.004), bilateral disease (p=0.047) and concurrent glaucomatous optic neuropathy (p=0.005) were predictors of poor TTO HRQOL. No correlation was found between HRQOL and duration of diagnosis, a flare of uveitis or being on systemic therapy. Patients with uveitis with poor vision have a TTO value worse than patients with end-stage renal failure on haemodialysis or those with AIDS.ConclusionLoss of vision resulting from uveitis is associated with reduced HRQOL. The TTO and SG utility values appear directly dependent on the degree of vision loss and not on the duration of disease or systemic medications.

Download Full-text