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Hays RD, Tarver ME, Eydelman M, Spaeth GL, Parke DW, Singh K, Nguyen D, Saltzmann RM, Smith O, Shaw ML, Rosenberg L, Seibold L, Teymoorian S, Provencher LM, Bicket AK, Arora N, Junk AK, Chaya C, Salim S, Kuo D, Weiner A, Zhang Z, Rhee BFD, McMillan B, Choo C, Garris W, Noecker R, Fellman R, Caprioli J, Vold S, Pasquale L, Cui Q, Mbagwu M. A Health-Related Quality of Life Measure for Patients Who Undergo Minimally Invasive Glaucoma Surgery. Am J Ophthalmol 2024; 266:313-320. [PMID: 38880374 DOI: 10.1016/j.ajo.2024.05.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Accepted: 05/31/2024] [Indexed: 06/18/2024]
Abstract
PURPOSE To develop a patient-reported outcome measure to assess the impact of glaucoma and treatment, including minimally invasive glaucoma surgery (MIGS). DESIGN Observational study before and after concomitant cataract and Food and Drug Administration-approved implantable MIGS device surgery. SETTING Survey administration was on a computer, iPad, or similar device. PATIENT POPULATION 184 adults completed the baseline survey, 124 a survey 3 months after surgery, and 106 the 1-month test-retest reliability survey. The age range was 37 to 89 (average age = 72). Most were female (57%), non-Hispanic White (81%), and had a college degree (56%). MAIN OUTCOME MEASURES The Glaucoma Outcomes Survey (GOS) assesses functional limitations (27 items), vision-related symptoms (7 items), psychosocial issues (7 items), and satisfaction with microinvasive glaucoma surgery (1 item). These multiple-item scales were scored on a 0 to 100 range, with a higher score indicating worse health. RESULTS Internal consistency reliability estimates ranged from 0.75 to 0.93, and 1-month test-retest intraclass correlations ranged from 0.83 to 0.92 for the GOS scales. Product-moment correlations among the scales ranged from 0.56 to 0.60. Improvement in visual acuity in the study eye from baseline to the 3-month follow-up was significantly related to improvements in GOS functional limitations (r = 0.18, P = .0485), vision-related symptoms (r = 0.19, P = .0386), and psychosocial concerns (r = 0.18, P = .0503). Responders to treatment ranged from 17% for vision-related symptoms to 48% for functional limitations. CONCLUSIONS This study supports using the GOS for ophthalmic procedures such as MIGS. Further evaluation of the GOS in different patient subgroups and clinical settings is needed.
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Affiliation(s)
- Ron D Hays
- Department of Medicine (RDH), University of California, Los Angeles, California, USA; The RAND Corporation (RDH), Santa Monica, California, USA.
| | - Michelle E Tarver
- US Food and Drug Administration (MET and ME), Center for Devices and Radiologic Health, Silver Spring, Maryland, USA
| | - Malvina Eydelman
- US Food and Drug Administration (MET and ME), Center for Devices and Radiologic Health, Silver Spring, Maryland, USA
| | - George L Spaeth
- Wills Eye Hospital, Sidney Kimmel School of Medicine (GLS), Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | | | - Kuldev Singh
- Stanford University School of Medicine (KS), Stanford, California, USA
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Claessens JL, Wanten JC, Bauer NJ, Nuijts RM, Vrijman V, Selek E, Wouters RJ, Reus NJ, van Dorst FJ, Findl O, Ruiss M, Boden K, Januschowski K, Imhof SM, Wisse RP. Web-based telemonitoring of visual function and self-reported postoperative outcomes in cataract care: international multicenter randomized controlled trial. J Cataract Refract Surg 2024; 50:947-955. [PMID: 38809014 PMCID: PMC11338021 DOI: 10.1097/j.jcrs.0000000000001492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 05/13/2024] [Accepted: 05/20/2024] [Indexed: 05/30/2024]
Abstract
PURPOSE To compare web-based, self-administered follow-up after cataract surgery to conventional face-to-face follow-up. SETTING Eye clinics in the Netherlands, Austria, and Germany. DESIGN Randomized controlled trial with an embedded method comparison study (ClinicalTrials.gov: NCT04809402). METHODS Routine patients with cataract were randomized into 2 groups: The telemonitoring group undertook web-based vision self-assessments and questionnaires from home, while the usual care group received conventional care. All participants had a 4- to 6-week postoperative clinic visit for safety and validation purposes. Outcomes included, the web test's accuracy for assessing postoperative visual acuity (VA) and refractive error, adverse event rates, and patient-reported outcome measurements (PROMs). RESULTS 94 participants (188 eyes) were enrolled. Web-based uncorrected distance VA testing demonstrated a negligible mean difference (-0.03 ± 0.14 logMAR) when compared with conventional Early Treatment Diabetic Retinopathy Study chart testing, with 95% limits of agreement ranging from -0.30 to 0.24 logMAR. The web-based refraction assessment overestimated the postoperative refractive error (mean difference in spherical equivalent 0.15 ± 0.67 diopters), resulting in a poorer corrected distance VA compared with subjective refraction (mean 0.1 vs -0.1 logMAR). Rates of adverse events and unscheduled consultations were minimal across both groups. Preoperative and postoperative PROM questionnaires had a 100% response rate. Visual functioning (Catquest-9SF and National Eye Institute Visual Function Questionnaire-25) improved postoperatively (mean improvement -0.80 and 16.70, respectively) and did not significantly differ between the 2 groups. CONCLUSIONS The patients with cataract in this study effectively provided postoperative outcome data using a web interface. Both conventional and web-based follow-ups yielded similar PROMs and adverse event rates. Future developments should reduce the variability in the web-based VA test and yield representative refraction outcomes.
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Affiliation(s)
- Janneau L.J. Claessens
- From the Department of Ophthalmology, University Medical Centre Utrecht, Utrecht, the Netherlands (Claessens, Imhof, Wisse); University Eye Clinic Maastricht, Maastricht University Medical Center+, Maastricht, the Netherlands (Wanten, Bauer, Nuijts); Oogcentrum Noordholland, Heerhugowaard, the Netherlands (Vrijman, Selek, Wouters); Department of Ophthalmology, Amphia Hospital, Breda, the Netherlands (Reus, van Dorst); Vienna Institute for Research in Ocular Surgery, a Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria (Findl, Ruiss); Eye Clinic Sulzbach, Knappschaft Hospital Saar, Sulzbach, Germany (Boden); Mount Saint Peter Eye Clinic, Trier, Germany (Januschowski)
| | - Joukje C. Wanten
- From the Department of Ophthalmology, University Medical Centre Utrecht, Utrecht, the Netherlands (Claessens, Imhof, Wisse); University Eye Clinic Maastricht, Maastricht University Medical Center+, Maastricht, the Netherlands (Wanten, Bauer, Nuijts); Oogcentrum Noordholland, Heerhugowaard, the Netherlands (Vrijman, Selek, Wouters); Department of Ophthalmology, Amphia Hospital, Breda, the Netherlands (Reus, van Dorst); Vienna Institute for Research in Ocular Surgery, a Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria (Findl, Ruiss); Eye Clinic Sulzbach, Knappschaft Hospital Saar, Sulzbach, Germany (Boden); Mount Saint Peter Eye Clinic, Trier, Germany (Januschowski)
| | - Noël J.C. Bauer
- From the Department of Ophthalmology, University Medical Centre Utrecht, Utrecht, the Netherlands (Claessens, Imhof, Wisse); University Eye Clinic Maastricht, Maastricht University Medical Center+, Maastricht, the Netherlands (Wanten, Bauer, Nuijts); Oogcentrum Noordholland, Heerhugowaard, the Netherlands (Vrijman, Selek, Wouters); Department of Ophthalmology, Amphia Hospital, Breda, the Netherlands (Reus, van Dorst); Vienna Institute for Research in Ocular Surgery, a Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria (Findl, Ruiss); Eye Clinic Sulzbach, Knappschaft Hospital Saar, Sulzbach, Germany (Boden); Mount Saint Peter Eye Clinic, Trier, Germany (Januschowski)
| | - Rudy M.M.A. Nuijts
- From the Department of Ophthalmology, University Medical Centre Utrecht, Utrecht, the Netherlands (Claessens, Imhof, Wisse); University Eye Clinic Maastricht, Maastricht University Medical Center+, Maastricht, the Netherlands (Wanten, Bauer, Nuijts); Oogcentrum Noordholland, Heerhugowaard, the Netherlands (Vrijman, Selek, Wouters); Department of Ophthalmology, Amphia Hospital, Breda, the Netherlands (Reus, van Dorst); Vienna Institute for Research in Ocular Surgery, a Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria (Findl, Ruiss); Eye Clinic Sulzbach, Knappschaft Hospital Saar, Sulzbach, Germany (Boden); Mount Saint Peter Eye Clinic, Trier, Germany (Januschowski)
| | - Violette Vrijman
- From the Department of Ophthalmology, University Medical Centre Utrecht, Utrecht, the Netherlands (Claessens, Imhof, Wisse); University Eye Clinic Maastricht, Maastricht University Medical Center+, Maastricht, the Netherlands (Wanten, Bauer, Nuijts); Oogcentrum Noordholland, Heerhugowaard, the Netherlands (Vrijman, Selek, Wouters); Department of Ophthalmology, Amphia Hospital, Breda, the Netherlands (Reus, van Dorst); Vienna Institute for Research in Ocular Surgery, a Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria (Findl, Ruiss); Eye Clinic Sulzbach, Knappschaft Hospital Saar, Sulzbach, Germany (Boden); Mount Saint Peter Eye Clinic, Trier, Germany (Januschowski)
| | - Esen Selek
- From the Department of Ophthalmology, University Medical Centre Utrecht, Utrecht, the Netherlands (Claessens, Imhof, Wisse); University Eye Clinic Maastricht, Maastricht University Medical Center+, Maastricht, the Netherlands (Wanten, Bauer, Nuijts); Oogcentrum Noordholland, Heerhugowaard, the Netherlands (Vrijman, Selek, Wouters); Department of Ophthalmology, Amphia Hospital, Breda, the Netherlands (Reus, van Dorst); Vienna Institute for Research in Ocular Surgery, a Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria (Findl, Ruiss); Eye Clinic Sulzbach, Knappschaft Hospital Saar, Sulzbach, Germany (Boden); Mount Saint Peter Eye Clinic, Trier, Germany (Januschowski)
| | - Rob J. Wouters
- From the Department of Ophthalmology, University Medical Centre Utrecht, Utrecht, the Netherlands (Claessens, Imhof, Wisse); University Eye Clinic Maastricht, Maastricht University Medical Center+, Maastricht, the Netherlands (Wanten, Bauer, Nuijts); Oogcentrum Noordholland, Heerhugowaard, the Netherlands (Vrijman, Selek, Wouters); Department of Ophthalmology, Amphia Hospital, Breda, the Netherlands (Reus, van Dorst); Vienna Institute for Research in Ocular Surgery, a Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria (Findl, Ruiss); Eye Clinic Sulzbach, Knappschaft Hospital Saar, Sulzbach, Germany (Boden); Mount Saint Peter Eye Clinic, Trier, Germany (Januschowski)
| | - Nicolaas J. Reus
- From the Department of Ophthalmology, University Medical Centre Utrecht, Utrecht, the Netherlands (Claessens, Imhof, Wisse); University Eye Clinic Maastricht, Maastricht University Medical Center+, Maastricht, the Netherlands (Wanten, Bauer, Nuijts); Oogcentrum Noordholland, Heerhugowaard, the Netherlands (Vrijman, Selek, Wouters); Department of Ophthalmology, Amphia Hospital, Breda, the Netherlands (Reus, van Dorst); Vienna Institute for Research in Ocular Surgery, a Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria (Findl, Ruiss); Eye Clinic Sulzbach, Knappschaft Hospital Saar, Sulzbach, Germany (Boden); Mount Saint Peter Eye Clinic, Trier, Germany (Januschowski)
| | - Fallon J.G.M. van Dorst
- From the Department of Ophthalmology, University Medical Centre Utrecht, Utrecht, the Netherlands (Claessens, Imhof, Wisse); University Eye Clinic Maastricht, Maastricht University Medical Center+, Maastricht, the Netherlands (Wanten, Bauer, Nuijts); Oogcentrum Noordholland, Heerhugowaard, the Netherlands (Vrijman, Selek, Wouters); Department of Ophthalmology, Amphia Hospital, Breda, the Netherlands (Reus, van Dorst); Vienna Institute for Research in Ocular Surgery, a Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria (Findl, Ruiss); Eye Clinic Sulzbach, Knappschaft Hospital Saar, Sulzbach, Germany (Boden); Mount Saint Peter Eye Clinic, Trier, Germany (Januschowski)
| | - Oliver Findl
- From the Department of Ophthalmology, University Medical Centre Utrecht, Utrecht, the Netherlands (Claessens, Imhof, Wisse); University Eye Clinic Maastricht, Maastricht University Medical Center+, Maastricht, the Netherlands (Wanten, Bauer, Nuijts); Oogcentrum Noordholland, Heerhugowaard, the Netherlands (Vrijman, Selek, Wouters); Department of Ophthalmology, Amphia Hospital, Breda, the Netherlands (Reus, van Dorst); Vienna Institute for Research in Ocular Surgery, a Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria (Findl, Ruiss); Eye Clinic Sulzbach, Knappschaft Hospital Saar, Sulzbach, Germany (Boden); Mount Saint Peter Eye Clinic, Trier, Germany (Januschowski)
| | - Manuel Ruiss
- From the Department of Ophthalmology, University Medical Centre Utrecht, Utrecht, the Netherlands (Claessens, Imhof, Wisse); University Eye Clinic Maastricht, Maastricht University Medical Center+, Maastricht, the Netherlands (Wanten, Bauer, Nuijts); Oogcentrum Noordholland, Heerhugowaard, the Netherlands (Vrijman, Selek, Wouters); Department of Ophthalmology, Amphia Hospital, Breda, the Netherlands (Reus, van Dorst); Vienna Institute for Research in Ocular Surgery, a Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria (Findl, Ruiss); Eye Clinic Sulzbach, Knappschaft Hospital Saar, Sulzbach, Germany (Boden); Mount Saint Peter Eye Clinic, Trier, Germany (Januschowski)
| | - Karl Boden
- From the Department of Ophthalmology, University Medical Centre Utrecht, Utrecht, the Netherlands (Claessens, Imhof, Wisse); University Eye Clinic Maastricht, Maastricht University Medical Center+, Maastricht, the Netherlands (Wanten, Bauer, Nuijts); Oogcentrum Noordholland, Heerhugowaard, the Netherlands (Vrijman, Selek, Wouters); Department of Ophthalmology, Amphia Hospital, Breda, the Netherlands (Reus, van Dorst); Vienna Institute for Research in Ocular Surgery, a Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria (Findl, Ruiss); Eye Clinic Sulzbach, Knappschaft Hospital Saar, Sulzbach, Germany (Boden); Mount Saint Peter Eye Clinic, Trier, Germany (Januschowski)
| | - Kai Januschowski
- From the Department of Ophthalmology, University Medical Centre Utrecht, Utrecht, the Netherlands (Claessens, Imhof, Wisse); University Eye Clinic Maastricht, Maastricht University Medical Center+, Maastricht, the Netherlands (Wanten, Bauer, Nuijts); Oogcentrum Noordholland, Heerhugowaard, the Netherlands (Vrijman, Selek, Wouters); Department of Ophthalmology, Amphia Hospital, Breda, the Netherlands (Reus, van Dorst); Vienna Institute for Research in Ocular Surgery, a Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria (Findl, Ruiss); Eye Clinic Sulzbach, Knappschaft Hospital Saar, Sulzbach, Germany (Boden); Mount Saint Peter Eye Clinic, Trier, Germany (Januschowski)
| | - Saskia M. Imhof
- From the Department of Ophthalmology, University Medical Centre Utrecht, Utrecht, the Netherlands (Claessens, Imhof, Wisse); University Eye Clinic Maastricht, Maastricht University Medical Center+, Maastricht, the Netherlands (Wanten, Bauer, Nuijts); Oogcentrum Noordholland, Heerhugowaard, the Netherlands (Vrijman, Selek, Wouters); Department of Ophthalmology, Amphia Hospital, Breda, the Netherlands (Reus, van Dorst); Vienna Institute for Research in Ocular Surgery, a Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria (Findl, Ruiss); Eye Clinic Sulzbach, Knappschaft Hospital Saar, Sulzbach, Germany (Boden); Mount Saint Peter Eye Clinic, Trier, Germany (Januschowski)
| | - Robert P.L. Wisse
- From the Department of Ophthalmology, University Medical Centre Utrecht, Utrecht, the Netherlands (Claessens, Imhof, Wisse); University Eye Clinic Maastricht, Maastricht University Medical Center+, Maastricht, the Netherlands (Wanten, Bauer, Nuijts); Oogcentrum Noordholland, Heerhugowaard, the Netherlands (Vrijman, Selek, Wouters); Department of Ophthalmology, Amphia Hospital, Breda, the Netherlands (Reus, van Dorst); Vienna Institute for Research in Ocular Surgery, a Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria (Findl, Ruiss); Eye Clinic Sulzbach, Knappschaft Hospital Saar, Sulzbach, Germany (Boden); Mount Saint Peter Eye Clinic, Trier, Germany (Januschowski)
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Namgung E, Kim H, Kim YH, Kim YS, Lee EJ, Lee JH, Sasaki Y, Watanabe T, Kang DW. Customized Visual Discrimination Digital Therapy According to Visual Field Defects in Chronic Stroke Patients. J Clin Neurol 2024; 20:509-518. [PMID: 39227334 PMCID: PMC11372206 DOI: 10.3988/jcn.2024.0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 06/19/2024] [Accepted: 06/21/2024] [Indexed: 09/05/2024] Open
Abstract
BACKGROUND AND PURPOSE Visual perceptual learning (VPL) may improve visual field defects (VFDs) after chronic stroke, but the optimal training duration and location remain unknown. This prospective study aimed to determine the efficacy of 8 weeks of VFD-customized visual discrimination training in improving poststroke VFDs. METHODS Prospectively enrolled patients with poststroke VFDs initially received no training for 8 weeks (no-training phase). They subsequently underwent our customized VPL program that included orientation-discrimination tasks in individualized blind fields and central letter-discrimination tasks three times per week for 8 weeks (training phase). We analyzed the luminance detection sensitivity and deviation as measured using Humphrey visual field tests before and after the no-training and training phases. The vision-related quality of life was assessed at baseline and at a 16-week follow-up using the National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25). RESULTS Changes in mean total deviation (MTD) scores were greater during the training phase than during the no-training phase (defective hemifield, p=0.002; whole field, p=0.004). The MTD scores improved during the training phase (defective hemifield, p=0.004; whole field, p=0.016), but not during the no-training phase (defective hemifield, p=0.178; whole field, p=0.178). The difference between the improved and worsened areas (≥6 dB changes in luminance detection sensitivity) was greater during the training phase than during the no-training phase (p=0.009). The vision-specific social functioning subscore of the NEI-VFQ-25 improved after the 16-week study period (p=0.040). CONCLUSIONS Our 8-week VFD-customized visual discrimination training protocol may effectively improve VFDs and vision-specific social functioning in chronic stroke patients.
