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Choo CH, Gonzales J, Shantha JG. Anxiety and depression in patients with uveitis: a comprehensive review of observational studies. Curr Opin Ophthalmol 2023; 34:543-549. [PMID: 37729665 DOI: 10.1097/icu.0000000000000999] [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: 09/22/2023]
Abstract
PURPOSE OF THE REVIEW The purpose of this review is to provide a comprehensive summary of observational studies evaluating anxiety and depression in patients with uveitis. RECENT FINDINGS A higher prevalence of depression was reported in patients with uveitis compared to healthy controls in most observational studies. Symptoms of anxiety were often, but not always, significantly worse in patients with uveitis compared to controls. Most studies found that patients with uveitis had reduced vision-related quality of life that was associated with anxiety and depression symptoms. SUMMARY Patients with uveitis have a higher risk of experiencing symptoms of depression and could benefit from screening and treatment. Preliminary screening for vision-related quality of life could also help determine if the patient requires assistance in mental health or other aspects of daily living.
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Affiliation(s)
- Charlene H Choo
- F.I. Proctor Foundation, University of California San Francisco, San Francisco, California, USA
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2
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Zhang Z, Griva K, Rojas-Carabali W, Patnaik G, Liu R, Sobrin L, Kempen JH, Finger RP, Gupta V, Ang B, Agrawal R. Psychosocial Well-Being and Quality of Life in Uveitis: A Review. Ocul Immunol Inflamm 2023:1-15. [PMID: 37713271 DOI: 10.1080/09273948.2023.2247077] [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: 05/27/2023] [Revised: 08/07/2023] [Accepted: 08/07/2023] [Indexed: 09/17/2023]
Abstract
PURPOSE As a potentially sight-threatening disease with ocular, systemic, and treatment-related complications, uveitis diminishes quality of life (QOL) and affects psychosocial well-being. This review summarizes the existing tools for evaluating psychosocial well-being and/or QOL in patients with uveitis, explores the biological and non-biological factors affecting psychosocial well-being and/or QOL, and proposes future directions for incorporating these tools into clinical practice. METHODS A systematic search of the MEDLINE, Embase, and Cochrane databases from inception to June 8, 2022 was conducted, screening for articles focused on psychosocial well-being and/or QOL in patients with uveitis. Both quantitative and qualitative analyses were performed. RESULTS In uveitis research, the most frequently studied patient-reported outcome measures were vision-related QOL (e.g. Visual Function Questionnaire [VFQ-25]) and health-related QOL (e.g. Short Form Survey [SF-36]), followed by mental health indicators including depression and anxiety. Instruments have also been developed specific to the pediatric population (e.g. Effects of Youngsters' Eyesight on Quality of Life [EYE-Q]). Generally, studies report worse psychosocial outcomes and QOL in patients with uveitis compared to the general population. Contributory factors include both clinical (e.g. visual impairment, ocular comorbidities) and patient-related (e.g. older age, female sex) factors. CONCLUSION Given the heterogeneity of instruments used, it is worth considering standardization across large uveitis studies and trials. Beyond research, given the biopsychosocial effects on patients with uveitis, there are benefits to incorporating QOL and psychosocial assessments into clinical practice. Simplification of questionnaires into abridged forms, focusing on the most clinically relevant aspects of patient care, may be considered.
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Affiliation(s)
- Zheting Zhang
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Konstadina Griva
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - William Rojas-Carabali
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Gazal Patnaik
- Sankara Netralaya, Medical Research Foundation, Chennai, India
| | - Renee Liu
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Schepens Eye Research Institute, Boston, Massachusetts, USA
| | - Lucia Sobrin
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Schepens Eye Research Institute, Boston, Massachusetts, USA
| | - John H Kempen
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Schepens Eye Research Institute, Boston, Massachusetts, USA
- MyungSung Christian Medical Center (MCM) Eye Unit, MCM Comprehensive Specialized Hospital and MyungSung Medical School, Addis Ababa, Ethiopia
| | - Robert P Finger
- Department of Ophthalmology, St. Franziskus Hospital Münster, Münster, Germany
| | - Vishali Gupta
- Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Bryan Ang
- Department of Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore
| | - Rupesh Agrawal
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- Department of Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore
- Moorfields Eye Hospital, NHS Foundation Trust, London, UK
- Singapore Eye Research Institute, The Academia, Singapore, Singapore
- Department of Ophthalmology and Visual Sciences, Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
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3
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Silva MSF, Arantes TE, Moreto R, Smith JR, Furtado JM. Vision-related quality of life in patients treated for ocular syphilis. Sci Rep 2023; 13:13413. [PMID: 37591975 PMCID: PMC10435556 DOI: 10.1038/s41598-023-40289-0] [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: 03/13/2023] [Accepted: 08/08/2023] [Indexed: 08/19/2023] Open
Abstract
Multiple studies have showed negative impact of non-infectious uveitis on quality of life (QoL). Less is understood regarding life experiences in patients with infectious uveitis. We investigated vision-related QoL in individuals who had recovered from ocular syphilis. 32 adults treated for ocular syphilis at a uveitis service in Brazil completed the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25), and a comprehensive ophthalmic examination was performed. Medical records were reviewed to confirm resolution of ocular inflammation for 3 months pre-enrolment, and collect clinical data. The NEI VFQ-25 composite score was low overall (75.5 ± 19.8, mean ± standard deviation), and subscale scores varied from relative lows of 59.1 ± 39.6 (driving) and 60.9 ± 24.5 (mental health), to relative highs of 84.8 ± 21.8 (ocular) and 89.1 ± 21.0 (color vision). Adults aged over 40 years and those with a final visual acuity of 20/50 or worse had significantly lower mean composite and subscale scores. Other clinical characteristics-including gender, HIV co-infection, and type of uveitis-did not significantly influence scores. Our findings, taken in context with previous observations that prompt recognition achieves better vision outcomes, suggest early treatment may improve QoL after recovery from ocular syphilis.
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Affiliation(s)
- Milena Simões F Silva
- Division of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, 3900 Bandeirantes Avenue, Ribeirão Preto, São Paulo, 14049-900, Brazil
| | | | - Renata Moreto
- Division of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, 3900 Bandeirantes Avenue, Ribeirão Preto, São Paulo, 14049-900, Brazil
| | - Justine R Smith
- Flinders University College of Medicine and Public Health, Adelaide, Australia
| | - João M Furtado
- Division of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, 3900 Bandeirantes Avenue, Ribeirão Preto, São Paulo, 14049-900, Brazil.
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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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5
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Dlamini ST, Htet KM, Theint ECC, Mayadilanuari AM, Li WM, Tung YC, Tu HP. Herpes Zoster Risk in Patients with Rheumatoid Arthritis and Its Association with Medications Used. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2123. [PMID: 36767490 PMCID: PMC9915285 DOI: 10.3390/ijerph20032123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
Rheumatoid arthritis (RA) was associated with the risk of incident herpes zoster (HZ), which might be influenced by medication use by RA patients. We aimed to investigate the association of RA with the risk of incident HZ and how the HZ risk effected by RA medications in CIC RA patients. We conducted an observational study including population-based representative insurance claims data of 19,673 patients with RA and 39,346 matched patients without RA during 1997-2010 from the Taiwan National Health Insurance Research Database; we identified 1651 patients with catastrophic illness-certified (CIC) RA and 11,557 matched patients with non-CIC RA. Exploratory analyses assessed the association between RA/CIC RA and risk of incident HZ and its complications. The association of prescribed medications with HZ risk in CIC RA patients was also estimated. The incidence rates of HZ were higher in CIC RA patients and non-CIC RA than in the matched people without RA (21.95 and 14.03 vs. 7.36 events per 1000 person-years, respectively). The adjusted incidence rate ratio (95% confidence interval (CI)) for HZ was 1.74 (1.65-1.84) in RA patients vs. matched non-RA and 1.65 (1.44-1.89) in CIC RA patients vs. non-CIC RA. For HZ complications, RA had a 2.85-fold higher risk than non-RA, and CIC RA had a 1.78-fold higher risk than non-CIC RA. Moreover, in CIC RA patients, prednisolone use was associated with incident HZ risk compared with prednisolone nonuse (adjusted odds ratio 1.48, 1.08-2.03); prolonged prednisolone use (approximately 5 years) increased the risk (adjusted odds ratio 2.16, 1.46-3.19). Our results suggested that RA was positively associated with HZ risk, particularly in RA patients with prednisolone use.