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Affiliation(s)
- Eun Namgung
- Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea
| | | | | | | | - Eun-Jae Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | | | - Yuka Sasaki
- Department of Cognitive, Linguistic and Psychological Sciences, Brown University, Providence, RI, USA
| | - Takeo Watanabe
- Department of Cognitive, Linguistic and Psychological Sciences, Brown University, Providence, RI, USA
| | - Dong-Wha Kang
- Nunaps Inc., Seoul, Korea
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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Woudstra-de Jong JE, Busschbach JJ, Manning-Charalampidou SS, Vingerling JR, Pesudovs K. Assessment of patient-reported outcomes in vitreomacular interface disorders: A systematic literature review. Surv Ophthalmol 2024:S0039-6257(24)00099-7. [PMID: 39222799 DOI: 10.1016/j.survophthal.2024.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 08/26/2024] [Accepted: 08/26/2024] [Indexed: 09/04/2024]
Abstract
Patient-reported outcome measures (PROMs) assess the impact of disease on quality of life from the patient's perspective. Our purpose was to provide an overview of current PROMs used for vitreomacular interface disorders: macular hole, epiretinal membrane, and vitreomacular traction. We review the content coverage of all identified PROMs, assess them against quality-of-life issues as identified from earlier qualitative studies, and assess their psychometric quality (measurement properties). We identified 86 studies that used a PROM and 2 qualitative studies on quality of life of patients with a vitreomacular interface disorder. Current PROMs used in vitreomacular interface disorders have a limited content coverage and unknown psychometric quality. The National Eye Institute Visual Functioning Questionnaire was used most. None of the condition-specific PROMs used patient consultation during content development, and there is only a small overlap between the content of PROMs and quality-of-life issues in qualitative studies. Reporting of psychometric quality was sparse, and mostly limited to concurrent validity and responsiveness. There is a need for properly developed and validated PROMs in vitreomacular interface disorders.
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Affiliation(s)
- J E Woudstra-de Jong
- Rotterdam Ophthalmic Institute, Eye Hospital Rotterdam, Rotterdam, the Netherlands; Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - J J Busschbach
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - S S Manning-Charalampidou
- Rotterdam Ophthalmic Institute, Eye Hospital Rotterdam, Rotterdam, the Netherlands; Department of Vitreoretinal Surgery, Eye Hospital Rotterdam, Rotterdam, the Netherlands
| | - J R Vingerling
- Department of Ophthalmology, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - K Pesudovs
- School of Optometry and Vision Science, Medicine & Health, University of New South Wales, Sydney, New South Wales, Australia
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Szmulewicz DJ, Galli R, Tarnutzer AA. Patient-Related Outcome Measures for Oculomotor Symptoms in the Cerebellar Ataxias: Insights from Non-Cerebellar Disorders. CEREBELLUM (LONDON, ENGLAND) 2024; 23:1435-1448. [PMID: 38214833 PMCID: PMC11269357 DOI: 10.1007/s12311-024-01656-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/05/2024] [Indexed: 01/13/2024]
Abstract
In patients with cerebellar ataxia (CA), symptoms related to oculomotor dysfunction significantly affect quality of life (QoL). This study aimed to analyze the literature on patient-related outcome measures (PROMs) assessing QoL impacts of vestibular and cerebellar oculomotor abnormalities in patients with CA to identify the strengths and limitations of existing scales and highlight any areas of unmet need. A systematic review was conducted (Medline, Embase) of English-language original articles reporting on QoL measures in patients with vertigo, dizziness or CA. Pre-specified parameters were retrieved, including diseases studied, scales applied and conclusions drawn. Our search yielded 3671 articles of which 467 studies (n = 111,606 participants) were deemed relevant. The most frequently studied disease entities were (a) non-specific dizziness/gait imbalance (114 studies; 54,581 participants), (b) vestibular schwannomas (66; 15,360), and (c) vestibular disorders not further specified (66; 10,259). The Dizziness Handicap Inventory (DHI) was the most frequently used PROM to assess QoL (n = 91,851), followed by the Penn Acoustic Neuroma Quality-of-Life Scale (n = 12,027) and the Activities-Specific Balance Confidence Scale (n = 2'471). QoL-scores capturing symptoms related to oculomotor abnormalities in CA were rare, focused on visual impairments (e.g., National-Eye-Institute Visual Function Questionnaire, Oscillopsia Functional Impact, oscillopsia severity score) and were unvalidated. The DHI remains the most widely used and versatile scale for evaluating dizziness. A lack of well-established PROMs for assessing the impact of oculomotor-related symptoms on QoL in CA was noted, emphasizing the need for developing and validating a new QoL-score dedicated to the oculomotor domain for individuals with CA.
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Affiliation(s)
- David J Szmulewicz
- Balance Disorders and Ataxia Service, Royal Victoria Eye and Ear Hospital, Melbourne, VIC, Australia
- The Bionics Institute, Melbourne, VIC, Australia
- University of Melbourne AU, Melbourne, VIC, Australia
| | - Rocco Galli
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Alexander A Tarnutzer
- Faculty of Medicine, University of Zurich, Zurich, Switzerland.
- Department of Neurology, Cantonal Hospital of Baden, Baden, Switzerland.
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Pigeon C, Renaud J, Couturier Y, Giroux D, Sévigny A, Levert MJ, Levasseur M. Personalized Citizen Assistance for Social Participation (APIC) adapted for older adults with visual impairment: results from a mixed study. Disabil Rehabil 2024:1-12. [PMID: 39082247 DOI: 10.1080/09638288.2024.2383833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 07/19/2024] [Accepted: 07/19/2024] [Indexed: 08/02/2024]
Abstract
PURPOSE To explore the effects of the Personalized Citizen Assistance for Social Participation (APIC), an intervention adapted here for visual impairment, involving weekly stimulation sessions over six to twelve months, provided by trained and supervised attendants, on seven outcomes (social participation, leisure, independence, mobility, quality of life, health-related quality of life, and empowerment) in older adults with visual impairment, and to document its facilitators and barriers. METHODS A mixed-method design, which included a pre-experimental and an exploratory qualitative clinical research component, was used on 8 older adults (7 women) with visual impairment aged 70-86, and 8 attendants (5 women) aged 20-74. Before the intervention, directly after, and four months later, older adults completed questionnaires on the 7 outcomes. During the intervention, attendants completed diaries and participated in monthly meetings. Semi-structured interviews were administered to all participants after the intervention. RESULTS Social participation, leisure, mobility, quality of life and empowerment had increased immediately after the APIC. These improvements were still generally observed four months later. Participants reported that the APIC improved older adults' capabilities, social participation, and social environment. CONCLUSIONS The APIC is a promising intervention which helps older adults with visual impairment to deal with social restrictions.
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Affiliation(s)
- Caroline Pigeon
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Canada
- Research Centre on Aging, Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Canada
| | - Judith Renaud
- School of Optometry, Université de Montréal, Montreal, Canada
| | - Yves Couturier
- School of Social Work, Université de Sherbrooke, Sherbrooke, Canada
| | - Dominique Giroux
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec, Canada
- Centre d'Excellence du Vieillissement de Québec, Chu de Québec, Québec, Canada
- VITAM Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Laval University, Québec, Canada
| | - Andrée Sévigny
- Centre d'Excellence du Vieillissement de Québec, Chu de Québec, Québec, Canada
| | - Marie-Josée Levert
- Faculty of Nursing, University of Montreal, Montréal, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Québec, Canada
| | - Mélanie Levasseur
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Canada
- Research Centre on Aging, Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Canada
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Eom Y, Jun I, Jeon HS, Lim DH, Lee H, Hwang HS, Chung SH, Chung TY, Kim JY, Kim SW, Choi CY, Song JS, Kim MK, Seo KY, Hyon JY. Re-Esterified Triglyceride ω-3 Fatty Acids in Dry Eye Disease With Meibomian Gland Dysfunction: A Randomized Clinical Trial. JAMA Ophthalmol 2024; 142:617-624. [PMID: 38753336 PMCID: PMC11099841 DOI: 10.1001/jamaophthalmol.2024.1482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 03/10/2024] [Indexed: 05/19/2024]
Abstract
Importance Taking ω-3 supplements has been associated with a reduction in symptoms of dry eye disease (DED) associated with meibomian gland dysfunction (MGD). However, a recent relatively large clinical trial concluded that treating DED with ω-3 consumption was ineffective, potentially warranting additional investigations. Objectives To investigate the effect of re-esterified triglyceride (rTG) ω-3 fatty acid supplementation on DED associated with MGD. Design, Setting, and Participants This double-masked, parallel-group, randomized clinical trial was conducted at 7 institutions from September 2020 to January 2023. Patients with DED associated with MGD were included and randomly assigned to the ω-3 group (received 1680 mg of eicosapentaenoic acid and 560 mg of docosahexaenoic acid), whereas those in the grape-seed group received 3000 mg of grape-seed oil daily. Interventions rTG ω-3 Fatty acid supplementation vs grape-seed oil. Main Outcome Measures The primary end point was the Ocular Surface Disease Index (OSDI) from baseline to 6 and 12 weeks. The safety parameters were visual acuity and intraocular pressure change. Results A total of 132 patients (mean [SD] age, 50.6 [13.8] years; 103 female [78.0%]) were included in this study. The mean (SD) baseline OSDI scores of the ω-3 and grape-seed groups were 43.5 (16.5) and 44.1 (16.6), respectively. A total of 58 patients (87.9%) and 57 patients (86.4%) in the ω-3 and grape-seed groups, respectively, completed 12 weeks of follow-up. There were no differences in compliance with the dietary supplement intake between groups (ω-3, 95.8% and grape-seed, 95.4%). The OSDI (SD) change from baseline to 6 and 12 weeks was -20.5 (16.0) and -22.7 (15.7), respectively, in the ω-3 group and -15.1 (20.2) and -18.8 (21.7), respectively, in the grape-seed control group (difference at 6 weeks = -5.4; 95% CI, -12.15 to 1.33; P = .12 and at 12 weeks = -3.9; 95% CI, -10.90 to 3.13; P = .28). There were no changes in safety parameters or adverse events related to taking the dietary supplement in either group. Conclusions and Relevance This randomized clinical trial did not show a benefit of the rTG form of ω-3 for ameliorating symptoms of DED associated with MGD, although fewer than 60 participants were evaluated in each group. Any secondary outcomes from this study should be considered for hypothesis generation of future evaluations of the effect of the rTG form of ω-3 on DED associated with MGD. Trial Registration CRIS Identifier: KCT0004927.
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Affiliation(s)
- Youngsub Eom
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Republic of Korea
- Department of Ophthalmology, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - Ikhyun Jun
- The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Republic of Korea
- Corneal Dystrophy Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyun Sun Jeon
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Dong Hui Lim
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hun Lee
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Ho Sik Hwang
- Department of Ophthalmology, Yeouido St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - So-Hyang Chung
- Department of Ophthalmology, Seoul St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Tae-Young Chung
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jae Yong Kim
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sun Woong Kim
- Department of Ophthalmology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Chul Young Choi
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jong Suk Song
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Republic of Korea
- Department of Ophthalmology, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Mee Kum Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea
- Laboratory of Ocular Regenerative Medicine and Immunology, Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute, Republic of Korea
| | - Kyoung Yul Seo
- The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Joon Young Hyon
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
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8
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Dogra N, Redmond BV, Lilley S, Johnson BA, Lam BL, Tamhankar M, Feldon SE, Fahrenthold B, Yang J, Huxlin KR, Cavanaugh MR. Vision-related quality of life after unilateral occipital stroke. Brain Behav 2024; 14:e3582. [PMID: 38956813 PMCID: PMC11219293 DOI: 10.1002/brb3.3582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 04/22/2024] [Accepted: 05/17/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND/OBJECTIVES Stroke damage to the primary visual cortex induces large, homonymous visual field defects that impair daily living. Here, we asked if vision-related quality of life (VR-QoL) is impacted by time since stroke. SUBJECTS/METHODS We conducted a retrospective meta-analysis of 95 occipital stroke patients (female/male = 26/69, 27-78 years old, 0.5-373.5 months poststroke) in whom VR-QoL was estimated using the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ) and its 10-item neuro-ophthalmic supplement (Neuro10). Visual deficit severity was represented by the perimetric mean deviation (PMD) calculated from 24-2 Humphrey visual fields. Data were compared with published cohorts of visually intact controls. The relationship between VR-QoL and time poststroke was assessed across participants, adjusting for deficit severity and age with a multiple linear regression analysis. RESULTS Occipital stroke patients had significantly lower NEI-VFQ and Neuro10 composite scores than controls. All subscale scores describing specific aspects of visual ability and functioning were impaired except for ocular pain and general health, which did not differ significantly from controls. Surprisingly, visual deficit severity was not correlated with either composite score, both of which increased with time poststroke, even when adjusting for PMD and age. CONCLUSIONS VR-QoL appears to improve with time postoccipital stroke, irrespective of visual deficit size or patient age at insult. This may reflect the natural development of compensatory strategies and lifestyle adjustments. Thus, future studies examining the impact of rehabilitation on daily living in this patient population should consider the possibility that their VR-QoL may change gradually over time, even without therapeutic intervention.
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Affiliation(s)
- Neil Dogra
- Department of Ophthalmology, Flaum Eye Institute and Center for Visual ScienceUniversity of RochesterRochesterNew YorkUSA
| | - Bryan V. Redmond
- Department of Ophthalmology, Flaum Eye Institute and Center for Visual ScienceUniversity of RochesterRochesterNew YorkUSA
| | - Selena Lilley
- Department of Ophthalmology, Flaum Eye Institute and Center for Visual ScienceUniversity of RochesterRochesterNew YorkUSA
| | - Brent A. Johnson
- Department of Biostatistics and Computational BiologyUniversity of RochesterRochesterNew YorkUSA
| | - Byron L. Lam
- Bascom Palmer Eye InstituteUniversity of MiamiMiamiFloridaUSA
| | - Madhura Tamhankar
- Scheie Eye InstituteUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Steven E. Feldon
- Department of Ophthalmology, Flaum Eye Institute and Center for Visual ScienceUniversity of RochesterRochesterNew YorkUSA
| | - Berkeley Fahrenthold
- Department of Ophthalmology, Flaum Eye Institute and Center for Visual ScienceUniversity of RochesterRochesterNew YorkUSA
| | - Jingyi Yang
- Department of Ophthalmology, Flaum Eye Institute and Center for Visual ScienceUniversity of RochesterRochesterNew YorkUSA
| | - Krystel R. Huxlin
- Department of Ophthalmology, Flaum Eye Institute and Center for Visual ScienceUniversity of RochesterRochesterNew YorkUSA
| | - Matthew R. Cavanaugh
- Department of Ophthalmology, Flaum Eye Institute and Center for Visual ScienceUniversity of RochesterRochesterNew YorkUSA
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Ríos HA, Lövestam-Adrian M, Plainis S, Tsilimbaris M, Joussen AM, Keegan D, Charles M, Cunha-Vaz J, Midena E. Additional measures of macular function beyond visual acuity. Graefes Arch Clin Exp Ophthalmol 2024; 262:1723-1736. [PMID: 37938378 PMCID: PMC11106142 DOI: 10.1007/s00417-023-06272-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 09/29/2023] [Accepted: 10/09/2023] [Indexed: 11/09/2023] Open
Abstract
PURPOSE Visual function is a complex process in which external visual stimuli are interpreted. Patients with retinal diseases and prolonged follow-up times may experience changes in their visual function that are not detected by the standard visual acuity measure, as they are a result of other alterations in visual function. With the advancement of different methods to evaluate visual function, additional measurements have become available, and further standardization suggests that some methods may be promising for use in clinical trials or routine clinical practice. The objectives of this article are to review these additional measurements and to provide guidance on their application. METHODS The Vision Academy's membership of international retinal disease experts reviewed the literature and developed consensus recommendations for the application of additional measures of visual function in routine clinical practice or clinical trials. RESULTS Measures such as low-luminance visual acuity, contrast sensitivity, retinal fixation and microperimetry, and reading performance are measures which can complement visual acuity measurements to provide an assessment of overall visual function, including impact on patients' quality of life. Measures such as dark adaptation, color vision testing, binocular vision testing, visual recognition testing, and shape discrimination require further optimization and validation before they can be implemented in everyday clinical practice. CONCLUSION Additional measurements of visual function may help identify patients who could benefit from earlier diagnosis, detection of disease progression, and therapeutic intervention. New and additional functional clinical trial endpoints are required to fully understand the early stages of macular disease, its progression, and the response to treatment.
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Affiliation(s)
- Hernán Andrés Ríos
- Retina y Vítreo, Fundación Oftalmológica Nacional, Universidad del Rosario, Bogotá, Colombia
| | | | - Sotiris Plainis
- Laboratory of Optics and Vision, University of Crete Medical School, Heraklion, Crete, Greece
| | - Miltiadis Tsilimbaris
- Laboratory of Optics and Vision, University of Crete Medical School, Heraklion, Crete, Greece
| | | | - David Keegan
- Department of Ophthalmology, Mater Misericordiae University Hospital, Dublin, Ireland
| | | | - José Cunha-Vaz
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Edoardo Midena
- Department of Ophthalmology, University of Padova, Padua, Italy.
- IRCCS Fondazione Bietti, Rome, Italy.
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10
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Kha R, Macken O, Mitchell P, Liew G, Keay L, Waddell C, Yang E, Do V, Fricke T, Newall J, Gopinath B. The Australian Eye and Ear Health Survey (AEEHS): Study protocol for a population-based cross-sectional study. PLoS One 2024; 19:e0301846. [PMID: 38820367 PMCID: PMC11142534 DOI: 10.1371/journal.pone.0301846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 03/21/2024] [Indexed: 06/02/2024] Open
Abstract
INTRODUCTION Vision and hearing impairments are highly prevalent and have a significant impact on physical, psychological and social wellbeing. There is a need for accurate, contemporary national data on the prevalence, risk factors and impacts of vision and hearing loss in Australian adults. OBJECTIVES The Australian Eye and Ear Health Survey (AEEHS) aims to determine the prevalence, risk factors and impacts of vision and hearing loss in both Aboriginal and Torres Strait Islander and non-Indigenous older adults. METHODS AND ANALYSIS The AEEHS is a population-based cross-sectional survey which will include 5,000 participants (3250 non-Indigenous aged 50 years or older and 1750 Aboriginal and Torres Strait Islander people aged 40 years or older) from 30 sites covering urban and rural/regional geographic areas, selected using a multi-stage, random cluster sampling strategy. Questionnaires will be administered to collect data on socio-demographic, medical, ocular and ontological history. The testing battery includes assessment of blood pressure, blood sugar, anthropometry, visual acuity (presenting, unaided, pinhole and best-corrected), refraction, tonometry, slit lamp and dilated eye examination, ocular imaging including optical coherence tomography (OCT), OCT-angiography and retinal photography, and automated visual fields. Audiometry, tympanometry and video otoscopy will also be performed. The primary outcomes are age-standardised prevalence of cause-specific vision and hearing impairment. Secondary outcomes are prevalence of non-blinding eye diseases (including dry eye disease), patterns in health service utilisation, universal health coverage metrics, risk factors for vision and hearing impairment, and impact on quality of life.