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Affiliation(s)
| | - Kyaw Moe Htet
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan
| | - Ei Chue Chue Theint
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan
| | | | - Wei-Ming Li
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung 807378, Taiwan
- Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan
- Department of Urology, Ministry of Health and Welfare, Pingtung Hospital, Pingtung 90054, Taiwan
| | - Yi-Ching Tung
- Department of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan
| | - Hung-Pin Tu
- Department of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 807378, Taiwan
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Cui B, Jia HZ, Gao LX, Dong XF. Risk of anxiety and depression in patients with uveitis: a Meta-analysis. Int J Ophthalmol 2022; 15:1381-1390. [PMID: 36017044 DOI: 10.18240/ijo.2022.08.23] [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: 05/21/2021] [Accepted: 10/11/2021] [Indexed: 11/23/2022] Open
Abstract
AIM To quantitatively evaluate the risk of anxiety and depression in patients with uveitis via performing a Meta-analysis. METHODS Three electronic database (PubMed, Embase, and Cochrane Library databases) were searched for studies recording data about uveitis and anxiety as well as depression simultaneously up to January 2021. The incidence rate and standard mean difference (SMD) with a 95% confidence interval (95%CI) were calculated to analyse the association using random-effects models based on heterogeneity tests. RESULTS In total, 12 observational studies containing 874 patients with uveitis were included. The results showed that there was a significant association between uveitis and anxiety (SMD=0.97, 95%CI: 0.39 to 1.54, P=0.0009) and depression (SMD=0.79, 95%CI: 0.51 to 1.07, P<0.00001). The overall morbidities of anxiety and depression in patients with uveitis were 39% and 17%, respectively. With subgroup analysis, the heterogeneity actually came from different kinds of uveitis. Specifically, the incidence rates of both anxiety and depression were relatively low in patients with anterior uveitis (33% and 15%), moderate in patients with infectious uveitis (46% and 22%), and high in patients with unspecified uveitis (59% and 35%). CONCLUSION It is preliminarily indicated that patients with uveitis may have a high risk of anxiety and depression. Ophthalmologists and psychologists should pay more attention to the psychological state when dealing with patients with uveitis. Further high-quality studies with detailed direct data are needed to draw more precise conclusions.
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Affiliation(s)
- Bei Cui
- Senior Department of Ophthalmology, the Third Medical Centre of Chinese People's Liberation Army General Hospital, Beijing 100039, China
| | - Hong-Zhen Jia
- Senior Department of Ophthalmology, the Third Medical Centre of Chinese People's Liberation Army General Hospital, Beijing 100039, China
| | - Li-Xiong Gao
- Senior Department of Ophthalmology, the Third Medical Centre of Chinese People's Liberation Army General Hospital, Beijing 100039, China
| | - Xiao-Fei Dong
- Department of Ophthalmology, No.967 Hospital of the Joint Logistics Support Force of the Chinese PLA, Dalian 116000, Liaoning Province, China