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Affiliation(s)
- Richard Kha
- Centre for Vision Research, Department of Ophthalmology, The Westmead Institute for Medical Research, Westmead, Sydney, NSW, Australia
| | - Oonagh Macken
- Macquarie University Hearing, Faculty of Medicine, Health and Human Sciences, The Australian Hearing Hub, Macquarie University, Macquarie Park, NSW, Australia
| | - Paul Mitchell
- Centre for Vision Research, Department of Ophthalmology, The Westmead Institute for Medical Research, Westmead, Sydney, NSW, Australia
| | - Gerald Liew
- Centre for Vision Research, Department of Ophthalmology, The Westmead Institute for Medical Research, Westmead, Sydney, NSW, Australia
| | - Lisa Keay
- School of Optometry and Vision Science, Faculty of Science, UNSW Sydney, Sydney, NSW, Australia
| | | | - Eleanor Yang
- School of Optometry and Vision Science, Faculty of Science, UNSW Sydney, Sydney, NSW, Australia
| | - Vu Do
- Centre for Vision Research, Department of Ophthalmology, The Westmead Institute for Medical Research, Westmead, Sydney, NSW, Australia
| | - Tim Fricke
- School of Optometry and Vision Science, Faculty of Science, UNSW Sydney, Sydney, NSW, Australia
- Brien Holden Foundation, Sydney, NSW, Australia
| | - John Newall
- School of Optometry and Vision Science, Faculty of Science, UNSW Sydney, Sydney, NSW, Australia
| | - Bamini Gopinath
- School of Optometry and Vision Science, Faculty of Science, UNSW Sydney, Sydney, NSW, Australia
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11
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Marolo P, Borrelli E, Caselgrandi P, Parisi G, Gelormini F, Ricardi F, Ceroni L, Fallico M, Toro MD, Ventre L, Reibaldi M. Comparison of Functional, Structural, and Microvascular Features in Different Stages of Idiopathic Epiretinal Membrane. J Clin Med 2024; 13:3188. [PMID: 38892898 PMCID: PMC11172683 DOI: 10.3390/jcm13113188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 05/20/2024] [Accepted: 05/23/2024] [Indexed: 06/21/2024] Open
Abstract
Background: Idiopathic epiretinal membrane (ERM) often leads to visual symptoms such as metamorphopsia and decreased central vision. This study aimed to evaluate functional, structural, and microvascular characteristics in patients with different stages of idiopathic ERM who were candidates for surgery, with a focus on identifying potential indicators for surgical timing. Methods: A retrospective cohort study was conducted on consecutive patients with unilateral idiopathic ERM who were candidates for surgery. Patients underwent comprehensive ophthalmological assessments, including OCT grading, reading performance evaluation, and OCT angiography. Data analysis included comparisons between different ERM stages for functional, structural, and microvascular parameters. Results: A total of 44 eyes were included, classified into four ERM stages according to the Govetto grading system. Functional parameters, including distance and near visual acuity, worsened significantly with higher ERM stages, particularly in the transition from Stage 3 to Stage 4. Structural assessments revealed significant increases in central macular thickness (CMT) from Stage 3 to Stage 4. No significant differences were observed in microvascular features across different ERM stages. Conclusions: This study highlights the significant functional and anatomical impact of OCT staging in idiopathic ERM, particularly during the transition from Stage 3 to Stage 4, characterized by notable reductions in visual acuity and increases in CMT. These findings underscore the importance of considering both functional and structural parameters in surgical decision-making for ERM management. However, further research with larger cohorts is needed to confirm these observations and inform clinical practice.
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Affiliation(s)
- Paola Marolo
- Department of Ophthalmology, University of Turin, 10126 Turin, Italy; (E.B.); (P.C.); (G.P.); (F.G.); (F.R.); (M.R.)
| | - Enrico Borrelli
- Department of Ophthalmology, University of Turin, 10126 Turin, Italy; (E.B.); (P.C.); (G.P.); (F.G.); (F.R.); (M.R.)
| | - Paolo Caselgrandi
- Department of Ophthalmology, University of Turin, 10126 Turin, Italy; (E.B.); (P.C.); (G.P.); (F.G.); (F.R.); (M.R.)
| | - Guglielmo Parisi
- Department of Ophthalmology, University of Turin, 10126 Turin, Italy; (E.B.); (P.C.); (G.P.); (F.G.); (F.R.); (M.R.)
| | - Francesco Gelormini
- Department of Ophthalmology, University of Turin, 10126 Turin, Italy; (E.B.); (P.C.); (G.P.); (F.G.); (F.R.); (M.R.)
| | - Federico Ricardi
- Department of Ophthalmology, University of Turin, 10126 Turin, Italy; (E.B.); (P.C.); (G.P.); (F.G.); (F.R.); (M.R.)
| | - Luca Ceroni
- Department of Psychology, University of Turin, 10124 Turin, Italy;
| | - Matteo Fallico
- Department of Ophthalmology, University of Catania, 95123 Catania, Italy;
| | - Mario Damiano Toro
- Department of General Ophthalmology, Medical University of Lublin, 20079 Lublin, Poland;
- Eye Clinic, Public Health Department, Federico II University, 80131 Naples, Italy
| | - Luca Ventre
- Department of Ophthalmology, Beauregard Hospital, 11100 Aosta, Italy;
| | - Michele Reibaldi
- Department of Ophthalmology, University of Turin, 10126 Turin, Italy; (E.B.); (P.C.); (G.P.); (F.G.); (F.R.); (M.R.)
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12
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Bek T, Bech BH. Ophthalmic quality of life in the adult Danish population: an epidemiological study. Br J Ophthalmol 2024:bjo-2023-324414. [PMID: 38777390 DOI: 10.1136/bjo-2023-324414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 05/08/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Ophthalmic quality of life (OQoL) has been investigated in selected parts of general populations and in patients with ocular disease, but OQoL in unselected general populations has not been studied in detail. The present study reports OQoL obtained from a representative sample of the adult Danish population 2020-2022. METHODS The FORSYN study invited 10 350 citizen representatives for the adult Danish population for a non-mydriatic eye examination and answer the National Eye Institute Visual Function Questionnaire with 39 items in the validated Danish translation. The results from the 3384 (32.7%) persons who participated in the study were weighted on the basis of relevant socio-economic factors, and data were projected to represent the total population. Binocular visual acuity was below 0.1 corresponding to legal blindness in 0.22% of this population. RESULTS OQoL was positively correlated with binocular visual acuity up to better than 93 ETDRS letters, negatively correlated with age for persons younger than 60 years of age and again positively correlated with age for persons older than 60 years. OQoL was negatively correlated with increasing ametropia and refractive error above 1 dioptre and encompassed more OQoL parameters for hyperopic than for myopic persons. CONCLUSIONS The study underlines the benefits of improving visual acuity even within the normal range and of adjusting uncorrected refraction errors in the general population. OQoL is positively correlated with age in older persons independently of visual acuity, sex, refractive power and previous cataract surgery.
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Affiliation(s)
- Toke Bek
- Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark
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13
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Ktistakis E, Gleni A, Tsilimbaris MK, Plainis S. Comparing silent reading performance for single sentences and paragraphs: an eye movement-based analysis. Clin Exp Optom 2024; 107:449-456. [PMID: 37674271 DOI: 10.1080/08164622.2023.2237974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 07/14/2023] [Indexed: 09/08/2023] Open
Abstract
CLINICAL RELEVANCE Reading performance in clinical practice is commonly evaluated by reading 'aloud' and 'as fast as possible' single sentences. Assessing comprehensive silent reading performance using passages, composed of multiple sentences, is the preferred reading mode in real-life reading conditions. BACKGROUND The purpose of this study was to compare eye movement-based silent reading performance for standardised short sentences and paragraphs. METHODS A group of 15 young volunteers (age range: 22-36 years) read silently and comprehensively in two sessions: (a) a paragraph with continuous text and (b) standardised short sentences. Text print size was 0.4 logMAR (1.0 M at 40 cm distance). Eye movements during reading were recorded using video oculography (EyeLink II, SR Research Ltd). Data analysis included computation of reading speed, fixation duration, the number of fixations, saccadic amplitude and percentage of regressions. Moreover, frequency distributions of fixation durations were analysed with ex-Gaussian fittings. RESULTS Repeatability coefficient in silent reading speed was found better for the paragraph (66 wpm) than for short sentences (88 wpm). The superiority in repeatability coefficient for the corresponding eye movement parameters, i.e. fixation duration (35 vs 73 ms), regressions (10.1 vs. 22.3%) and fixations per word (0.21 vs. 0.37 fpw), was even more pronounced. In addition, a statistically significant improvement with the paragraph was found in average fixation duration (19 ± 26 ms, p = 0.02), regressions (4.2 ± 7.0%, p = 0.04) and ex-Gaussian fixation parameter, τ (82 vs. 111 ms). No statistically significant difference was found between average reading speed with the paragraph (220 ± 59 wpm) and the short sentences (206 ± 57 wpm) (p = 0.11). DISCUSSION Due to their superior repeatability, paragraphs are preferable to short sentences when evaluating silent comprehensive reading. The concurrent recording of eye movement parameters in silent reading further improves variability and could offer an efficient measure of reading performance and a reliable biomarker of visuo-motor function.
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Affiliation(s)
- Emmanouil Ktistakis
- Laboratory of Optics and Vision, School of Medicine, University of Crete, Heraklion, Greece
| | - Angeliki Gleni
- Laboratory of Optics and Vision, School of Medicine, University of Crete, Heraklion, Greece
| | | | - Sotiris Plainis
- Laboratory of Optics and Vision, School of Medicine, University of Crete, Heraklion, Greece
- Optometry & Vision Science Research Group, Aston University School of Life and Health Sciences, Birmingham, UK
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14
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van der Zee C, Muijzer MB, van den Biggelaar FJHM, Nuijts RMMA, Delbeke H, Dickman MM, Imhof SM, Wisse RPL. Cost-effectiveness of the ADVISE trial: An intraoperative OCT protocol in DMEK surgery. Acta Ophthalmol 2024; 102:254-262. [PMID: 37340731 DOI: 10.1111/aos.15729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 05/09/2023] [Accepted: 06/12/2023] [Indexed: 06/22/2023]
Abstract
The intraoperative optical coherence tomography (iOCT) is recently introduced in Descemet membrane endothelial keratoplasty (DMEK) surgery, which aims to increase clinical performance and surgery safety. However, the acquisition of this modality is a substantial investment. The objective of this paper is to report on the cost-effectiveness of an iOCT-protocol in DMEK surgery with the Advanced Visualization in Corneal Surgery Evaluation (ADVISE) trial. This cost-effectiveness analysis uses data 6 months postoperatively from the multicentre prospective randomized clinical ADVISE trial. Sixty-five patients were randomized to usual care (n = 33) or the iOCT-protocol (n = 32). Quality-Adjusted Life Years (EQ-5D-5L), Vision-related Quality of Life (NEI-VFQ-25) and self-administered resources questionnaires were administered. Main outcome is the incremental cost-effectiveness ratio (ICER) and sensitivity analyses. The iOCT protocol reports no statistical difference in ICER. For the usual care group compared with the iOCT protocol, respectively, the mean societal costs are €5027 compared with €4920 (Δ€107). The sensitivity analyses report the highest variability on time variables. This economic evaluation learned that there is no added value in quality of life or cost-effectiveness in using the iOCT protocol in DMEK surgery. The variability of cost variables depends on the characteristics of an eye clinic. The added value of iOCT could gain incrementally by increasing surgical efficiency, and aiding in surgical decision-making.
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Affiliation(s)
- Casper van der Zee
- Utrecht Cornea Research Group, Ophthalmology Department, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marc B Muijzer
- Utrecht Cornea Research Group, Ophthalmology Department, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Rudy M M A Nuijts
- University Eye Clinic, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Heleen Delbeke
- Ophthalmology Department, University Hospital Leuven, Leuven, Belgium
- KU Leuven, Biomedical Sciences Group, Department of Neurosciences, Research Group Ophthalmology, Leuven, Belgium
| | - Mor M Dickman
- University Eye Clinic, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Saskia M Imhof
- Utrecht Cornea Research Group, Ophthalmology Department, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Robert P L Wisse
- Utrecht Cornea Research Group, Ophthalmology Department, University Medical Center Utrecht, Utrecht, The Netherlands
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Flaharty K, Niziol LM, Woodward MA, Elam A, Bicket A, Killeen OJ, Zhang J, Johnson L, Kershaw M, John DA, Wood SK, Musch DC, Newman-Casey PA. Association of Contrast Sensitivity With Eye Disease and Vision-Related Quality of Life. Am J Ophthalmol 2024; 261:176-186. [PMID: 38281569 DOI: 10.1016/j.ajo.2024.01.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 01/15/2024] [Accepted: 01/19/2024] [Indexed: 01/30/2024]
Abstract
PURPOSE To investigate contrast sensitivity (CS) as a screening tool to detect eye disease and assess its association with both eye disease and vision-related quality of life. DESIGN Cross-sectional study. METHODS Setting and population: Adults receiving care from a free clinic and a Federally Qualified Health Center in Michigan. MAIN OUTCOME MEASURES Screening positive for eye disease and Visual Function Questionnaire (VFQ) score. OBSERVATION Participants received a vision exam reviewed via telemedicine for disease, completed a demographic survey, and the 9-item VFQ. The ability of CS to predict eye disease was explored and area under the curve (AUC) is reported. Logistic and linear regression were used to investigate the continuous effect of CS on the probability of screening positive for eye disease and VFQ score, respectively, adjusting for age and visual acuity. RESULTS 1159 included participants were, on average, 54.9 ± 14.5 years old, 62% identified as female, 34% as White, 54% as Black, 10% as Hispanic/Latino, and reported mean VFQ score of 79.7 ± 15.3. CS ranged from 0.00 to 1.95 log units (mean = 1.54 ± 0.24), 21% of eyes had glaucoma, 19% cataract, 6% DR, and 2% AMD. AUCs were 0.53 to 0.73. A 0.3 log unit decrease in better eye CS was associated with increased odds of glaucoma (odds ratio [OR] = 1.35, confidence interval [CI] = 1.09-1.67), cataract (OR = 1.35, CI = 1.05-1.72), DR (OR = 2.05, CI = 1.51-2.77), and AMD (OR = 2.08, CI = 1.10-3.91). A 0.3 log unit increase in better eye CS was associated with a 5.9 unit increase in VFQ. CONCLUSION While CS alone is not sufficient to identify people with eye disease, it is an important measure of visual function that can add value to comprehensive eye screening.
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Affiliation(s)
- Kathryn Flaharty
- From the University of Michigan Medical School (K.F.), Ann Arbor, Michigan, USA
| | - Leslie M Niziol
- Department of Ophthalmology and Visual Sciences, University of Michigan (L.M.N., M.A.W., A.E., A.B., O.J.K., J.Z., D.A.J., S.K.W., D.C.M., P.A.N.-C.), Ann Arbor, Michigan, USA
| | - Maria A Woodward
- Department of Ophthalmology and Visual Sciences, University of Michigan (L.M.N., M.A.W., A.E., A.B., O.J.K., J.Z., D.A.J., S.K.W., D.C.M., P.A.N.-C.), Ann Arbor, Michigan, USA
| | - Angela Elam
- Department of Ophthalmology and Visual Sciences, University of Michigan (L.M.N., M.A.W., A.E., A.B., O.J.K., J.Z., D.A.J., S.K.W., D.C.M., P.A.N.-C.), Ann Arbor, Michigan, USA
| | - Amanda Bicket
- Department of Ophthalmology and Visual Sciences, University of Michigan (L.M.N., M.A.W., A.E., A.B., O.J.K., J.Z., D.A.J., S.K.W., D.C.M., P.A.N.-C.), Ann Arbor, Michigan, USA
| | - Olivia J Killeen
- Department of Ophthalmology and Visual Sciences, University of Michigan (L.M.N., M.A.W., A.E., A.B., O.J.K., J.Z., D.A.J., S.K.W., D.C.M., P.A.N.-C.), Ann Arbor, Michigan, USA
| | - Jason Zhang
- Department of Ophthalmology and Visual Sciences, University of Michigan (L.M.N., M.A.W., A.E., A.B., O.J.K., J.Z., D.A.J., S.K.W., D.C.M., P.A.N.-C.), Ann Arbor, Michigan, USA
| | - Leroy Johnson
- Hamilton Community Health Network (L.J.), Flint, Michigan, USA
| | | | - Denise A John
- Department of Ophthalmology and Visual Sciences, University of Michigan (L.M.N., M.A.W., A.E., A.B., O.J.K., J.Z., D.A.J., S.K.W., D.C.M., P.A.N.-C.), Ann Arbor, Michigan, USA
| | - Sarah K Wood
- Department of Ophthalmology and Visual Sciences, University of Michigan (L.M.N., M.A.W., A.E., A.B., O.J.K., J.Z., D.A.J., S.K.W., D.C.M., P.A.N.-C.), Ann Arbor, Michigan, USA
| | - David C Musch
- Department of Ophthalmology and Visual Sciences, University of Michigan (L.M.N., M.A.W., A.E., A.B., O.J.K., J.Z., D.A.J., S.K.W., D.C.M., P.A.N.-C.), Ann Arbor, Michigan, USA; Department of Epidemiology, School of Public Health, University of Michigan (D.C.M.), Ann Arbor, Michigan, USA
| | - Paula Anne Newman-Casey
- Department of Ophthalmology and Visual Sciences, University of Michigan (L.M.N., M.A.W., A.E., A.B., O.J.K., J.Z., D.A.J., S.K.W., D.C.M., P.A.N.-C.), Ann Arbor, Michigan, USA.
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Gittel L, Li JQ, Dell J, Wintergerst MWM, Heinz C, Finger RP, Terheyden JH. Piloting Rasch model scoring of the National Eye Institute Visual Function Questionnaire in uveitis. J Ophthalmic Inflamm Infect 2024; 14:16. [PMID: 38625428 PMCID: PMC11021379 DOI: 10.1186/s12348-024-00398-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 04/07/2024] [Indexed: 04/17/2024] Open
Abstract
INTRODUCTION The National Eye Institute Visual Function Questionnaire (NEI VFQ) is a common patient-reported outcome measure (PROM) in uveitis trials. Its psychometric properties using state-of-the-art scoring based on Rasch models, a latent trait model that improves accuracy of PROMs assessment, has not yet been investigated. METHODS The study participants were recruited online from uveitis patient organizations, where individuals self-reported their uveitis diagnosis and visual acuity level. These participants then completed the NEI VFQ-25. The visual function (VF) and socioemotional (SE) subscales were psychometrically analysed in terms of item fit, targeting, internal consistency, dimensionality, and differential item functioning (DIF), using Rasch models. Criterion validity was examined based on associations between NEI VFQ person measures and recent visual acuity (VA) levels. RESULTS Ninety-nine participants recruited online from uveitis patient organizations (68 women, 31 men; mean age 50 ± 15 years; 46.5% self-reported receiving systematic therapy for uveitis, 0.6% NEI VFQ-25 missing data) were included. The mean difficulty of items was lower than the average person ability. None of the items demonstrated misfit to an extent that would induce noise into the measurement. The consistency metrics person reliability and person separation index of the subscales were 0.85 and 2.34 (NEI VFQ-VF), 0.86 and 2.52 (NEI VFQ-SE), respectively. There was no evidence of multidimensionality and none of the items showed DIF by gender. The differences between item and person measures were 1.44 (NEI VFQ-VF) and 1.03 (NEI VFQ-SE). NEI VFQ-25 person measures were significantly lower in participants with visual impairment (all p values ≤ 0.007). CONCLUSION Rasch model-based scoring of the re-engineered NEI VFQ-25 demonstrates acceptable internal consistency, item fit and construct validity for assessing two key domains of quality of life in individuals self-reporting uveitis. The PROM was targeted at a higher level of difficulty than present in our heterogeneous sample.
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Affiliation(s)
- Lisa Gittel
- Department of Ophthalmology, University Hospital Bonn, Venusberg-Campus 1, Bonn, NRW, 53127, Germany
| | - Jeany Q Li
- Department of Ophthalmology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Jennifer Dell
- Department of Ophthalmology, University Hospital Bonn, Venusberg-Campus 1, Bonn, NRW, 53127, Germany
| | | | - Carsten Heinz
- Department of Ophthalmology, St. Franziskus Hospital Münster, Münster, Germany
- Department of Ophthalmology, University Duisburg-Essen, Essen, Germany
| | - Robert P Finger
- Department of Ophthalmology, University Hospital Bonn, Venusberg-Campus 1, Bonn, NRW, 53127, Germany
- Department of Ophthalmology, University Hospital Mannheim & Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Jan Henrik Terheyden
- Department of Ophthalmology, University Hospital Bonn, Venusberg-Campus 1, Bonn, NRW, 53127, Germany.
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Abdin AD, Eppinger A, Aljundi W, Abu-Dail Y, Munteanu C, Weinstein I, Seitz B. Vision-Related Quality of Life among Patients with Different Types of Age-Related Macular Degeneration. Klin Monbl Augenheilkd 2024; 241:283-291. [PMID: 37673087 DOI: 10.1055/a-2134-7622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
BACKGROUND This study aimed to assess the vision-related quality of life (VRQol) of patients with age-related macular degeneration (AMD) and to evaluate VRQol according to different types of AMD. METHODS In this small-scale, single-center, prospective investigation, patients with AMD and subjects without any signs of macular disease were asked to complete the NEI-VFQ-39. A total of 159 subjects were included and grouped according to the type of AMD as follows: 40 patients with dry AMD in both eyes (DD), 40 patients with exudative AMD in one eye (DE), 41 patients with exudative AMD in both eyes (EE), and 38 subjects without any signs of macular disease, as a control group (CG). RESULTS The average age of the participants was 76 ± 7 years, and 44% were male. Most participants were retired (22.4%), and 75% of patients were initially diagnosed by their ophthalmologist. All the AMD groups had significantly worse overall VRQol than the CG. For general vision, near vision, mental health, and role difficulties, all the AMD groups had significantly lower scores than the CG. For distance vision, color vision, peripheral vision, driving difficulties, dependency, and social functioning, only patients in the EE and DE groups had significantly worse scores than the CG. The type of retinal fluid in patients with exudative AMD had no effect on overall VRQol; however, we found that the presence of pigment epithelial detachment could be associated with more role difficulties, such as completing work or working long hours. CONCLUSION All types of AMD had a negative effect on vision-related quality of life. This effect was significantly more pronounced in patients with exudative AMD in at least one eye. However, the type of retinal fluid in patients with exudative AMD had no influence on their overall vision-related quality of life.
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Affiliation(s)
- Alaa Din Abdin
- Department of Ophthalmology, Saarland University Medical Center UKS, Homburg/Saar, Germany
| | - Anna Eppinger
- Department of Ophthalmology, Saarland University Medical Center UKS, Homburg/Saar, Germany
| | - Wissam Aljundi
- Department of Ophthalmology, Saarland University Medical Center UKS, Homburg/Saar, Germany
| | - Yaser Abu-Dail
- Department of Ophthalmology, Saarland University Medical Center UKS, Homburg/Saar, Germany
| | - Cristian Munteanu
- Department of Ophthalmology, Saarland University Medical Center UKS, Homburg/Saar, Germany
| | - Isabel Weinstein
- Department of Ophthalmology, Saarland University Medical Center UKS, Homburg/Saar, Germany
| | - Berthold Seitz
- Department of Ophthalmology, Saarland University Medical Center UKS, Homburg/Saar, Germany
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Zang B, Rong S, Wang Y, Feng K, Ding X, Wen L, Zang D, Li D, Liang Y, Wang F, Zhai G. ASSOCIATION OF DIABETIC MACULAR EDEMA WITH QUALITY OF LIFE IN PATIENTS WITH TYPE 2 DIABETES: The Fushun Diabetic Retinopathy Cohort Study. Retina 2024; 44:537-544. [PMID: 37972959 DOI: 10.1097/iae.0000000000003992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/21/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE To report the vision-related quality of life in patients with diabetic macular edema (DME) in a population-based study. METHODS In this cross-sectional study, we analyzed 1,659 subjects with type 2 diabetes. Questionnaires were administered to assess the patient's vision-related quality of life. Diabetic macular edema severity was graded according to the established protocols. A subject's DME score ranged from 1 (no DME in either eye) to 7 (severe bilateral DME) using predefined criteria. RESULTS Composite 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) scores for participants with DME were 88.9 (interquartile range [IQR]: 76.2-94.9) compared with 92.0 (IQR: 82.7-96.0) for those without DME ( P < 0.001). Locally weighted scatterplot smoothing plots depicted a consistent decline in composite NEI-VFQ-25 scores corresponding to the escalation of bilateral DME severity: starting from 88.59 for no DME in either eye, progressing through 86.65, 85.83, 85.31, 84.91, 83.85, and culminating at 82.71 for bilateral severe DME. Notably, the locally weighted scatterplot smoothing plots highlighted significant NEI-VFQ-25 composite score reduction at unilateral mild DME (slope m = -1.94). CONCLUSION Significant changes in vision-related quality of life manifest in the early stage of DME. Therefore, early identification and intervention for these patients are crucial clinical objectives.
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Affiliation(s)
- Bo Zang
- Department of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, China
| | - Shisong Rong
- Ophthalmology, Mass Eye and Ear, Mass General Brigham, Harvard Medical School, Boston, Massachusetts
| | - Yu Wang
- Department of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, China
| | - Kemi Feng
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China; and
| | - Xiaoxia Ding
- Department of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, China
| | - Liang Wen
- Department of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, China
| | - Dongxiao Zang
- Department of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, China
| | - Dong Li
- Department of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, China
| | - Yuanbo Liang
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China; and
| | - Fenghua Wang
- Department of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Science Key Laboratory, Beijing, China
| | - Gang Zhai
- Department of Ophthalmology, Fushun Eye Hospital, Fushun, Liaoning, China
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Kulmala M, Jørgensen APM, Aakvik KAD, Jussinniemi L, Benum SD, Ingvaldsen SH, Austeng D, Kajantie E, Evensen KAI, Majander A, Morken TS. Visual function in adults born preterm with very low birth weight-A two-country birth cohort study. Acta Ophthalmol 2024; 102:49-57. [PMID: 37172142 DOI: 10.1111/aos.15683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/17/2023] [Accepted: 04/21/2023] [Indexed: 05/14/2023]
Abstract
PURPOSE The purpose of the study was to investigate visual function and vision-related general health in adults that were born preterm with very low birth weight (VLBW: birth weight < 1500 g) in their 30s-40s. METHODS We recruited 137 adults born preterm with VLBW and 158 term-born controls aged 31-43 years from two birth cohorts: the Helsinki Study of Very Low Birth Weight Adults (Finland) and the NTNU Low Birth Weight in a Lifetime Perspective study (Norway). We used neonatal data and measured refraction, best-corrected visual acuity (BCVA) using the Early Treatment Diabetic Retinopathy Study (ETDRS) chart, contrast sensitivity, visual fields, intraocular pressure (IOP), self-reported vision-targeted health status with the National Eye Institute Visual Function Questionnaire-25. RESULTS VLBW adults had a lower BCVA ETDRS score than controls: mean (SD) better eye 86.7 (13.4) versus 90.2 (4.4), p = 0.02; mean (SD) worse eye 82.3 (14.9) versus 87.6 (4.6), p = 0.003. VLBW adults also had lower contrast sensitivity thresholds in several spatial frequencies and scored lower than controls in eight out of the 12 subscales of self-reported vision-targeted health status. Refraction, visual fields and IOP were similar between groups. Two VLBW participants were blind. None had been treated for retinopathy of prematurity. CONCLUSION We suggest that lower visual function and vision-related health represent life-long consequences of prematurity and VLBW in the studied 31- to 43-year-old cohort. The underlying mechanisms remain to be determined.
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Affiliation(s)
- Maarit Kulmala
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Ophthalmology, Helsinki University Hospital, Helsinki, Finland
| | | | | | - Laura Jussinniemi
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Population Health Unit, Finnish Institute for Health and Welfare, Oulu, Finland
| | - Silje Dahl Benum
- Department of Clinical and Molecular Medicine, NTNU, Trondheim, Norway
| | - Sigrid Hegna Ingvaldsen
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Ophthalmology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Dordi Austeng
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Ophthalmology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Eero Kajantie
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Clinical and Molecular Medicine, NTNU, Trondheim, Norway
- PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Population Health Unit, Finnish Institute for Health and Welfare, Oulu, Finland
- Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Kari Anne I Evensen
- Department of Clinical and Molecular Medicine, NTNU, Trondheim, Norway
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
- Children's Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Anna Majander
- Department of Ophthalmology, Helsinki University Hospital, Helsinki, Finland
- University of Helsinki, Helsinki, Finland
| | - Tora Sund Morken
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Ophthalmology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
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Lee HJ, Cho S, Park J, Jin Y, Kim HM, Jee D. Cost-effectiveness of the anti-vascular endothelial growth factor intravitreal injection and panretinal photocoagulation for patients with proliferative diabetic retinopathy in South Korea. BMC Health Serv Res 2023; 23:1388. [PMID: 38082399 PMCID: PMC10714639 DOI: 10.1186/s12913-023-10280-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 11/06/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND We determined the cost-effectiveness of the anti-vascular endothelial growth factor (VEGF) intravitreal injection versus panretinal photocoagulation (PRP) for patients with proliferative diabetic retinopathy (PDR) in South Korea. METHODS We simulated four treatment strategies using PRP and the anti-VEGF injection by constructing a Markov model for a hypothetical cohort of 50-year-old PDR patients: (1) PRP only; (2) anti-VEGF injection only; (3) PRP first; and (4) anti-VEGF injection first. RESULTS In this cost-effectiveness analysis, compared with only-PRP, the incremental cost-effectiveness ratio was $95,456 per quality-adjusted life-year (QALY) for PRP first, $34,375 per QALY for anti-VEGF injection first, and $33,405 per QALY for anti-VEGF injection only from a healthcare perspective. From the societal and payer perspective, strategy (2) was more cost-saving and effective than (1). In the probabilistic sensitivity analysis, only-PRP was cost-effective up to the willingness-to-pay (WTP) of about $42,000, while anti-VEGF injection only was cost-effective from a healthcare perspective. From the societal and payer perspectives, regardless of the value of WTP, anti-VEGF injection only was the most cost-effective strategy. CONCLUSION In our study, the anti-VEGF injection for PDR was cost-effective from the payer and societal perspectives.
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Grants
- NA20-011, NAM21-004 National Evidence-based Healthcare Collaborating Agency
- NA20-011, NAM21-004 National Evidence-based Healthcare Collaborating Agency
- NA20-011, NAM21-004 National Evidence-based Healthcare Collaborating Agency
- NA20-011, NAM21-004 National Evidence-based Healthcare Collaborating Agency
- NA20-011, NAM21-004 National Evidence-based Healthcare Collaborating Agency
- NA20-011, NAM21-004 National Evidence-based Healthcare Collaborating Agency
- HC23C0130 Patient-Centered Clinical Research Coordinating Center (PACEN) funded by the Ministry of Health & Welfare, Republic of Korea
- HC23C0130 Patient-Centered Clinical Research Coordinating Center (PACEN) funded by the Ministry of Health & Welfare, Republic of Korea
- HC23C0130 Patient-Centered Clinical Research Coordinating Center (PACEN) funded by the Ministry of Health & Welfare, Republic of Korea
- HC23C0130 Patient-Centered Clinical Research Coordinating Center (PACEN) funded by the Ministry of Health & Welfare, Republic of Korea
- HC23C0130 Patient-Centered Clinical Research Coordinating Center (PACEN) funded by the Ministry of Health & Welfare, Republic of Korea
- HC23C0130 Patient-Centered Clinical Research Coordinating Center (PACEN) funded by the Ministry of Health & Welfare, Republic of Korea
- Patient-Centered Clinical Research Coordinating Center (PACEN) funded by the Ministry of Health & Welfare, Republic of Korea
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Affiliation(s)
- Hyeon-Jeong Lee
- Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, South Korea
| | - Songhee Cho
- Patient-Centered Clinical Research Coordinating Center, National Evidence-based Healthcare Collaborating Agency, Seoul, South Korea
| | - Jungeun Park
- Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, South Korea
| | - Yan Jin
- Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, South Korea
- Department of Rehabilitation, College of Acupuncture and Moxibustion and Massage Health Preservation and Rehabilitation, Nanjing University of Chinese Medicine, Jiangsu, China
| | - Hyung Min Kim
- Artificial intelligence, Kai Health, Seoul, South Korea
| | - Donghyun Jee
- Department of Ophthalmology and Visual Science, St. Vincent's Hospital, Suwon, South Korea.
- The College of Medicine, Catholic University of Korea, Seoul, South Korea.
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Jammal HM, Khader Y, Kanaan SF, Al-Dwairi R, Mohidat H, Al-Omari R, Alqudah N, Saleh OA, Alshorman H, Al Bdour M. The Effect of Visual Impairment and Its Severity on Vision-Related and Health-Related Quality of Life in Jordan: A Comparative Cross-Sectional Study. J Multidiscip Healthc 2023; 16:3043-3056. [PMID: 37873536 PMCID: PMC10590562 DOI: 10.2147/jmdh.s431159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 10/05/2023] [Indexed: 10/25/2023] Open
Abstract
Purpose To assess the effect of visual impairment (VI), its severity, and ocular diseases on vision-related and health-related quality of life (QoL) in Jordan. Patients and Methods A comparative, cross-sectional, hospital-based study was conducted among a group of 278 patients with VI aged ≥ 18 years, and age and sex-matched control group of 278 individuals with no VI. An interviewer administered the National Eye Institute Visual Function Questionnaire (NEI VFQ-25) and the Medical Outcomes Study 12-Item Short Form Health Survey (SF-12) to all participants. Results All the mean VFQ-25 subscales scores, physical component scale (PCS) and the mental component scale (MCS) of the SF-12 were significantly lower in patients with VI compared to controls with no VI. The VFQ-25 subscales (except general health and ocular pain), PCS, and MCS scores significantly decreased with more severity of VI. In the adjusted multivariate analysis, lower level of education (p=0.013), male sex (p=0.016), and the presence of cerebrovascular disease (p=0.019) were significantly associated with lower VFQ-25 composite scores in visually impaired patients compared to controls. Ocular disease duration of >5 years and progressive VI were significantly associated with lower VFQ-25 composite scores (p= 0.026 and p<0.001) respectively, in patients with VI. Glaucoma had a significantly larger reduction in mean scores of all the VFQ-25 subscales, and the PCS of the SF-12 compared to all other ocular diseases. Conclusion Both VI and increasing severity of impairment were associated with reduced vision-related and health-related quality of life in adult Jordanians. Glaucoma patients and less educated people were particularly affected. Routine assessment of QoL in visually impaired patients and improving referral protocols to vision rehabilitation services is recommended to improve the QoL in those patients.
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Affiliation(s)
- Hisham M Jammal
- Department of Ophthalmology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Yousef Khader
- Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Saddam F Kanaan
- Department of Rehabilitation Science, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Rami Al-Dwairi
- Department of Ophthalmology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Hasan Mohidat
- Department of Ophthalmology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Rami Al-Omari
- Department of Ophthalmology, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Noor Alqudah
- Department of Ophthalmology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Omar A Saleh
- Department of Ophthalmology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Haneen Alshorman
- Department of Ophthalmology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Muawyah Al Bdour
- Department of Ophthalmology, School of Medicine, The University of Jordan, Amman, Jordan
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Ktistakis E, Simos P, Tsilimbaris MK, Plainis S. Efficacy οf Wet Age-related Macular Degeneration Treatment οn Reading: A Pilot Study Using Eye-movement Analysis. Optom Vis Sci 2023; 100:670-678. [PMID: 37966366 DOI: 10.1097/opx.0000000000002064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023] Open
Abstract
SIGNIFICANCE Functional vision, as evaluated with silent passage reading speed, improves after anti-vascular endothelial growth factor (anti-VEGF) treatment in patients with wet age-related macular antidegeneration (wAMD), reflecting primarily a concomitant reduction in the number of fixations. Implementing eye movement analysis when reading may better characterize the effectiveness of therapeutic approaches in wAMD. PURPOSE This study aimed to evaluate silent reading performance by means of eye fixation analysis before and after anti-VEGF treatment in wAMD patients. METHODS Sixteen wAMD patients who underwent anti-VEGF treatment in one eye and visual acuity (VA) better than 0.5 logMAR served as the AMD group. Twenty adults without ocular pathology served as the control group. Central retinal thickness and near VA were assessed at baseline and 3 to 4 months after their first visit. Reading performance was evaluated using short passages of 0.4-logMAR print size. Eye movements were recorded using EyeLink II video eye tracker. Data analysis included computation of reading speed, fixation duration, number of fixations, and percentage of regressions. Frequency distributions of fixation durations were analyzed with ex-Gaussian fittings. RESULTS In the AMD group, silent reading speed in the treated eye correlated well with central retinal thickness reduction and improved significantly by an average of 15.9 ± 28.5 words per minute (P = .04). This improvement was accompanied by an average reduction of 0.24 ± 0.38 in fixations per word (P = .03). The corresponding improvement in monocular VA was not statistically significant. Other eye fixation parameters did not change significantly after treatment. No statistically significant differences were found in the control group. CONCLUSIONS Visual acuity tests may underestimate the potential therapeutic effects after anti-VEGF treatment in patients with relatively good acuity who are being treated for wAMD. Evaluating silent reading performance and eye fixation parameters may better characterize the effectiveness of therapeutic approaches in wAMD patients.
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Affiliation(s)
- Emmanouil Ktistakis
- Laboratory of Optics and Vision (LOV), School of Medicine, University of Crete, Heraklion, Greece
| | | | - Miltiadis K Tsilimbaris
- Laboratory of Optics and Vision (LOV), School of Medicine, University of Crete, Heraklion, Greece
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Panthagani J, O'Donovan C, Aiyegbusi OL, Liu X, Bayliss S, Calvert M, Pesudovs K, Denniston AK, Moore DJ, Braithwaite T. Evaluating patient-reported outcome measures (PROMs) for future clinical trials in adult patients with optic neuritis. Eye (Lond) 2023; 37:3097-3107. [PMID: 36932161 PMCID: PMC10022552 DOI: 10.1038/s41433-023-02478-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 01/09/2023] [Accepted: 02/28/2023] [Indexed: 03/19/2023] Open
Abstract
OBJECTIVE To search for and critically appraise the psychometric quality of patient-reported outcome measures (PROMs) developed or validated in optic neuritis, in order to support high-quality research and care. METHODS We systematically searched MEDLINE(Ovid), Embase(Ovid), PsycINFO(Ovid) and CINAHLPlus(EBSCO), and additional grey literature to November 2021, to identify PROM development or validation studies applicable to optic neuritis associated with any systemic or neurologic disease in adults. We included instruments developed using classic test theory or Rasch analysis approaches. We used established quality criteria to assess content development, validity, reliability, and responsiveness, grading multiple domains from A (high quality) to C (low quality). RESULTS From 3142 screened abstracts we identified five PROM instruments potentially applicable to optic neuritis: three differing versions of the National Eye Institute (NEI)-Visual Function Questionnaire (VFQ): the 51-item VFQ; the 25-item VFQ and a 10-item neuro-ophthalmology supplement; and the Impact of Visual Impairment Scale (IVIS), a constituent of the Multiple Sclerosis Quality of Life Inventory (MSQLI) handbook, derived from the Functional Assessment of Multiple Sclerosis (FAMS). Psychometric appraisal revealed the NEI-VFQ-51 and 10-item neuro module had some relevant content development but weak psychometric development, and the FAMS had stronger psychometric development using Rasch Analysis, but was only somewhat relevant to optic neuritis. We identified no content or psychometric development for IVIS. CONCLUSION There is unmet need for a PROM with strong content and psychometric development applicable to optic neuritis for use in virtual care pathways and clinical trials to support drug marketing authorisation.