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Kim JH, Lee JY, Choi JA. Long-term prognosis for glaucoma in patients with Posner-Schlossman syndrome. Graefes Arch Clin Exp Ophthalmol 2021; 259:3757-3767. [PMID: 34296346 DOI: 10.1007/s00417-021-05291-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 06/16/2021] [Accepted: 06/16/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The aim of this study is to investigate the long-term prognosis for glaucoma in patients with Posner-Schlossman syndrome (PSS). METHODS In this retrospective case series study, a total of 98 patients with PSS from January 2014 to February 2019 were included in this study. Initial presentations and follow-up data were obtained from medical records. Vision-related quality of life (VR-QoL) was assessed using the 25-item National Eye Institute Visual Functioning Questionnaire. RESULTS Of the 98 patients included in the study, 66 (67%) presented with glaucoma, and among them, 21 (32%) required glaucoma surgery. The mean follow-up time was 50.1 months (range 1-263 months). Iris involvement was noted in 46 (46.9%) eyes; 26 (26.5%) had sectoral iris changes and 20 (20.4%) showed diffuse iris changes. Eyes with iris involvement had a significantly higher number of acute attacks of uveitis than those without (p = 0.010). The 5-year glaucoma surgery-free interval was 77.8% according to Kaplan-Meier analysis. Significant predictors of glaucoma surgery included iris involvement (hazard ratio [HR] = 5.215; confidence interval [CI] = 1.387-19.610), highest number of anti-glaucoma agents (HR = 5.069; CI = 1.848-13.905), baseline average retinal nerve fiber layer thickness (RNFLT) thickness (HR = 0.949; CI = 0.917-0.982), and disease duration (HR = 0.977; CI = 0.957-0.996). Overall complete surgical success and qualified success at 2 years was 35.3% and 75.5%, respectively. Patients with iris involvement, glaucoma surgery, and thinner average RNFLT had significantly poorer VR-QoL (all, p < 0.05). CONCLUSIONS Patients with PSS and glaucoma required glaucoma surgery in a high rate. Iris involvement increased the probability of surgical treatment and lowered the VR-QoL of PSS patients.
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Affiliation(s)
- Jin-Ho Kim
- Department of Ophthalmology and Visual Science, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ji-Young Lee
- Department of Ophthalmology and Visual Science, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jin A Choi
- Department of Ophthalmology and Visual Science, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
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Vakros G, Scollo P, Hodson J, Murray PI, Rauz S. Anxiety and depression in inflammatory eye disease: exploring the potential impact of topical treatment frequency as a putative psychometric item. BMJ Open Ophthalmol 2021; 6:e000649. [PMID: 34307892 PMCID: PMC8261890 DOI: 10.1136/bmjophth-2020-000649] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 01/07/2021] [Accepted: 01/21/2021] [Indexed: 01/01/2023] Open
Abstract
Objective To evaluate whether topical therapy is linked to scores related to anxiety, depression and quality of life (QoL) in inflammatory eye disease (IED). Methods and analysis Patients with ocular surface disease (OSD, N=100) and Uveitis (N=100) completed self-administered validated questions on ocular symptoms and well-being, with supplemental questions on eye drop frequency. Results Forty (20%) patients had scores consistent with depression and 33 (17%) anxiety. Anxiety, depression, QoL and OSD index (OSDI) scores did not differ significantly between OSD and Uveitis groups. In those with anxiety or depression, QoL was significantly reduced in all WHO Quality Of Life-BREF domains (all p<0.001). Multivariable analysis considering demographic and disease-related factors found daily topical drop frequency to be independently associated with anxiety (p=0.009) but not depression (p=0.300). Conclusion A high proportion of patients with IED demonstrated scores indicative of anxiety and depression. Preliminary evidence suggests that the frequency of topical eye drops potentially plays a significant role in the psychological health status of patients with IED.
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Affiliation(s)
- Georgios Vakros
- Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
- Birmingham and Midland Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | - Paolo Scollo
- Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
- Birmingham and Midland Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | - James Hodson
- Department of Biostatistics, Institute of Translational Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Philip I Murray
- Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
- Birmingham and Midland Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | - Saaeha Rauz
- Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
- Birmingham and Midland Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
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Canamary AM, Monteiro IR, Machado Silva MKM, Regatieri CVS, Silva LMP, Casaroli-Marano RP, Muccioli C. Quality-of-Life and Psychosocial Aspects in Patients with Ocular Toxoplasmosis: A Clinical Study in a Tertiary Care Hospital in Brazil. Ocul Immunol Inflamm 2020; 28:679-687. [PMID: 31589483 DOI: 10.1080/09273948.2019.1612453] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE To evaluate quality of life in patients with uveitis-related to toxoplasmosis and its correlation with demographic, ocular involvement and psychosocial aspects.Methods: Data were collected through standardized interviews using a form to collect clinical and demographic data, in addition forms such as HADS, SF-12, NEI-VFQ-25 for health-related quality of life and anxiety and depression symptoms.Results: 81 patients were included with a mean age of 41.5 ± 14.5 years, females (50.6%) They were divided into three categories of best corrected visual acuity in the better seeing eye: normal (0-0.4 logMAR, 60 participants), low vision (0.48-0.9 logMAR, 9 participants) and blindness (>1 logMAR, 12 participants). The mean of VFQ-25 score was 75.5 ± 19.5 and the mean of SF-12 physical and mental components scores were 48.5 ± 7.4 and 52.4 ± 10.6 for health-related quality of life (HRQol). Anxiety symptoms were most prevalente than depression and were found in 38% of the subjects.Conclusions: Slightly more than a quarter of the sample presented impaired vision. It is associated with worsening of the quality of life since it affects mostly mental and related to the vision domains. This affects familiar, social and in addition, labor relations, since the majority of the subjects are in the economically active age group.
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Affiliation(s)
| | - Isabela Ribeiro Monteiro
- Ophthalmology and Visual Science, Universidade Federal de Sao Paulo Escola Paulista de Medicina , Sao Paulo, Brazil
| | | | | | - Luci Meire Pereira Silva
- Ophthalmology and Visual Science, Universidade Federal de Sao Paulo Escola Paulista de Medicina , Sao Paulo, Brazil
| | | | - Cristina Muccioli
- Ophthalmology and Visual Science, Universidade Federal de Sao Paulo Escola Paulista de Medicina , Sao Paulo, Brazil
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Neumann R, Barequet D, Rosenblatt A, Amer R, Ben-Arie-Weintrob Y, Hareuveni-Blum T, Vishnevskia-Dai V, Raskin E, Blumenfeld O, Shulman S, Sanchez JM, Flores V, Habot-Wilner Z. Herpetic Anterior Uveitis – Analysis of Presumed and PCR Proven Cases. Ocul Immunol Inflamm 2018; 27:211-218. [DOI: 10.1080/09273948.2018.1483521] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Ron Neumann
- Private Inflammatory Eye Disease Clinic, Tel-Aviv, Israel
| | - Dana Barequet
- Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Amir Rosenblatt
- Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Radgonde Amer
- Department of Ophthalmology, Hadassah Medical Center, The Hebrew University Hadassah Medical School, Jerusalem, Israel
| | - Yael Ben-Arie-Weintrob
- Department of Ophthalmology, Rambam Medical Center, The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
| | - Tamar Hareuveni-Blum
- Department of Ophthalmology, Faculty of Medicine in the Galilee, Galilee Medical Center, Bar Ilan University, Naharia, Israel
| | - Vicktoria Vishnevskia-Dai
- The Goldschleger Eye Institute, Department of Ophthalmology, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Ramat Gan, Israel
| | - Eyal Raskin
- Department of Ophthalmology, Barzilai University Medical Center, Ben-Gurion University, Ashkelon, Israel
| | - Oren Blumenfeld
- Department of Ophthalmology, Wolfson Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Holon, Israel
| | - Shiri Shulman
- Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Juan M. Sanchez