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Affiliation(s)
| | - Charles O'Donovan
- School of Immunology and Microbiology, King's College London, London, UK.
| | - Olalekan Lee Aiyegbusi
- Centre for Patient Reported Outcomes Research (CPROR), Institute of Applied Health Research, Birmingham Health Partners for Regulatory Science and Innovation, NIHR Birmingham Biomedical Research Centre, NIHR Applied Research Collaboration West Midlands, and NIHR Birmingham-Oxford Blood and Transplant Research Unit (BTRU) in Precision Transplant and Cellular Therapeutics, University of Birmingham, Birmingham, B15 2TT, UK
| | - Xiaoxuan Liu
- Institute of Inflammation and Ageing, University of Birmingham, University Hospitals Birmingham, Health Data Research UK, London, UK
| | - Susan Bayliss
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Melanie Calvert
- Centre for Patient Reported Outcomes Research (CPROR), Institute of Applied Health Research, Birmingham Health Partners for Regulatory Science and Innovation, NIHR, Birmingham Biomedical Research Centre, NIHR Surgical Reconstruction and Microbiology Centre, NIHR Applied Research Collaboration West Midlands, and NIHR Birmingham-Oxford Blood and Transplant Research Unit (BTRU) in Precision Transplant and Cellular Therapeutics, University of Birmingham, Birmingham, B15 2TT, UK
| | | | - Alastair K Denniston
- Institute of Inflammation and Ageing, and Centre for Patient Reported Outcomes Research (CPROR), Institute of Applied Health Research, Birmingham Health Partners for Regulatory Science and Innovation, NIHR Birmingham-Oxford Blood and Transplant Research Unit (BTRU) in Precision Transplant and Cellular Therapeutics, University of Birmingham, University Hospitals Birmingham, Health Data Research UK, London, UK
| | - David J Moore
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Tasanee Braithwaite
- School of Immunology and Microbiology, King's College London, and The Medical Eye Unit, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK
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Schümmer L, Kreps EO, Pesudovs K, Berwouts J, Estramil N, Mathysen DGP, Rozema JJ. Investigating the Link Between Visual Quality and Vision-Related Quality of Life in Patients With Keratoconus. Cornea 2023; 42:1280-1285. [PMID: 36729659 DOI: 10.1097/ico.0000000000003200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 10/15/2022] [Indexed: 02/03/2023]
Abstract
PURPOSE The purpose of the study was to investigate the optical and visual determinants of vision-related quality of life (VR-QoL) in patients with keratoconus. METHODS A cross-sectional case-control study was conducted at the Department of Ophthalmology, Antwerp University Hospital, Belgium. Patients previously diagnosed with keratoconus and healthy emmetropic or ametropic volunteers were included. Patients younger than 18 years, with ametropia of more than ±10 D, or with a history of corneal surgery or relevant ocular comorbidity limiting visual acuity were excluded. Assessment included autorefraction, high-contrast visual acuity testing, corneal imaging, intraocular straylight analysis, contrast sensitivity, aberrometry, and the National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25). The Rasch-modified visual functioning scale (VFS) and socio-emotional scale were used to quantify VR-QoL. Stepwise linear regression was used to investigate the association between the clinical variables and VR-QoL. RESULTS Seventy-seven patients with keratoconus (77 pairs of eyes) and 77 age-matched and sex-matched controls were included in the study. The scores on the VFS and the SES were significantly lower in patients with keratoconus compared with controls ( P < 0.001). Higher-order and lower-order aberrations, high-contrast visual acuity, and contrast sensitivity were poorer in patients with keratoconus ( P < 0.001). Bivariate analyses showed that spectacle-corrected high-contrast visual acuity, higher spatial frequency contrast sensitivity, and higher-order aberration metrics were strong predictors of SES ( P < 0.001) and of VFS ( P < 0.001). Higher-order aberration of the worse eye was the strongest predictor for both SES (b = 0.310, P < 0.001) and VFS (b = 0.638, P < 0.001) on stepwise regression. Contrast sensitivity was not included in the stepwise regression because of insufficient data in the keratoconus group (33/77 patients; 42.9%). CONCLUSIONS Both higher and lower aberration showed a strong correlation with VR-QoL, surpassing high-contrast visual acuity. These findings underline the importance of visual quality measures within keratoconus research and clinical care.
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Affiliation(s)
- Laura Schümmer
- Department of Ophthalmology, Ghent University Hospital, Ghent, Belgium
| | - Elke O Kreps
- Department of Ophthalmology, Ghent University Hospital, Ghent, Belgium
| | - Konrad Pesudovs
- School of Optometry and Vision Science, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Jesse Berwouts
- Research and Development Department, Christian Health Insurance Fund, Ghent, Belgium
| | - Natalia Estramil
- Department of Ophthalmology, Antwerp University Hospital, Edegem, Belgium; and
| | - Danny G P Mathysen
- Department of Ophthalmology, Antwerp University Hospital, Edegem, Belgium; and
- Visual Optics Lab Antwerp, Department of Medicine and Health Science, University of Antwerp, Wilrijk, Belgium
| | - Jos J Rozema
- Department of Ophthalmology, Antwerp University Hospital, Edegem, Belgium; and
- Visual Optics Lab Antwerp, Department of Medicine and Health Science, University of Antwerp, Wilrijk, Belgium
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25
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Latif K, Nishida T, Moghimi S, Weinreb RN. Quality of life in glaucoma. Graefes Arch Clin Exp Ophthalmol 2023; 261:3023-3030. [PMID: 37017741 DOI: 10.1007/s00417-023-06050-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 03/07/2023] [Accepted: 03/24/2023] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND An essential goal of glaucoma management is to prevent a patient's visual impairment that compromises their health-related quality of life (QOL). The disease itself, in addition to the medical or surgical treatment, can have a large impact on one's life. We aim to briefly review and evaluate aspects of QOL in glaucoma. METHODS The PubMed database was utilized for the literature examination of this review. Keywords that were searched included glaucoma, quality of life, vision-related QOL (VRQOL), quality of life questionnaire, and glaucoma therapy. RESULTS The main topics identified and analyzed during the literature review stages include factors affecting VRQOL, the assessment of VRQOL using questionnaires, QOL in early and severe glaucoma, glaucoma and activities of daily living, glaucoma treatments, and new advances in clinically assessing QOL. The study findings indicate a relationship between the deterioration of visual field and the quality of life. The investigation shows that visual loss can result in a range of daily life challenges, which include compromised mental health status and difficulties with driving, reading, and recognizing people. CONCLUSION Glaucoma-induced visual field loss can significantly impact different aspects of patients' life, and several methods exist for evaluating changes in quality of life. Quality of life assessments have their limitations as they are subjective. As potential future steps, we suggest exploring technological advancements such as virtual reality to improve patient care and outcomes.
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Affiliation(s)
- Kareem Latif
- Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California, 9500 Campus Point Drive, La Jolla,, San Diego, CA, 92093-0946, USA
- School of Medicine, California University of Science and Medicine, Colton, CA, USA
| | - Takashi Nishida
- Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California, 9500 Campus Point Drive, La Jolla,, San Diego, CA, 92093-0946, USA.
| | - Sasan Moghimi
- Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California, 9500 Campus Point Drive, La Jolla,, San Diego, CA, 92093-0946, USA
| | - Robert N Weinreb
- Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California, 9500 Campus Point Drive, La Jolla,, San Diego, CA, 92093-0946, USA
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26
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Le DTM, Kandel H, Watson SL. Evaluation of ocular neuropathic pain. Ocul Surf 2023; 30:213-235. [PMID: 37748645 DOI: 10.1016/j.jtos.2023.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 09/27/2023]
Abstract
AIM To identify and assess the quality of current validated questionnaires that could be used to evaluate ocular neuropathic pain and its associated aetiologies. METHODS A literature search was performed on MEDLINE, PubMed, EMBASE, PsycINFO and The Cochrane Library. Articles evaluating questionnaires for ocular neuropathic pain and its associated aetiologies were included. Data on psychometric properties, validity, and reliability of the questionnaires was extracted and analysed using a set of quality criteria. Clinical and demographical associations with ocular neuropathic pain were also reviewed. RESULTS The search generated 1738 results with 61 publications meeting the inclusion criteria. The 61 publications covered 28 questionnaires including 3 ocular pain, 12 dry eye disease, 2 blepharitis, 2 refractive surgery, 3 contact lens wear, 3 Sjogren's Syndrome, and 3 that were non-disease-specific. Only 57 publications provided enough data on psychometric properties and validity of the questionnaire to be included for quality assessment. The Contact Lens Discomfort Index (CLDI) had the highest rated psychometric properties, whereas the English version of the Ocular Comfort Index (OCI) provided the most data on psychometric properties (9 out of 10 criteria). Most ocular pain and disease-specific questionnaires contained appropriate items to assess ocular pain in specific populations. However, non-disease-specific ophthalmic questionnaires demonstrated poor reliability and validity when evaluating ocular pain. CONCLUSION Ocular pain questionnaires can potentially diagnose ocular neuropathic pain. Disease-specific questionnaires were limited to their target populations, and non-disease-specific ophthalmic questionnaires were unreliable. Further studies are required to determine the most appropriate questionnaire to evaluate ocular neuropathic pain.
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Affiliation(s)
- Damien Tuan-Man Le
- The University of Sydney, Save Sight Institute, Sydney, NSW, 2000, Australia; Sydney Eye Hospital, Sydney, NSW, 2000, Australia.
| | - Himal Kandel
- The University of Sydney, Save Sight Institute, Sydney, NSW, 2000, Australia; Sydney Eye Hospital, Sydney, NSW, 2000, Australia
| | - Stephanie L Watson
- The University of Sydney, Save Sight Institute, Sydney, NSW, 2000, Australia; Sydney Eye Hospital, Sydney, NSW, 2000, Australia
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27
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Skrzypecki J, Izdebska J, Ordon AJ, Przybek-Skrzypecka J, Szaflik JP. Spherical aberrations and their role in modern ophthalmology. Clin Exp Optom 2023; 106:703-710. [PMID: 36822601 DOI: 10.1080/08164622.2022.2160235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 10/31/2022] [Accepted: 11/03/2022] [Indexed: 02/25/2023] Open
Abstract
Spherical aberration is an imperfection of the optical system of the human eye. The role of spherical aberration of the human eye in the quality of vision and pseudoaccommodation is reviewed. Spherical aberration is an imperfection of the optical system of the human eye. In most cases, due to well-developed neuroadaptation, it is insignificant for the perception of the image. Nevertheless, its role in modern ophthalmology is far from straightforward. On the one hand, there are clinical scenarios in which an excess of spherical aberration degrades the retinal image and leads to a high dissatisfaction rate among patients.©Recently, there is a growing interest in the modulation of spherical aberration in the clinical setting. Modern intraocular lenses as well as laser refractive procedures are aimed at interfering with spherical aberrations of the optical system in order to increase range of pseudoaccommodation. Here, we review the role of spherical aberration of the human eye in the quality of vision and pseudoaccommodation.
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Affiliation(s)
- Janusz Skrzypecki
- Departament of Ophthalmology, Independent Public University Eye Hospital, Warsaw, Poland
- Department of Experimental Physiology and Pathophysiology, Medical University of Warsaw, Warsaw, Poland
| | - Justyna Izdebska
- Departament of Ophthalmology, Independent Public University Eye Hospital, Warsaw, Poland
- Department of Ophthalmology, Medical University of Warsaw, Warsaw, Poland
| | - Agata Joanna Ordon
- Departament of Ophthalmology, Independent Public University Eye Hospital, Warsaw, Poland
- Department of Binocular Vision Pathophysiology and Strabismus, Medical University of Lodz, Lodz, Poland
| | - Joana Przybek-Skrzypecka
- Departament of Ophthalmology, Independent Public University Eye Hospital, Warsaw, Poland
- Department of Ophthalmology, Medical University of Warsaw, Warsaw, Poland
| | - Jacek Pawel Szaflik
- Departament of Ophthalmology, Independent Public University Eye Hospital, Warsaw, Poland
- Department of Ophthalmology, Medical University of Warsaw, Warsaw, Poland
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Rogers CM, Salzman MM, Li Z, Merten N, Russell LJ, Lillesand HK, Mowat FM. Subjective vision assessment in companion dogs using dogVLQ demonstrates age-associated visual dysfunction. Front Vet Sci 2023; 10:1244518. [PMID: 37662991 PMCID: PMC10469761 DOI: 10.3389/fvets.2023.1244518] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 08/07/2023] [Indexed: 09/05/2023] Open
Abstract
Introduction Dim light vision as assessed by proxy and clinical tools is commonly impaired in older humans and impacts quality of life. Although proxy visual assessment tools have been developed for dogs, it is unclear if they are sensitive enough to detect subtle visual dysfunction in older dogs. We sought to determine if a newly designed proxy visual function questionnaire could detect age-associated differences in visual behaviors in varying lighting conditions in dogs. Methods A 27-item questionnaire (the dog variable lighting questionnaire, dogVLQ) was designed to assess visual behavior in dogs in different lighting settings. We conducted the dogVLQ, a previously validated visual function questionnaire the dog vision impairment score and performed light- and dark-adapted electroretinography (ERG) on a subset of dogs. Questionnaire scores were analyzed for dog age associations using correlation analysis. Results Questionnaire responses from 235 dog owners were obtained (122 female, 112 male dogs), 79 of which underwent ERG (43 female, 36 male dogs). Bright light visual behavior was significantly associated with light-adapted bright flash ERG amplitudes, visual behavior in near darkness was associated with dark-adapted ERG amplitudes. The dogVLQ identified worse vision in older dogs in bright light, dim light, and darkness; predicted onset was younger for vision in near darkness. Older dogs had more difficulty navigating transitions between lighting conditions. Discussion Subjective dog owner assessment of visual function associates with objective measurement of retinal function in dogs and supports reduced vision-mediated behaviors in older dogs.
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Affiliation(s)
- Callie M. Rogers
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin–Madison, Madison, WI, United States
| | - Michele M. Salzman
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin–Madison, Madison, WI, United States
| | - Zhanhai Li
- Department of Biostatistics and Medical Informatics, University of Wisconsin–Madison, Madison, WI, United States
| | - Natascha Merten
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin–Madison, Madison, WI, United States
- Department of Medicine (Geriatrics and Gerontology), School of Medicine and Public Health, University of Wisconsin–Madison, Madison, WI, United States
| | - Leah J. Russell
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin–Madison, Madison, WI, United States
| | - Hannah K. Lillesand
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin–Madison, Madison, WI, United States
| | - Freya M. Mowat
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin–Madison, Madison, WI, United States
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin–Madison, Madison, WI, United States
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Audo I, Patalano F, Naujoks C, Spera C, Fischer MD, Green J, Kay C, Durham T, Williamson N, Bradley H, Barclay M, Boparai K, Banhazi J. Development of Novel Patient-Reported Outcome (PRO) and Observer-Reported Outcome (ObsRO) Instruments in Retinitis Pigmentosa (RP) and Leber Congenital Amaurosis (LCA): ViSIO-PRO and ViSIO-ObsRO. Ophthalmol Ther 2023; 12:2069-2085. [PMID: 37210697 PMCID: PMC10287847 DOI: 10.1007/s40123-023-00724-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 04/20/2023] [Indexed: 05/22/2023] Open
Abstract
INTRODUCTION Retinitis pigmentosa (RP) and Leber congenital amaurosis (LCA) are rare inherited retinal degenerative disorders resulting in visual impairments and impacts on patients' vision-dependent activities of daily living (ADL), mobility and distal health-related quality of life (HRQoL). This study aimed to conduct qualitative research to understand the patient experience of RP/LCA across genotypes and inform development of patient- and observer-reported outcome (PRO/ObsRO) instruments in RP/LCA. METHODS Research activities included a qualitative literature review and review of existing visual function PRO instruments in RLBP1 RP, and concept elicitation (CE) and cognitive debriefing (CD) interviews of existing PRO instruments with patients with RLBP1 RP, expert clinicians, and payers. In wider RP/LCA, a social media listening (SML) study and a qualitative literature review was conducted, while psychometric evaluation of a PRO instrument in LCA was performed. Input from expert clinicians was sought at key stages. RESULTS Findings from the qualitative literature reviews identified a range of visual function symptoms which had significant impacts on patients' vision-related ADL and distal HRQoL. Patient interviews identified additional visual function symptoms and impacts not previously reported in published literature. These sources informed development and refinement of a conceptual model displaying the patient experience of RP/LCA. Review of existing visual function PRO instruments, and CD interviews evaluating their content validity, confirmed that no existing instrument provides a comprehensive assessment of all concepts relevant to patients with RP/LCA. This highlighted the need for development of the Visual Symptom and Impact Outcomes PRO and ObsRO instruments to adequately assess the patient experience of RP/LCA. CONCLUSIONS Results informed and supported development of the instruments to assess visual functioning symptoms and vision-dependent ADL, mobility and distal HRQoL in RP/LCA, in accordance with regulatory standards. Next steps to further support use in RP/LCA clinical trials/practice includes content and psychometric validation of the instruments in this population.
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Affiliation(s)
- Isabelle Audo
- Sorbonne Université, INSERM, CNRS, Institut de La Vision, CHNO Des Quinze-Vingts, National Rare Disease Center REFERET and INSERM-DGOS CIC 1423, 75012, Paris, France
| | | | | | | | - M Dominik Fischer
- Department of Clinical Neurosciences, University of Oxford, Oxford, UK
- Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Centre for Ophthalmology, University Hospital Tuebingen, Tuebingen, Germany
| | - Jane Green
- Discipline of Genetics, Faculty of Medicine, Memorial University of Newfoundland, Craig L Dobbin Genetics Research Centre, St. John's, Canada
| | | | - Todd Durham
- Foundation Fighting Blindness, Columbia, MD, USA
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Moghimi S, Kamalipour A, Nishida T, Zangwill L, Fazio M, Girkin CA, Liebmann JM, Weinreb RN. Progressive Visual Field Loss and Subsequent Quality of Life Outcomes in Glaucoma. Am J Ophthalmol 2023; 252:295-305. [PMID: 37142176 DOI: 10.1016/j.ajo.2023.04.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 04/17/2023] [Accepted: 04/19/2023] [Indexed: 05/06/2023]
Abstract
PURPOSE To evaluate the association between baseline severity of visual field (VF) damage and the initial rates of VF progression with quality of life (QOL) outcomes over an extended follow-up in glaucoma. DESIGN Retrospective cohort study. METHODS Both eyes of 167 glaucoma or suspected glaucoma patients were followed for 10.0±0.3 years. The National Eye Institute Visual Function Questionnaire (NEI-VFQ)-25 was performed at the end of the follow-up. Separate linear regression models included the VF parameters of the better eye, the worse eye, and the central and peripheral points of the integrated binocular VF to evaluate the association of baseline and initial rates of change of VF parameters (first half of the follow-up) with NEI-VFQ-25 Rasch-calibrated disability scores over an extended follow-up. RESULTS All models demonstrated association of worse baseline severity of VF damage with worse subsequent NEI-VFQ-25 scores. Faster rates of decline in VF mean deviation of the better eye and the mean sensitivity of the central and peripheral test locations of the integrated binocular VF were significantly associated with worse subsequent NEI-VFQ-25 scores. VF parameters of the better eye performed better than those of the worse eye (R2 of 0.21, and 0.15, respectively), and the VF parameters of the central test locations performed better than those of the peripheral test locations (R2 of 0.25, and 0.20, respectively). CONCLUSIONS Baseline severity and initial rates of change of VF damage are associated with QOL outcomes over an extended follow-up. Assessment of longitudinal VF changes, especially in better eye, provides prognostic utility to identify glaucoma patients at a higher risk for developing disease-related disability.