- Department of Ophthalmology, Hadassah Medical Center, The Hebrew University Hadassah Medical School, Jerusalem, Israel
| | - Victor Flores
- Department of Ophthalmology, Rambam Medical Center, The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
| | - Zohar Habot-Wilner
- Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Sittivarakul W, Wongkot P. Anxiety and Depression among Patients with Uveitis and Ocular Inflammatory Disease at a Tertiary Center in Southern Thailand: Vision-Related Quality of Life, Sociodemographics, and Clinical Characteristics Associated. Ocul Immunol Inflamm 2018; 27:731-742. [DOI: 10.1080/09273948.2018.1484495] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Wantanee Sittivarakul
- Department of Ophthalmology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Prapaipim Wongkot
- Department of Ophthalmology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
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12
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Akinsoji E, Goldhardt R, Galor A. A Glimpse into Uveitis in the Aging Eye: Pathophysiology, Clinical Presentation and Treatment Considerations. Drugs Aging 2018; 35:399-408. [PMID: 29663152 PMCID: PMC5955816 DOI: 10.1007/s40266-018-0545-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Uveitis describes a group of inflammatory conditions of the eye that have various underlying causes and clinical presentations. Susceptibilities to uveitis in the elderly may be attributed to age-related risk factors such as immunosenescence, increased immunological inflammatory mediators, and autoimmunity. Overall, anterior uveitis is more common than posterior and panuveitis in the general population and also in the elderly. Some causes of uveitis in the elderly are herpes simplex virus, ocular ischemic syndrome, sarcoidosis, and central nervous system lymphoma, and these will be discussed in detail herein. Eye care professionals need to consider the wide differential for uveitis, obtain the appropriate history, conduct a detailed clinical examination, and tailor management to the clinical presentation and underlying cause of disease. The challenges of polypharmacy and nonadherence in the elderly impact patient outcomes and must be taken into consideration when considering treatment.
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Affiliation(s)
| | - Raquel Goldhardt
- University of Miami Miller School of Medicine, Miami, FL, USA
- Miami Veterans Administration Medical Center, Miami, FL, USA
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17th Street, Miami, FL, 33136, USA
| | - Anat Galor
- University of Miami Miller School of Medicine, Miami, FL, USA.
- Miami Veterans Administration Medical Center, Miami, FL, USA.
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17th Street, Miami, FL, 33136, USA.
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Haasnoot AMJW, Sint Jago NFM, Tekstra J, de Boer JH. Impact of Uveitis on Quality of Life in Adult Patients With Juvenile Idiopathic Arthritis. Arthritis Care Res (Hoboken) 2017; 69:1895-1902. [DOI: 10.1002/acr.23224] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 02/14/2017] [Indexed: 11/08/2022]
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Silva LMP, Arantes TE, Casaroli-Marano R, Vaz T, Belfort R, Muccioli C. Quality of Life and Psychological Aspects in Patients with Visual Impairment Secondary to Uveitis: A Clinical Study in a Tertiary Care Hospital in Brazil. Ocul Immunol Inflamm 2017; 27:99-107. [PMID: 29020477 DOI: 10.1080/09273948.2017.1370551] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To evaluate the quality of life in individuals with bilateral visual impairment secondary to uveitis and its association with sociodemographic, clinical and psychosocial aspects. METHODS Data were collected through a structured interviews, using four forms; the SF-12v2, HADS, NEI-VFQ-25 and a specific form developed to collect clinical and sociodemographic data. RESULTS 80 patients were included with a mean age of 42.8 years; 63.8% female; 57.5% with permanent reduction of familiar income. The average number of medical visits was 15.2 ±10.7/year. In terms of health-related quality of life (HRQol), the mean of VFQ-25 score was 36.6 ± 15.1 and the mean of SF-12 physical and mental components scores were 43.3 ± 9.9 and 44.9 ± 12.2. Anxiety and depression symptoms were found in 65.1% and 32.5% of patients, respectively. CONCLUSIONS Visual impairment has impact on several scales of HRQoL leading to productivity loss and consumption of health resources.