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Affiliation(s)
- Sasan Moghimi
- From the Hamilton Glaucoma Center (S.M., A.K., T.N., L.Z., R.N.W.), Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA.
| | - Alireza Kamalipour
- From the Hamilton Glaucoma Center (S.M., A.K., T.N., L.Z., R.N.W.), Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Takashi Nishida
- From the Hamilton Glaucoma Center (S.M., A.K., T.N., L.Z., R.N.W.), Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Linda Zangwill
- From the Hamilton Glaucoma Center (S.M., A.K., T.N., L.Z., R.N.W.), Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Massimo Fazio
- Department of Ophthalmology and Vision Sciences (M.F., C.A.G.), Heersink School of Medicine, Callahan Eye Hospital, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Christopher A Girkin
- Department of Ophthalmology and Vision Sciences (M.F., C.A.G.), Heersink School of Medicine, Callahan Eye Hospital, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jeffrey M Liebmann
- Bernard and Shirlee Brown Glaucoma Research Laboratory (J.M.L.), Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, New York, USA
| | - Robert N Weinreb
- From the Hamilton Glaucoma Center (S.M., A.K., T.N., L.Z., R.N.W.), Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
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Fournié P, Acquadro M, Touboul D, Cochener B, Chiambaretta F, Muraine M, Borderie V, Bourges JL, Benmedjahed K, Tugaut B, Bernheim D, Bourcier T, Burillon C, David T, Delbosc B, Gain P, Hoffart L, Labetoulle M, Laroche L, Malet F, Orignac I, Robert PY, Thuret G, Vabres B, Malecaze F, Arnould B. Keratoconus and the Impact of Treatment on Patients' Quality of Life: A Qualitative Study. Ophthalmol Ther 2023; 12:1939-1956. [PMID: 37157013 PMCID: PMC10287584 DOI: 10.1007/s40123-023-00717-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 04/11/2023] [Indexed: 05/10/2023] Open
Abstract
INTRODUCTION Keratoconus has a significant impact on patients' quality of life (QoL), from diagnosis to the advanced stages of the disease. The aim of this research was to identify domains of QoL affected by this disease and its treatment. METHODS Phone interviews were conducted using a semi-structured interview guide, with patients with keratoconus stratified according to their current treatment. A board of keratoconus experts helped identify the guide's main themes. RESULTS Thirty-five patients (rigid contact lenses, n = 9; cross-linking, n = 9; corneal ring implants, n = 8; and corneal transplantation, n = 9) were interviewed by qualitative researchers. Phone interviews revealed several QoL domains affected by the disease and its treatments: "psychological", "social life", "professional life", "financial costs" and "student life". All domains were impacted, independently of the treatment history. Few differences were found between treatment regimens and keratoconus stages. Qualitative analysis enabled the development of a conceptual framework based on Wilson and Cleary's model for patient outcomes common to all patients. This conceptual model describes the relationship between patients' characteristics, their symptoms, their environment, their functional visual impairment and the impact on their QoL. CONCLUSIONS These qualitative findings supported the generation of a questionnaire to evaluate the impact of keratoconus and its treatment on patients' QoL. Cognitive debriefings confirmed its content validity. The questionnaire is applicable for all stages of keratoconus and treatments and may help tracking change over time in regular clinical settings. Psychometric validation is yet to be performed before its use in research and clinical practices.
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Affiliation(s)
- Pierre Fournié
- CHU Toulouse, Université Paul Sabatier, Toulouse, France
| | | | - David Touboul
- CHU Bordeaux, Université de Bordeaux, Bordeaux, France
| | | | | | | | | | | | | | | | - Diane Bernheim
- CHU Grenoble, Université Grenoble-Alpes, Grenoble, France
| | - Tristan Bourcier
- Hôpitaux Universitaires de Strasbourg (NHC), Université de Strasbourg, Strasbourg, France
| | | | - Thierry David
- CHU Marseille, Université Aix-Marseille, Marseille, France
| | | | - Philippe Gain
- CHU Saint-Etienne, Université Jean Monnet, Saint-Etienne, France
| | | | - Marc Labetoulle
- CHU Bicêtre, APHP, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Laurent Laroche
- Faculté de Médecine Sorbonne Université, Institut de La Vision-Paris, Paris, France
| | | | | | | | - Gilles Thuret
- CHU Saint-Etienne, Université Jean Monnet, Saint-Etienne, France
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Ungureanu L, Chaudhuri KR, Diaconu S, Falup-Pecurariu C. Dry eye in Parkinson's disease: a narrative review. Front Neurol 2023; 14:1236366. [PMID: 37602267 PMCID: PMC10436221 DOI: 10.3389/fneur.2023.1236366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 07/14/2023] [Indexed: 08/22/2023] Open
Abstract
In Parkinson's disease (PD) patients, a wide range of ocular and visual disorders are present. Tear film instability, inflammation and dysfunction of the ocular surface, and the presence of symptoms of visual disturbance characterize dry eye, a multifactorial disease of the ocular surface. Based on a literature search, we discuss the frequency, pathogenesis, and influence on the quality of life of patients with dry eye in Parkinson's disease. Furthermore, we review the available means of diagnosis and management of dry eye. An improvement in awareness and recognition of dry eye is needed to provide suitable, personalized therapeutic options for PD patients, aiming to improve their quality of life, independence, and safety.
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Affiliation(s)
- Larisa Ungureanu
- Department of Neurology, County Clinic Hospital, Braşov, Romania
- Faculty of Medicine, Transilvania University, Braşov, Romania
| | - K. Ray Chaudhuri
- Department Basic and Clinical Neuroscience, Parkinson Foundation Centre of Excellence, King's College London, Denmark Hill Campus, King's College Hospital, The Maurice Wohl Clinical Neuroscience Institute, London, United Kingdom
| | - Stefania Diaconu
- Department of Neurology, County Clinic Hospital, Braşov, Romania
- Faculty of Medicine, Transilvania University, Braşov, Romania
| | - Cristian Falup-Pecurariu
- Department of Neurology, County Clinic Hospital, Braşov, Romania
- Faculty of Medicine, Transilvania University, Braşov, Romania
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Shiga Y, Nishida T, Jeoung JW, Di Polo A, Fortune B. Optical Coherence Tomography and Optical Coherence Tomography Angiography: Essential Tools for Detecting Glaucoma and Disease Progression. FRONTIERS IN OPHTHALMOLOGY 2023; 3:1217125. [PMID: 37982032 PMCID: PMC10655832 DOI: 10.3389/fopht.2023.1217125] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 07/03/2023] [Indexed: 11/21/2023]
Abstract
Early diagnosis and detection of disease progression are critical to successful therapeutic intervention in glaucoma, the leading cause of irreversible blindness worldwide. Optical coherence tomography (OCT) is a non-invasive imaging technique that allows objective quantification in vivo of key glaucomatous structural changes in the retina and the optic nerve head (ONH). Advances in OCT technology have increased the scan speed and enhanced image quality, contributing to early glaucoma diagnosis and monitoring, as well as the visualization of critically important structures deep within the ONH, such as the lamina cribrosa. OCT angiography (OCTA) is a dye-free technique for noninvasively assessing ocular microvasculature, including capillaries within each plexus serving the macula, peripapillary retina and ONH regions, as well as the deeper vessels of the choroid. This layer-specific assessment of the microvasculature has provided evidence that retinal and choroidal vascular impairments can occur during early stages of glaucoma, suggesting that OCTA-derived measurements could be used as biomarkers for enhancing detection of glaucoma and its progression, as well as to reveal novel insights about pathophysiology. Moreover, these innovations have demonstrated that damage to the macula, a critical region for the vision-related quality of life, can be observed in the early stages of glaucomatous eyes, leading to a paradigm shift in glaucoma monitoring. Other advances in software and hardware, such as artificial intelligence-based algorithms, adaptive optics, and visible-light OCT, may further benefit clinical management of glaucoma in the future. This article reviews the utility of OCT and OCTA for glaucoma diagnosis and disease progression detection, emphasizes the importance of detecting macula damage in glaucoma, and highlights the future perspective of OCT and OCTA. We conclude that the OCT and OCTA are essential glaucoma detection and monitoring tools, leading to clinical and economic benefits for patients and society.
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Affiliation(s)
- Yukihiro Shiga
- Neuroscience Division, Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Québec H2X 0A9, Canada
- Department of Neuroscience, Université de Montréal, Montréal, Québec H3C 3J7, Canada
| | - Takashi Nishida
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California 92093, USA
| | - Jin Wook Jeoung
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Adriana Di Polo
- Neuroscience Division, Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Québec H2X 0A9, Canada
- Department of Neuroscience, Université de Montréal, Montréal, Québec H3C 3J7, Canada
| | - Brad Fortune
- Discoveries in Sight Research Laboratories, Devers Eye Institute and Legacy Research Institute, Legacy Health, 1225 NE Second Avenue, Portland, Oregon 97232, USA
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Ekemiri KK, Botchway EN, Ezinne NE, Sirju N, Persad T, Masemola HC, Chidarikire S, Ekemiri CC, Osuagwu UL. Comparative Analysis of Health- and Vision-Related Quality of Life Measures among Trinidadians with Low Vision and Normal Vision-A Cross-Sectional Matched Sample Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6436. [PMID: 37510668 PMCID: PMC10378830 DOI: 10.3390/ijerph20146436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/28/2023] [Accepted: 07/08/2023] [Indexed: 07/30/2023]
Abstract
This cross-sectional study investigated the health-related and vision-related quality of life measures of adults with low vision compared to healthy individuals in Trinidad and Tobago. The health-related quality of life (HRQOL-14) and the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) were administered to 20 participants with low vision caused by diabetic retinopathy, retinitis pigmentosa, glaucoma, and macular degeneration, as well as 20 participants with no visual problems (control). Participants were recruited from the University Eye Clinic in Trinidad and Tobago. Compared to the controls, more participants in the low-vision group had lower age-adjusted NEI-VFQ-25 scores (48.3% vs. 95.1%; p < 0.001), had poor general (47.5% vs. 10%, p = 0.004) and mental (100% vs. 10%, p < 0.042) health, experienced greater activity limitation due to impairment or health problems (85% vs. 20%, p < 0.001), needed help with personal care (27.5% vs. 0%, p < 0.009) and daily routine (67.5% vs. 0%, p < 0.001), and experienced sleep problems (97.5% vs. 65%, p < 0.001) and symptoms of anxiety (100% vs. 90%, p = 0.042). All the diabetic retinopathy participants (100%, p = 0.028) had two or more impairments or vision problems compared to none in the other low-vision participants. In summary, the HRQOL-14 and NEI-VFQ-25 scores were significantly reduced in low-vision participants, who also demonstrated a greater vulnerability to poor quality of life in the presence of diabetes retinopathy. These findings have important clinical implications regarding offering appropriate support and interventions to improve quality of life outcomes in individuals with low vision.
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Affiliation(s)
- Kingsley K Ekemiri
- Optometry Unit, Department of Clinical Surgical Sciences, Faculty of Medical Sciences, University of the West Indies, St Augustine Campus, St. Augustine 685509, Trinidad and Tobago
- Department of Optometry, College of Health Sciences, University of Kwazulu-Natal, Westville Campus, Durban 3629, South Africa
| | - Edith N Botchway
- Brain and Mind Group, Clinical Sciences, Murdoch Children's Research Institute, Parkville, VIC 3052, Australia
- Department of Pediatrics, University of Melbourne, Parkville, VIC 3010, Australia
| | - Ngozika E Ezinne
- Optometry Unit, Department of Clinical Surgical Sciences, Faculty of Medical Sciences, University of the West Indies, St Augustine Campus, St. Augustine 685509, Trinidad and Tobago
- Department of Optometry, College of Health Sciences, University of Kwazulu-Natal, Westville Campus, Durban 3629, South Africa
| | - Nikolai Sirju
- Optometry Unit, Department of Clinical Surgical Sciences, Faculty of Medical Sciences, University of the West Indies, St Augustine Campus, St. Augustine 685509, Trinidad and Tobago
| | - Tea Persad
- Optometry Unit, Department of Clinical Surgical Sciences, Faculty of Medical Sciences, University of the West Indies, St Augustine Campus, St. Augustine 685509, Trinidad and Tobago
| | - Hlabje Carel Masemola
- Department of Optometry, Faculty of Health Sciences, University of Free State, Bloemfontein 9301, South Africa
| | - Sherphard Chidarikire
- School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Chioma C Ekemiri
- Department of Health Promotion, The University of the West Indies, St. Augustine Campus, St. Augustine 685509, Trinidad and Tobago
| | - Uchechukwu Levi Osuagwu
- Department of Optometry, College of Health Sciences, University of Kwazulu-Natal, Westville Campus, Durban 3629, South Africa
- Bathurst Rural Clinical School, School of Medicine, Western Sydney University, Bathurst, NSW 2795, Australia
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Kay C, Audo I, Naujoks C, Spera C, Fischer MD, Green J, Durham T, Williamson N, Bradley H, Barclay M, Sims J, Banhazi J, Patalano F. Qualitative exploration of the visual function impairments and impacts on vision-dependent activities of daily living in Retinitis Pigmentosa and Leber Congenital Amaurosis: content validation of the ViSIO-PRO and ViSIO-ObsRO measures. J Patient Rep Outcomes 2023; 7:74. [PMID: 37466759 PMCID: PMC10356708 DOI: 10.1186/s41687-023-00610-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 07/03/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Retinitis Pigmentosa (RP) and Leber Congenital Amaurosis (LCA) are rare inherited retinal degenerative disorders. The associated visual impairments have significant impacts on patients' vision-dependent activities of daily living (ADL), mobility, and distal health-related quality of life (HRQoL). To adequately capture patient and caregiver perspectives in clinical trials, patient and observer-reported outcome instruments must demonstrate sufficient evidence of content validity in the target population. This study aimed to explore the patient experience of RP/LCA and assess the content validity of the Visual Symptom and Impact Outcomes PRO (ViSIO-PRO) and ObsRO (ViSIO-ObsRO) instruments in RP/LCA. METHODS A total of 66 qualitative, combined concept elicitation (CE) and cognitive debriefing (CD) interviews were conducted (33 adults, 10 adolescents, 8 children and 15 caregivers of children) in the US, France, Germany, and Canada. Patients had a clinical and genetic diagnosis of RP/LCA from a range of genotypes. CE results were used to further inform the development of a conceptual model and CD interviews assessed the relevance and understanding of the 44-item ViSIO-PRO and 26-item ViSIO-ObsRO instruments. Interviews were conducted across two iterative rounds to allow item modifications. RESULTS Findings were consistent across RP/LCA genotypes. Night blindness, reduced peripheral vision, vision in very bright lighting and light/dark adaptation were the most frequently reported visual function symptoms impacting vision-dependent ADL and mobility. Impacts on distal HRQoL domains were also reported. The ViSIO-PRO and ObsRO items were well understood by participants and relevant across genotypes. The instructions, 7-day recall period and response scales were well understood and endorsed. Participant and expert clinician feedback supported modifications to item wording, the addition of six new ViSIO-PRO items and one new ViSIO-ObsRO item, and the removal of one ViSIO-PRO item due to lack of relevance. CONCLUSIONS Findings support the content validity of the ViSIO-PRO and ViSIO-ObsRO instruments for use across RP/LCA genotypes. Ongoing research to evaluate the psychometric validity of the instruments will support future use of the instruments as efficacy endpoints in clinical trials and in general clinical practice to track disease severity and impact of disease on functioning.
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Affiliation(s)
| | - Isabelle Audo
- INSERM, CNRS, Institut de la Vision, CHNO des Quinze-Vingts, National Rare Disease Center REFERET and INSERM-DGOS CIC 1423, Sorbonne Université, 75012, Paris, France
| | | | | | - M Dominik Fischer
- Department of Clinical Neurosciences, University of Oxford, Oxford, UK
- Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Centre for Ophthalmology, University Hospital Tuebingen, Tuebingen, Germany
| | - Jane Green
- Discipline of Genetics, Faculty of Medicine, Memorial University of Newfoundland, Craig L Dobbin Genetics Research Centre, St. John's, Canada
| | - Todd Durham
- Foundation Fighting Blindness, Columbia, MD, USA
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Newman-Casey PA, Niziol LM, Elam AR, Bicket AK, Killeen O, John D, Wood SD, Musch DC, Zhang J, Johnson L, Kershaw M, Woodward MA. Michigan Screening and Intervention for Glaucoma and Eye Health Through Telemedicine Program: First-Year Outcomes and Implementation Costs. Am J Ophthalmol 2023; 251:43-51. [PMID: 36906094 PMCID: PMC10247478 DOI: 10.1016/j.ajo.2023.02.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 02/27/2023] [Accepted: 02/28/2023] [Indexed: 03/13/2023]
Abstract
PURPOSE The Michigan Screening and Intervention for Glaucoma and Eye Health Through Telemedicine (MI-SIGHT) program aims to engage people who are at high risk of glaucoma; we assess first-year outcomes and costs. DESIGN Clinical cohort study. METHODS Participants ≥18 years of age were recruited from a free clinic and a federally qualified health center in Michigan. Ophthalmic technicians in the clinics collected demographic information, visual function, ocular health history, measured visual acuity, refraction, intraocular pressure, pachymetry, pupils, and took mydriatic fundus photographs and retinal nerve fiber layer optical coherence tomography. Data were interpreted by remote ophthalmologists. During a follow-up visit, technicians shared ophthalmologist recommendations, dispensed low-cost glasses, and collected participant satisfaction. The primary outcome measures were prevalence of eye disease, visual function, program satisfaction, and costs. Observed prevalence was compared with national disease prevalence rates using z tests of proportions. RESULTS Among 1171 participants, the average age was 55 years (SD 14.5 years), 38% were male, 54% identified as Black, 34% as White, 10% as Hispanic, 33% had less than or equal to a high school education, and 70% had an annual income <$30,000. The prevalence of visual impairment was 10.3% (national average 2.2%), glaucoma and suspected glaucoma 24% (national average 9%), macular degeneration 2.0% (national average 1.5%), and diabetic retinopathy 7.3% (national average 3.4%) (P < .0001). Seventy-one percent of participants received low-cost glasses, 41% were referred for ophthalmology follow-up, and 99% were satisfied or very satisfied with the program. Startup costs were $103,185; recurrent costs were $248,103 per clinic. CONCLUSIONS Telemedicine eye disease detection programs in low-income community clinics effectively identify high rates of pathology.