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Affiliation(s)
- Luci Meire P Silva
- a Department of Ophthalmology , Federal University of São Paulo , São Paulo , Brazil
| | - Tiago Eugênio Arantes
- a Department of Ophthalmology , Federal University of São Paulo , São Paulo , Brazil
| | | | - Tatiana Vaz
- a Department of Ophthalmology , Federal University of São Paulo , São Paulo , Brazil
| | - Rubens Belfort
- a Department of Ophthalmology , Federal University of São Paulo , São Paulo , Brazil
| | - Cristina Muccioli
- a Department of Ophthalmology , Federal University of São Paulo , São Paulo , Brazil
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Niemeyer KM, Gonzales JA, Rathinam SR, Babu M, Thundikandy R, Kanakath A, Porco TC, Browne EN, Rao MM, Acharya NR. Quality-of-Life Outcomes From a Randomized Clinical Trial Comparing Antimetabolites for Intermediate, Posterior, and Panuveitis. Am J Ophthalmol 2017; 179:10-17. [PMID: 28414043 DOI: 10.1016/j.ajo.2017.04.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 04/05/2017] [Accepted: 04/06/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE To evaluate the changes in quality of life in noninfectious uveitis patients treated with 2 of the most commonly prescribed antimetabolite treatments. DESIGN Secondary analysis of a multicenter, block-randomized clinical trial. METHODS Eighty patients at Aravind Eye Hospitals in Madurai and Coimbatore, India, with noninfectious intermediate, posterior, or panuveitis were randomized to receive oral methotrexate, 25 mg weekly, or oral mycophenolate mofetil, 1 g twice daily, and were followed up monthly for 6 months. Best-corrected visual acuity, Indian Vision Function Questionnaire (IND-VFQ), and Medical Outcomes Study 36-item Short Form Survey (SF-36) were obtained at enrollment and at 6 months (or prior, in the event of early treatment failure). RESULTS IND-VFQ scores, on average, increased by 9.2 points from trial enrollment to 6 months (95% confidence interval [CI]: 4.9, 13.5, P = .0001). Although the SF-36 physical component summary score did not significantly differ over the course of the trial, the mental component summary score decreased by 2.3 points (95% CI: -4.4, -0.1, P = .04) and the vitality subscale decreased by 3.5 points (95% CI: -5.6, -1.4, P = .001). Quality-of-life scores did not differ between treatment arms. Linear regression modeling showed a 3.2-point improvement in IND-VFQ score for every 5-letter improvement in visual acuity (95% CI: 1.9, 4.3; P < .001). CONCLUSIONS Although uveitis treatment was associated with increased vision and vision-related quality of life, patient-reported physical health did not change after 6 months of treatment, and mental health decreased. Despite improved visual outcomes, uveitis patients receiving systemic immunosuppressive therapy may experience a deterioration in mental health-related quality of life.
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O'Rourke M, Haroon M, Alfarasy S, Ramasamy P, FitzGerald O, Murphy CC. The Effect of Anterior Uveitis and Previously Undiagnosed Spondyloarthritis: Results from the DUET Cohort. J Rheumatol 2017; 44:1347-1354. [PMID: 28668811 DOI: 10.3899/jrheum.170115] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2017] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Anterior uveitis (AU) is an intraocular inflammatory condition closely linked to spondyloarthritis (SpA). Clinical disease variables may often underestimate the true effect of the disease on patient's quality of life. This study examines AU and associated undiagnosed SpA using established quality-of-life tools to inform clinicians of the effect of these diseases. METHODS The Dublin Uveitis Evaluation Tool (DUET) algorithm was developed and validated in a cohort of consecutive patients with AU who were all screened by a rheumatologist for the presence of SpA. This same cohort completed vision-related [Vision Core Measure 1 (VCM1)] and general health [Medical Outcomes Study Short Form-36 (SF-36)] questionnaires when AU was active and resolved. RESULTS VCM1 scores improved with AU resolution. VCM1 did not correlate with vision at baseline, but did on resolution of inflammation. Physical SF-36 scores were reduced during AU episodes and improved on resolution remaining below those of population norms. Subanalysis revealed that SpA scores were more affected than the idiopathic AU group. CONCLUSION AU affects physical aspects of quality of life more than is appreciated by clinical variables, especially in those with pre-existing, undiagnosed SpA. This study is unique in examining the effect of SpA on patients prior to diagnosis. These results highlight the role of the ophthalmologist in identifying patients with SpA who present with AU using the DUET algorithm.