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Affiliation(s)
- Paula Anne Newman-Casey
- From the Department of Ophthalmology and Visual Sciences (P.A.N-C., L.M.N., A.R.E., A.K.B., O.K., D.J., S.D.W., D.C.M., J.Z., M.A.W.); the Institute for Healthcare Policy and Innovation (P.A.N-C., A.R.E., O.K., D.C.M., M.A.W.), University of Michigan, Ann Arbor.
| | - Leslie M Niziol
- From the Department of Ophthalmology and Visual Sciences (P.A.N-C., L.M.N., A.R.E., A.K.B., O.K., D.J., S.D.W., D.C.M., J.Z., M.A.W.)
| | - Angela R Elam
- From the Department of Ophthalmology and Visual Sciences (P.A.N-C., L.M.N., A.R.E., A.K.B., O.K., D.J., S.D.W., D.C.M., J.Z., M.A.W.); the Institute for Healthcare Policy and Innovation (P.A.N-C., A.R.E., O.K., D.C.M., M.A.W.), University of Michigan, Ann Arbor
| | - Amanda K Bicket
- From the Department of Ophthalmology and Visual Sciences (P.A.N-C., L.M.N., A.R.E., A.K.B., O.K., D.J., S.D.W., D.C.M., J.Z., M.A.W.)
| | - Olivia Killeen
- From the Department of Ophthalmology and Visual Sciences (P.A.N-C., L.M.N., A.R.E., A.K.B., O.K., D.J., S.D.W., D.C.M., J.Z., M.A.W.); the Institute for Healthcare Policy and Innovation (P.A.N-C., A.R.E., O.K., D.C.M., M.A.W.), University of Michigan, Ann Arbor
| | - Denise John
- From the Department of Ophthalmology and Visual Sciences (P.A.N-C., L.M.N., A.R.E., A.K.B., O.K., D.J., S.D.W., D.C.M., J.Z., M.A.W.)
| | - Sarah Dougherty Wood
- From the Department of Ophthalmology and Visual Sciences (P.A.N-C., L.M.N., A.R.E., A.K.B., O.K., D.J., S.D.W., D.C.M., J.Z., M.A.W.)
| | - David C Musch
- From the Department of Ophthalmology and Visual Sciences (P.A.N-C., L.M.N., A.R.E., A.K.B., O.K., D.J., S.D.W., D.C.M., J.Z., M.A.W.); the Institute for Healthcare Policy and Innovation (P.A.N-C., A.R.E., O.K., D.C.M., M.A.W.), University of Michigan, Ann Arbor
| | - Jason Zhang
- From the Department of Ophthalmology and Visual Sciences (P.A.N-C., L.M.N., A.R.E., A.K.B., O.K., D.J., S.D.W., D.C.M., J.Z., M.A.W.)
| | | | | | - Maria A Woodward
- From the Department of Ophthalmology and Visual Sciences (P.A.N-C., L.M.N., A.R.E., A.K.B., O.K., D.J., S.D.W., D.C.M., J.Z., M.A.W.); the Institute for Healthcare Policy and Innovation (P.A.N-C., A.R.E., O.K., D.C.M., M.A.W.), University of Michigan, Ann Arbor
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Kaya Ünsal S, Sunay E. The Impact of Angle Lambda on Patient Satisfaction after Optiflex Trio Trifocal Intraocular Lens Implantation. J Ophthalmol 2023; 2023:7911449. [PMID: 37362312 PMCID: PMC10290561 DOI: 10.1155/2023/7911449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 06/07/2023] [Accepted: 06/09/2023] [Indexed: 06/28/2023] Open
Abstract
Purpose To evaluate the vision-related quality of life (QOL), visual acuities, and refractive outcomes of patients with different angle lambda (λ) after a trifocal intraocular lens (IOL) implantation at Veni Vidi Eye Hospital, İstanbul, Turkey. Methods This retrospective, nonrandomized, and noncomparative case series included patients who had phacoemulsification bilaterally with the implantation of a trifocal IOL (Optiflex Trio) and responded to a vision-related QOL questionnaire measuring patient satisfaction. The patients were divided into two groups according to the angle λ with a cutoff value of 0.5 mm. Evaluations were conducted to examine the monocular visual acuities, spherical equivalents, corneal astigmatism measured 3 months after surgery, and outcomes of the QOL questionnaire in the two groups. Results The study examined 130 eyes from 65 patients aged from 41 to 78 years old. There were no statistically significant differences between the two groups at 3 months after surgery in terms of uncorrected distance visual acuity (UDVA), monocular uncorrected intermediate visual acuity (UIVA), monocular uncorrected near visual acuity (UNVA), spherical equivalent, and corneal astigmatism (P > 0.05). Patients with a greater angle λ had significantly more difficulty going out to see movies, plays, or sporting events (P=0.02), driving at night (P=0.002), and driving in difficult conditions (P < 0.001) than patients with a lower angle λ. Conclusions The Optiflex Trio showed good results in terms of visual acuity at all distances, positive refractive outcomes, and high patient satisfaction in daily life according to the QOL questionnaire. An angle λ greater than 0.5 mm may potentially cause dysphotopsia symptoms, especially during nighttime activities.
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Affiliation(s)
| | - Ertan Sunay
- Veni Vidi Eye Hospital, Istanbul 34728, Turkey
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Gil P, Farcas A, Benito A, Tabernero J. Functional visual tests to evaluate the effect of small astigmatism correction with toric contact lenses. BIOMEDICAL OPTICS EXPRESS 2023; 14:2811-2820. [PMID: 37342708 PMCID: PMC10278640 DOI: 10.1364/boe.487410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/31/2023] [Accepted: 04/26/2023] [Indexed: 06/23/2023]
Abstract
The prescription of daily contact lenses does not often include a full astigmatic correction. We question here whether this full astigmatic correction (for low to moderate astigmatism) provides a substantial improvement in the overall visual performance compared to a more conservative approach based only on the prescription of spherical contact lenses. The visual performance of 56 contact lens neophytes divided in two contact lens fitting groups (toric versus spherical lens fit) was assessed using standard visual acuity and contrast sensitivity tests. A new set of functional tests simulating everyday tasks was also used. Results showed that subjects with toric lenses had significantly better visual acuity and contrast sensitivity than those with spherical lenses. Functional tests did not render significant differences between groups, which was explained by several factors like i) the visual demand of the functional tests, ii) the dynamic blur due to misalignments and iii) small misfits between the available and measured axis of the astigmatic contact lens.
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Affiliation(s)
- Pedro Gil
- Departamento de Electromagnetismo y Electrónica, Facultad de Química, Universidad de Murcia, Murcia 30100, Spain
- Laboratorio de Óptica, Universidad de Murcia, Campus de Espinardo (Edificio 34), Murcia 30100, Spain
| | - Alexandra Farcas
- Departamento de Electromagnetismo y Electrónica, Facultad de Química, Universidad de Murcia, Murcia 30100, Spain
- Laboratorio de Óptica, Universidad de Murcia, Campus de Espinardo (Edificio 34), Murcia 30100, Spain
| | - Antonio Benito
- Laboratorio de Óptica, Universidad de Murcia, Campus de Espinardo (Edificio 34), Murcia 30100, Spain
| | - Juan Tabernero
- Departamento de Electromagnetismo y Electrónica, Facultad de Química, Universidad de Murcia, Murcia 30100, Spain
- Laboratorio de Óptica, Universidad de Murcia, Campus de Espinardo (Edificio 34), Murcia 30100, Spain
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Gong L, Yu X, Wei L, Zhang R, Cao S, Xiong Y, He Z, Xu M, Yu H, Yu X, Lu F, Qu J, Zhou J. Translating and evaluating the Chinese version of Pediatric Eye Questionnaire (PedEyeQ-CN) for children. Eye (Lond) 2023; 37:1397-1404. [PMID: 35760903 PMCID: PMC10169794 DOI: 10.1038/s41433-022-02157-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 06/08/2022] [Accepted: 06/16/2022] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES To investigate the reliability and validity of Chinese version of the Pediatric Eye Questionnaire (PedEyeQ-CN) by testing ophthalmic patients in China. METHODS The PedEyeQ (standard English version) was translated by local researchers. Children were asked to complete the Child section, and their parents the Proxy and Parent sections. 160 children (32 normal controls, 77 with refractive error, 48 with strabismus/amblyopia, 3 with other eye conditions) aged 5-11 years old, and one parent of each child were recruited. Cronbach's α and intraclass correlation coefficient were calculated to examine the reliability and test-retest reliability; the score differences between controls and patients were compared to examine the validity. RESULTS The internal consistency (Cronbach's α ≥ 0.76) and test-retest reliability (r > 0.80) of PedEyeQ-CN were robust. Children with eye conditions had lower scores compared with children with normal vision (refractive error: 10 out of 13 domains, P ≤ 0.021; strabismus/amblyopia: all domains, P ≤ 0.015). Children with strabismus/amblyopia had lower scores compared with children with refractive error (two domains, P = 0.048, P = 0.001). Visual acuity was significantly correlated with functional vision (P = 0.005), but not significantly correlated with the eye-related quality of life (ER-QOL). CONCLUSIONS The PedEyeQ-CN is a valuable tool for assessing the functional vision and ER-QOL of Chinese children and help us increase our understanding about the impact of eye conditions on children and their families.
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Affiliation(s)
- Ling Gong
- School of Ophthalmology and Optometry, Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xi Yu
- School of Ophthalmology and Optometry, Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Lili Wei
- School of Ophthalmology and Optometry, Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ran Zhang
- School of Ophthalmology and Optometry, Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Suqi Cao
- School of Ophthalmology and Optometry, Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yue Xiong
- School of Ophthalmology and Optometry, Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zhifen He
- School of Ophthalmology and Optometry, Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Meiping Xu
- School of Ophthalmology and Optometry, Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Huanyun Yu
- School of Ophthalmology and Optometry, Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xinping Yu
- Zhongshan Ophthalmic Center, Sun Yat-Sun University, Guangzhou, Guangdong, China.
| | - Fan Lu
- School of Ophthalmology and Optometry, Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jia Qu
- School of Ophthalmology and Optometry, Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jiawei Zhou
- School of Ophthalmology and Optometry, Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, Zhejiang, China.
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Male SR, Shamanna BR, Bhardwaj R, Gandhi R, Bhagvati C, Theagarayan B. Impact of color vision deficiency on the quality of life in a sample of Indian population: Application of the CVD-QoL tool. Indian J Ophthalmol 2023; 71:2204-2211. [PMID: 37202949 PMCID: PMC10391464 DOI: 10.4103/ijo.ijo_1975_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Abstract
Purpose To investigate the quality of life (QoL) in a sample of color vision deficit (CVD) patients in India and how color vision deficiency affects them psychologically, economically, and in productivity related to their work and occupation. Methods A descriptive and case-control study design using a questionnaire was conducted on N = 120 participants, of whom 60 were patients of CVD (52 male and eight female) who visited two eye facilities in Hyderabad between 2020 and 2021 and 60 were age-matched normal color vision participants who served as controls. We validated English-Telugu adapted version of CVD-QoL, developed by Barry et al. in 2017 (CB-QoL). The CVD-QoL consists of 27 Likert-scale items with factors (lifestyle, emotions, and work). Color vision was assessed using the Ishihara and Cambridge Mollen color vision tests. A six-point Likert scale was used, with lower scores indicating poor QoL (from 1 = severe issue to 6 = no problem). Results The CVD-QoL questionnaire's reliability and internal consistency were measured, including Cronbach's α (α =0.70-0.90). There was no significance between the group in age (t = -1.2, P = 0.67) whereas the Ishihara colour vision test, scores showed a significant difference (t = 4.50, P < 0.001). The QoL scores showed a significant difference towards lifestyle, emotions and work (P = 0.001). The CVD group had a poorer QoL score than the normal color vision group odds ratio [OR] =0.31, 95% confidence interval [CI], (P = 0.002, CI = 0.14-0.65, Z = 3.0) . In this analysis, a low CI indicated that the OR was more precise. Conclusion Color vision deficiency affects Indians' QoL, according to this study. The mean scores of lifestyle, emotions, and work were lower than the UK sample.Since CVD is underreported and possibly affects developing countries more, advocacy for a new health care plan on CVD is essential. Increasing public understanding and awareness could also help diagnosing the CVD population.
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Affiliation(s)
- Shiva Ram Male
- School of Medical Sciences, University of Hyderabad, Gachibowli, Hyderabad, Telangana, India
| | - B R Shamanna
- School of Medical Sciences, University of Hyderabad, Gachibowli, Hyderabad, Telangana, India
| | - Rishi Bhardwaj
- School of Medical Sciences, University of Hyderabad, Gachibowli, Hyderabad, Telangana, India
| | - Rashmin Gandhi
- Consultant Neuro-Ophthalmologist, Centre for Sight Eye Hospital, Gachibowli, Hyderabad, Telangana, India
| | - Chakravarthy Bhagvati
- School of Computer and Information Sciences, University of Hyderabad, Gachibowli, Hyderabad, Telangana, India
| | - Baskar Theagarayan
- Centre for Vision Across the Life Span, Department of Optometry and Vision Sciences, School of Applied Sciences, University of Huddersfield, United Kingdom
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Nishida T, Moghimi S, Yamane MLM, Wu JH, Mohammadzadeh V, Kamalipour A, Mahmoudinezhad G, Liebmann JM, Fazio MA, Girkin CA, Zangwill LM, Weinreb RN. Vision-Related Quality of Life Among Healthy, Preperimetric Glaucoma, and Perimetric Glaucoma Patients. Am J Ophthalmol 2023; 248:127-136. [PMID: 36581193 PMCID: PMC10038908 DOI: 10.1016/j.ajo.2022.12.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 12/14/2022] [Accepted: 12/14/2022] [Indexed: 12/28/2022]
Abstract
PURPOSE To investigate the association of vision-related quality of life (VRQOL) with the central visual field and macular ganglion cell complex (GCC) thickness in healthy control participants, patients with preperimetric glaucoma, and patients with perimetric glaucoma. DESIGN Retrospective cross-sectional study. METHODS A total of 39 healthy, 34 preperimetric glaucoma, and 145 perimetric glaucoma patients completed the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ). A linear mixed-effect models was used to investigate the association between the glaucoma stage as measured by binocular 10-2 visual field mean sensitivity (VFMS) and GCC thickness with the Rasch-calibrated NEI-VFQ score. RESULTS A total of 436 eyes from 218 participants (mean age = 67.2 [95% CI = 65.1 to 69.2] years) were enrolled. VRQOL calculated by the NEI-VFQ Rasch-calibrated score was worst for patients with perimetric glaucoma (50.7 [95% CI = 47.2 to 54.2]), followed by patients with preperimetric glaucoma (41.2 [95% CI = 34.5 to 47.9]) and healthy controls (29.3 [95% CI = 24.0 to 34.7]. Worse VRQOL had a moderate association with a worse global binocular 10-2 VFMS (-3.4 [95% CI = -5.0 to -1.9] dB per 1 score; P < .001; adjusted R2 = 0.27), but not with a thinner global GCC in the better eye (-0.1 [95% CI = -0.2 to 0.1] µm per 1 score; P =.0485; adjusted R2 = 0.17). CONCLUSIONS These findings suggest that patients with perimetric and preperimetric glaucoma have worse VRQOL than patients with healthy eyes. As compared to macular thickness measurements, the central visual field is more strongly associated with VRQOL and may better help to identify patients in need of intervention.
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Affiliation(s)
- Takashi Nishida
- From the Hamilton Glaucoma Center (T.N., S.M., M.L.M.Y., J.-H.W., V.M., A.K., G.M., M.A.F., L.M.Z., R.N.W.), Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California-San Diego, La Jolla, California, USA
| | - Sasan Moghimi
- From the Hamilton Glaucoma Center (T.N., S.M., M.L.M.Y., J.-H.W., V.M., A.K., G.M., M.A.F., L.M.Z., R.N.W.), Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California-San Diego, La Jolla, California, USA
| | - Maya L M Yamane
- From the Hamilton Glaucoma Center (T.N., S.M., M.L.M.Y., J.-H.W., V.M., A.K., G.M., M.A.F., L.M.Z., R.N.W.), Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California-San Diego, La Jolla, California, USA
| | - Jo-Hsuan Wu
- From the Hamilton Glaucoma Center (T.N., S.M., M.L.M.Y., J.-H.W., V.M., A.K., G.M., M.A.F., L.M.Z., R.N.W.), Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California-San Diego, La Jolla, California, USA
| | - Vahid Mohammadzadeh
- From the Hamilton Glaucoma Center (T.N., S.M., M.L.M.Y., J.-H.W., V.M., A.K., G.M., M.A.F., L.M.Z., R.N.W.), Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California-San Diego, La Jolla, California, USA
| | - Alireza Kamalipour
- From the Hamilton Glaucoma Center (T.N., S.M., M.L.M.Y., J.-H.W., V.M., A.K., G.M., M.A.F., L.M.Z., R.N.W.), Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California-San Diego, La Jolla, California, USA
| | - Golnoush Mahmoudinezhad
- From the Hamilton Glaucoma Center (T.N., S.M., M.L.M.Y., J.-H.W., V.M., A.K., G.M., M.A.F., L.M.Z., R.N.W.), Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California-San Diego, La Jolla, California, USA
| | - Jeffrey M Liebmann
- Bernard and Shirlee Brown Glaucoma Research Laboratory (J.M.L.), Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Medical Center, New York, New York, USA
| | - Massimo A Fazio
- From the Hamilton Glaucoma Center (T.N., S.M., M.L.M.Y., J.-H.W., V.M., A.K., G.M., M.A.F., L.M.Z., R.N.W.), Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California-San Diego, La Jolla, California, USA; Heersink School of Medicine (M.A.F., C.A.G.), University of Alabama-Birmingham, Birmingham, Alabama, USA
| | - Christopher A Girkin
- Heersink School of Medicine (M.A.F., C.A.G.), University of Alabama-Birmingham, Birmingham, Alabama, USA
| | - Linda M Zangwill
- From the Hamilton Glaucoma Center (T.N., S.M., M.L.M.Y., J.-H.W., V.M., A.K., G.M., M.A.F., L.M.Z., R.N.W.), Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California-San Diego, La Jolla, California, USA
| | - Robert N Weinreb
- From the Hamilton Glaucoma Center (T.N., S.M., M.L.M.Y., J.-H.W., V.M., A.K., G.M., M.A.F., L.M.Z., R.N.W.), Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California-San Diego, La Jolla, California, USA.
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Almpanidou S, Almaliotis D, Karamitopoulos L, Topouzis F, Konstas AG, Labiris G, Dardavesis T, Fountoulakis KN, Chatzisavvas KC, Karampatakis V. Development and Validation of the Life for Low Vision Questionnaire (LIFE4LVQ) Using Rasch Analysis: A Questionnaire Evaluating Ability and Independence. J Clin Med 2023; 12:jcm12072549. [PMID: 37048633 PMCID: PMC10095134 DOI: 10.3390/jcm12072549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 02/24/2023] [Accepted: 03/21/2023] [Indexed: 03/30/2023] Open
Abstract
Low vision (LV) has a substantial impact on an individual’s daily functionality and patient-reported outcome measures (PROMs) are increasingly incorporated into the evaluation of this problem. The objective of this study was to describe the design of the new “Life for Low Vision Questionnaire (LIFE4LVQ)”, as a measure of daily functionality in LV and to explore its psychometric properties. A total of 294 participants completed the LIFE4LVQ and the data were subjected to Rasch analysis to determine the psychometric properties of the questionnaire, including response category ordering, item fit statistics, principal component analysis, precision, differential item functioning, and targeting. Test–retest reliability was evaluated with an interval of three weeks and intraclass correlation coefficients (ICC) were used. The correlation between the questionnaire score and Best Corrected Visual Acuity (BCVA) was examined using Spearman’s correlation coefficient. Rasch analysis revealed that for most items the infit and outfit mean square fit values were close to 1, both for the whole scale and its subscales (ability and independence). The separation index for person measures was 5.18 with a reliability of 0.96, indicating good discriminant ability and adequate model fit. Five response categories were found for all items. The ICC was 0.96 (p < 0.001; 95% CI, 0.93–0.98), suggesting excellent repeatability of the measure. Poorer BCVA was significantly associated with worse scores (rho = 0.559, p < 0.001), indicating excellent convergent validity. The functional, 40-item LIFE4LVQ proved to be a reliable and valid tool that effectively measures the impact of LV on ability and independence.
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Affiliation(s)
- Stavroula Almpanidou
- Laboratory of Experimental Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
- Correspondence: ; Tel.: +30-6946777213
| | - Diamantis Almaliotis
- Laboratory of Experimental Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Leonidas Karamitopoulos
- Laboratory of Experimental Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Fotios Topouzis
- 1st Department of Ophthalmology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | | | - Georgios Labiris
- Department of Ophthalmology, University Hospital of Alexandroupolis, 68100 Alexandroupolis, Greece
| | - Theodoros Dardavesis
- Department of Hygiene, Social-Preventative Medicine and Medical Statistics, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Konstantinos N. Fountoulakis
- Third Department of Psychiatry, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Konstantinos Ch. Chatzisavvas
- mSensis S.A., VEPE Technopolis, Bld C2, 55535 Thessaloniki, Greece
- Department of Electrical and Computer Engineering, University of Western Macedonia, ZEP Campus Kozani, 50100 Kozani, Greece
| | - Vasileios Karampatakis
- Laboratory of Experimental Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
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The influence of the topographic location of geographic atrophy on vision-related quality of life in nonexudative age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol 2023; 261:699-708. [PMID: 36269402 DOI: 10.1007/s00417-022-05849-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/17/2022] [Accepted: 09/22/2022] [Indexed: 11/04/2022] Open
Abstract
PURPOSE To examine associations between the topographic distribution of geographic atrophy (GA) and vision-related quality of life (VRQoL). METHODS This study included 237 eyes from 161 participants in the Age-Related Eye Disease Study (AREDS). GA lesions were manually delineated with color fundus photographs obtained by the AREDS Research Group and atrophic area was measured in an Early Treatment Diabetic Retinopathy Study (ETDRS) grid. VRQoL was measured using the National Eye Institute Visual Function Questionnaire (NEI-VFQ). Area of atrophy in the ETDRS grid subfields was correlated with VRQoL by linear regression modeling. RESULTS The average area of atrophy in the better and worse eye was 3.43mm2 and 7.15mm2 respectively. In multivariable analysis, VRQoL was not associated with total area of atrophy in the better eye (β, - 0.53; 95% confidence interval [CI], - 1.11 to 0.05; P = 0.07) or worse eye (β, 0.12; 95% CI, - 0.32 to 0.55; P = 0.59). However, area of atrophy in the central 1-mm-diameter zone of the better eye was significantly associated with VRQoL when the ETDRS subfields were examined individually (β, - 14.57; 95% CI, - 27.12 to - 2.02; P = 0.023), grouped into quadrants (β, - 18.35; 95% CI, - 30.03 to - 6.67; P = 0.002), inner and outer zones (β, - 17.26; 95% CI, - 29.38 to - 5.14; P = 0.006), or vertical and horizontal zones (β, - 18.97; 95% CI, - 30.18 to - 7.77; P = 0.001). CONCLUSION In patients with GA, greater area of atrophy in the central 1-mm-diameter zone of the better eye was independently associated with lower VRQoL, while total area of atrophy in the better or worse eye was not.
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Senthil MP, Simon S, Constable PA. A review of patient-reported outcome measures used in uveitis. Surv Ophthalmol 2023; 68:225-240. [PMID: 36395825 DOI: 10.1016/j.survophthal.2022.11.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 09/13/2022] [Accepted: 11/09/2022] [Indexed: 11/16/2022]
Abstract
We review patient-reported outcome measures (PROMs) used to evaluate the quality of life (QoL) in uveitis and provide a quality assessment of the psychometric properties of the PROMs, making it easier to choose the best questionnaire for uveitis. Our review included 158 articles. A total of 98 PROMs were used to measure QoL in uveitis and the National Eye Institute Visual Function Questionnaire 25 (NEI VFQ -25) was the most frequently used PROM in these studies. There were 5 uveitis-specific PROMs, but they were meant for either birdshot choroidopathy or cytomegalovirus retinitis or paediatric uveitis. There are no PROMs developed explicitly for the more common, anterior uveitis, intermediate uveitis, panuveitis, and chronic uveitis. The uveitis-specific PROMs performed better in our quality assessment criteria compared to other PROMs. However, these PROMs were constructed using traditional classical test theory and have not been assessed using the modern family of psychometric assessment methods such as Rasch analysis. As new therapeutic modalities for uveitis such as the new biological agents and steroid implants, continue to evolve, a comprehensive PROM will be increasingly valued in clinical trial settings to compare the effects of treatments from the patient's perspective.
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Affiliation(s)
- Mallika Prem Senthil
- College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Bedford Park, South Australia, Australia.
| | - Sumu Simon
- University of Adelaide, Adelaide, South Australia, Australia
| | - Paul A Constable
- College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Bedford Park, South Australia, Australia
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Demkowicz PC, Hajduk AM, Dodson JA, Oladele CR, Chaudhry SI. Racial disparities among older adults with acute myocardial infarction: The SILVER-AMI study. J Am Geriatr Soc 2023; 71:474-483. [PMID: 36415964 PMCID: PMC9957871 DOI: 10.1111/jgs.18084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 08/23/2022] [Accepted: 09/17/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Despite an aging population, little is known about racial disparities in aging-specific functional impairments and mortality among older adults hospitalized for acute myocardial infarction (AMI). METHODS We analyzed data from patients aged 75 years or older who were hospitalized for AMI at 94 US hospitals from 2013 to 2016. Functional impairments and geriatric conditions were assessed in-person during the AMI hospitalization. The association between race and risk of mortality (primary outcome) was evaluated with logistic regression adjusted sequentially for age, clinical characteristics, and measures of functional impairment and other conditions associated with aging. RESULTS Among 2918 participants, 2668 (91.4%) self-identified as White and 250 (8.6%) as Black. Black participants were younger (80.8 vs 81.7 years; p = 0.010) and more likely to be female (64.8% vs 42.5%; p < 0.001). Black participants were more likely to present with impairments in cognition (37.6% vs 14.5%; p < 0.001), mobility (66.0% vs 54.6%; p < 0.001) and vision (50.1% vs 35.7%; p < 0.001). Black participants were also more likely to report a disability in one or more activities of daily living (22.4% vs 13.0%; p < 0.001) and an unintentional loss of more than 10 lbs in the year prior to hospitalization (37.2% vs 13.0%; p < 0.001). The unadjusted odds of 6-month mortality among Black participants (odds ratio [OR] 2.0, 95% confidence interval [CI] 1.4-2.8) attenuated to non-significance after adjustment for age, clinical characteristics (OR 1.70, 95% CI 1.7, 1.2-2.5), and functional/geriatric conditions (OR 1.5, 95% CI 1.0-2.2). CONCLUSIONS Black participants had a more geriatric phenotype despite a younger average age, with more functional impairments. Controlling for functional impairments and geriatric conditions attenuated disparities in 6-month mortality somewhat. These findings highlight the importance of systematically assessing functional impairment during hospitalization and also ensuring equitable access to community programs to support post-AMI recovery among Black older adults.
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Affiliation(s)
- Patrick C. Demkowicz
- Department of Internal Medicine, Section of General Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
| | - Alexandra M. Hajduk
- Department of Internal Medicine, Section of Geriatrics, Yale University School of Medicine, New Haven, Connecticut
| | - John A. Dodson
- Department of Medicine, Division of Cardiology, NYU Grossman School of Medicine, New York, New York
- Department of Population Health, NYU Grossman School of Medicine, New York, New York
| | - Carol R. Oladele
- Department of Internal Medicine, Section of General Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
- Equity Research and Innovation Center, Yale University School of Medicine, New Haven, Connecticut
| | - Sarwat I. Chaudhry
- Department of Internal Medicine, Section of General Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
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Lindgren EC, Källstrand J, Alftberg Å, Johansson P, Kristén L, Håman L, Ivarsson A, Carlsson IM. Empowerment-Based Physical Activity Intervention for People with Advanced Dry Age-Related Macular Degeneration: Mixed-Methods Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:643. [PMID: 36612963 PMCID: PMC9819966 DOI: 10.3390/ijerph20010643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/23/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
Age-related macular degeneration (AMD) is the most common cause of incurable visual impairment and impacts daily life. These impacts include loss of social activities, decreased functional independence, and reduced physical activity. This protocol aims to describe a prospective, mixed-methodology for studying a population with AMD before, during, and after an empowerment-based physical activity intervention (EPI). A study framework was also developed for EPI. The intervention will include 20 older individuals (age 65+ years) with AMD recruited in Sweden. The intervention period is six months and comprises adapted physical activity and social activities in a group twice a week and individual health coaching on three occasions. The quantitative pre-test and three follow-ups include physical functional tests, an accelerometer that monitors physical activity continuously for one week, and questionnaires. Individual and focus-group interviews and ethnographic observations will explore the experience of living with AMD and what it means to participate in the EPI for individuals with AMD. The chosen methodology offers a structured way for researchers to explore the experiences and factors that may provide insights into the potential of creative supervised, adapted physical activity in groups, health coaching, and socialising that are significant to enable well-being among older individuals with AMD.
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Affiliation(s)
- Eva-Carin Lindgren
- School of Health and Welfare, Halmstad University, SE-30118 Halmstad, Sweden
| | - Jeanette Källstrand
- School of Health and Welfare, Halmstad University, SE-30118 Halmstad, Sweden
| | - Åsa Alftberg
- Department of Social Work, Faculty of Health and Society, Malmö University, SE-20506 Malmö, Sweden
| | - Pia Johansson
- School of Health and Welfare, Halmstad University, SE-30118 Halmstad, Sweden
| | - Lars Kristén
- School of Health and Welfare, Halmstad University, SE-30118 Halmstad, Sweden
| | - Linn Håman
- School of Health and Welfare, Halmstad University, SE-30118 Halmstad, Sweden
| | - Andreas Ivarsson
- School of Health and Welfare, Halmstad University, SE-30118 Halmstad, Sweden
| | - Ing-Marie Carlsson
- School of Health and Welfare, Halmstad University, SE-30118 Halmstad, Sweden
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Difficulties in Performing Daily Activities in Patients with Dry Eye before and after Treatment. Medicina (B Aires) 2022; 59:medicina59010025. [PMID: 36676649 PMCID: PMC9861134 DOI: 10.3390/medicina59010025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/24/2022] [Accepted: 12/20/2022] [Indexed: 12/25/2022] Open
Abstract
Dry eye disease (DED) represents an important public health problem causing visual discomfort which affects the quality of life. This paper investigates the current comprehension of DED on life quality and vision. METHODS This research consists of a cross-sectional study of 121 patients, with a mean age of 70 ± 9 years, diagnosed with DED. All patients were treated in the University Clinic for Ophthalmology in "St. Spiridon" Emergency Hospital, Iasi. For all patients, we evaluated visual acuity on the Snellen chart, tear breakup time (TBUT), Schirmer I test scores, and contrast sensitivity. For this study, we used the Visual Functioning Questionnaire-25 (VFQ-25) version 2000, modified and adapted for this research (19 items). RESULTS Prior to treatment, patients had very high difficulty reading a text in a newspaper or on TV, reading prices on products in shops, or recognizing people they already met. Performing manual work or favorite activities was also very difficult. Post-treatment visual challenges improved in the majority of cases, regardless of the treatment method used. CONCLUSIONS We found that symptomatic dry eye disease was associated with reduced ability in performing several important vision-related daily tasks and has a significant impact on life quality and visual performance.
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Pastore MR, Milan S, Agolini R, Egidi L, Agostini T, Belfanti L, Cirigliano G, Tognetto D. How Could Medical and Surgical Treatment Affect the Quality of Life in Glaucoma Patients? A Cross-Sectional Study. J Clin Med 2022; 11:jcm11247301. [PMID: 36555917 PMCID: PMC9784022 DOI: 10.3390/jcm11247301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 11/28/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND To evaluate and compare the visual function and the quality of life (QoL) in glaucomatous patients treated with topical medical therapy (TMT) alone, canaloplasty (CP), or trabeculectomy (TB). METHODS A total of 291 eyes of 167 patients with primary open-angle glaucoma or secondary pseudoexfoliative glaucoma in TMT or surgically treated with CP or TB were included. Eligibility criteria for surgical patients included not needing TMT after surgery. Each patient underwent a visual field assessment and peripapillary retinal nerve fiber layer (pRNFL) optical coherence tomography and filled out the Glaucoma Symptoms Scale (GSS) questionnaire and the 25-Item National Eye Institute Visual Functioning Questionnaire (25-NEI-VFQ). Comparison between the QoL level of the three groups and its correlation with optic nerve's anatomical and functional status was the primary outcome. RESULTS CP patients reported the best general vision (p = 0.01), a lower incidence of eye burning (p = 0.03), and the lowest annoyance level of non-visual symptoms (p = 0.006). QoL positively correlated with pRNFL thickness, whereas no correlation was found with visual field damage. CONCLUSION CP provides a better QoL when compared both to TB and TMT, regardless of glaucoma stage. pRNFL seems to provide additional information for predicting change in QoL.
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Affiliation(s)
- Marco Rocco Pastore
- Eye Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, 34129 Trieste, Italy
| | - Serena Milan
- Eye Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, 34129 Trieste, Italy
- Correspondence: ; Tel.: +39-040-399-2243
| | - Rossella Agolini
- Eye Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, 34129 Trieste, Italy
| | - Leonardo Egidi
- Department of Economics, Business, Mathematics and Statistics, University of Trieste, 34100 Trieste, Italy
| | - Tiziano Agostini
- Department of Life Sciences, University of Trieste, 34100 Trieste, Italy
| | - Lorenzo Belfanti
- Eye Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, 34129 Trieste, Italy
| | - Gabriella Cirigliano
- Eye Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, 34129 Trieste, Italy
| | - Daniele Tognetto
- Eye Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, 34129 Trieste, Italy
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Vichare N, Pushkar K, Agrawal M, Jindal I. Vision related quality-of-life among patients with traumatic or non-traumatic ocular disease and its association with the Rights of Persons with Disabilities Act: Unveiling-the-hidden. Indian J Ophthalmol 2022; 70:4245-4250. [PMID: 36453325 PMCID: PMC9940580 DOI: 10.4103/ijo.ijo_1530_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Purpose To assess vision-related quality of life (VrQoL) in cases with visual loss after ocular trauma (OT) or non-traumatic ocular disease (NTOD) using the National Eye Institute's 25-Item Visual Function Questionnaire 25 (VFQ-25) and its association with visual disability % (VD%) based on the Rights of Persons with Disabilities (RPwD) Act, 2016. Methods This was a prospective observational study conducted among cases with ocular morbidity in either or both eyes with a visual acuity of ≤6/24. VFQ-25 questionnaire was administered to measure QoL scores. Statistical analysis was done using the Statistical Package for the Social Sciences (SPSS) version 23. P < 0.05 was taken as significant. Results Eighty-eight respondents completed the questionnaire. Mean age of participants was 40.272 ± 9.35 years (range: 23-55 years). Forty-three (48.9%) and 45 (51.1%) participants had OT and NTOD, respectively. The most common cause was traumatic optic neuropathy (21.6%) followed by corneal causes (19.4%). Low visual QoL scores were reported in all the cases (57.52 ± 16.08). Between OT and NTOD, a significant difference in terms of age (P = 0.001) and general vision (P = 0.03) was seen. Lowest scores were for driving. Based on VD%, 77 cases had ≤40 and the rest had >40% VD with a significant difference in overall mean scores (P = 0.03), specifically in domains of general vision (P = 0.00), near activities (P = 0.00), and driving (P = 0.007). QoL was decreased in each subscale of ≤40%VD group, who faced the same predicament everywhere as by the cases with more disability. Conclusion Ocular morbidity is associated with low QoL, predominantly in domains like general vision, near activities and driving. The RPwD Act leaves out a huge population with VD without any government benefits. One might need to consider other vision-related factors also to provide them with social, psychological, and employment benefits.
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Affiliation(s)
- Nitin Vichare
- Department of Ophthalmology, Command Hospital, Pune, India
| | - Kumar Pushkar
- Department of Community Medicine, Command Hospital, Pune, India
| | - Mohini Agrawal
- Department of Ophthalmology, Command Hospital, Pune, India,Correspondence to: Dr. Mohini Agrawal, Department of Ophthalmology, Command Hospital, Pune - 411 040, Maharashtra, India. E-mail:
| | - Imroz Jindal
- Department of Orthopaedics, Armed Forces Medical College, Pune, India
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O'Donovan C, Panthagani J, Aiyegbusi OL, Liu X, Bayliss S, Calvert M, Pesudovs K, Denniston A, Moore D, Braithwaite T. Evaluating patient-reported outcome measures (PROMs) for clinical trials and clinical practice in adult patients with uveitis or scleritis: a systematic review. J Ophthalmic Inflamm Infect 2022; 12:29. [PMID: 36063293 PMCID: PMC9443634 DOI: 10.1186/s12348-022-00304-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 07/09/2022] [Indexed: 12/01/2022] Open
Abstract
Patient reported outcome measures (PROMs) capture impact of disease and treatment on quality of life, and have an emerging role in clinical trial outcome measurement. This study included a systematic review and quality appraisal of PROMs developed or validated for use in adults with uveitis or scleritis. We searched MEDLINE, EMBASE, PsycINFO, CINAHL and grey literature sources, to 5 November 2021. We used established quality criteria to grade each PROM instrument in multiple domains from A (high quality) to C (low quality), and assessed content development, validity, reliability and responsiveness. For instruments developed using classic test theory-based psychometric approaches, we assessed acceptability, item targeting and internal consistency. For instruments developed using Item Response Theory (IRT) (e.g. Rasch analysis), we assessed response categories, dimensionality, measurement precision, item fit statistics, differential item functioning and targeting. We identified and appraised four instruments applicable to certain uveitis types, but none for scleritis. Specifically, the National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ), a 3-part PROM for Birdshot retinochoroiditis (Birdshot Disease & Medication Symptoms Questionnaire [BD&MSQ], the quality of life (QoL) impact of Birdshot Chorioretinopathy [QoL BCR], and the QoL impact of BCR medication [QoL Meds], the Kings Sarcoidosis Questionnaire (KSQ), and a PROM for cytomegalovirus retinitis. These instruments had limited coverage for these heterogeneous conditions, with a focus on very rare subtypes. Psychometric appraisal revealed considerable variability between instruments, limited content development, and only one developed using Item Response Theory. In conclusion, there are few validated PROMs for patients with uveitis and none for scleritis, and existing instruments have suboptimal psychometric performance. We articulate why we do not recommend their inclusion as clinical trial outcome measures for drug licensing purposes, and highlight an unmet need for PROMs applicable to uveitis and scleritis.
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Affiliation(s)
- Charles O'Donovan
- School of Immunology and Microbiology, King's College London, London, England.
| | | | - Olalekan Lee Aiyegbusi
- Centre for Patient Reported Outcomes Research (CPROR), Institute of Applied Health Research, Birmingham Health Partners for Regulatory Science and Innovation, and NIHR, Birmingham Biomedical Research Centre, University of Birmingham, Birmingham, B15 2TT, UK
| | - Xiaoxuan Liu
- Institute of Inflammation and Ageing, University of Birmingham, University Hospitals Birmingham, Birmingham, England
- Health Data Research UK, London, England
| | - Susan Bayliss
- Institute of Applied Health Research, University of Birmingham, Birmingham, England
| | - Melanie Calvert
- Centre for Patient Reported Outcomes Research (CPROR), Institute of Applied Health Research, Birmingham Health Partners for Regulatory Science and Innovation, NIHR, Birmingham Biomedical Research Centre, NIHR Surgical Reconstruction and Microbiology Centre and NIHR Applied Research Collaboration West Midlands, University of Birmingham, Birmingham, B15 2TT, UK
| | - Konrad Pesudovs
- University of New South Wales, Kensington, Australia
- Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, UK
| | - Alastair Denniston
- Institute of Inflammation and Ageing, University of Birmingham, University Hospitals Birmingham, Birmingham, England
- Health Data Research UK, London, England
| | - David Moore
- Institute of Applied Health Research, University of Birmingham, Birmingham, England
| | - Tasanee Braithwaite
- School of Immunology and Microbiology, King's College London, London, England
- Institute of Applied Health Research, University of Birmingham, Birmingham, England
- The Medical Eye Unit, Guy's and St Thomas' Hospital NHS Foundation Trust, London, England
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