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Affiliation(s)
- Michael O'Rourke
- From the Department of Ophthalmology, Royal Victoria Eye and Ear Hospital; Department of Rheumatology, St. Vincent's University Hospital, Elm Park, Dublin; University Hospital Kerry, Tralee, Kerry, Ireland. .,M. O'Rourke, MB, MRCSI (Ophth), FEBO, PhD, Higher Surgical Trainee, Department of Ophthalmology, Royal Victoria Eye and Ear Hospital; M. Haroon, MB, MRCPI, MMedSc, PhD, Consultant Rheumatologist, University Hospital Kerry; S. Alfaresy, MB, Ophthalmology Trainee, Department of Ophthalmology, Royal Victoria Eye and Ear Hospital; P. Ramasamy, MB, MRCSI (Ophth), MD, Higher Surgical Trainee, Department of Ophthalmology, Royal Victoria Eye and Ear Hospital; O. FitzGerald, MB, MRCPI, MRCP, FRCPI, MD, Professor of Rheumatology (University College, Dublin), Department of Rheumatology, St Vincent's University Hospital; C.C. Murphy, MB, MMedSc, FRCSI, FRCOphth ( UK), PhD, Professor of Ophthalmology (Royal College of Surgeons in Ireland), Department of Ophthalmology, Royal Victoria Eye and Ear Hospital.
| | - Muhammad Haroon
- From the Department of Ophthalmology, Royal Victoria Eye and Ear Hospital; Department of Rheumatology, St. Vincent's University Hospital, Elm Park, Dublin; University Hospital Kerry, Tralee, Kerry, Ireland.,M. O'Rourke, MB, MRCSI (Ophth), FEBO, PhD, Higher Surgical Trainee, Department of Ophthalmology, Royal Victoria Eye and Ear Hospital; M. Haroon, MB, MRCPI, MMedSc, PhD, Consultant Rheumatologist, University Hospital Kerry; S. Alfaresy, MB, Ophthalmology Trainee, Department of Ophthalmology, Royal Victoria Eye and Ear Hospital; P. Ramasamy, MB, MRCSI (Ophth), MD, Higher Surgical Trainee, Department of Ophthalmology, Royal Victoria Eye and Ear Hospital; O. FitzGerald, MB, MRCPI, MRCP, FRCPI, MD, Professor of Rheumatology (University College, Dublin), Department of Rheumatology, St Vincent's University Hospital; C.C. Murphy, MB, MMedSc, FRCSI, FRCOphth ( UK), PhD, Professor of Ophthalmology (Royal College of Surgeons in Ireland), Department of Ophthalmology, Royal Victoria Eye and Ear Hospital
| | - Salman Alfarasy
- From the Department of Ophthalmology, Royal Victoria Eye and Ear Hospital; Department of Rheumatology, St. Vincent's University Hospital, Elm Park, Dublin; University Hospital Kerry, Tralee, Kerry, Ireland.,M. O'Rourke, MB, MRCSI (Ophth), FEBO, PhD, Higher Surgical Trainee, Department of Ophthalmology, Royal Victoria Eye and Ear Hospital; M. Haroon, MB, MRCPI, MMedSc, PhD, Consultant Rheumatologist, University Hospital Kerry; S. Alfaresy, MB, Ophthalmology Trainee, Department of Ophthalmology, Royal Victoria Eye and Ear Hospital; P. Ramasamy, MB, MRCSI (Ophth), MD, Higher Surgical Trainee, Department of Ophthalmology, Royal Victoria Eye and Ear Hospital; O. FitzGerald, MB, MRCPI, MRCP, FRCPI, MD, Professor of Rheumatology (University College, Dublin), Department of Rheumatology, St Vincent's University Hospital; C.C. Murphy, MB, MMedSc, FRCSI, FRCOphth ( UK), PhD, Professor of Ophthalmology (Royal College of Surgeons in Ireland), Department of Ophthalmology, Royal Victoria Eye and Ear Hospital
| | - Pathma Ramasamy
- From the Department of Ophthalmology, Royal Victoria Eye and Ear Hospital; Department of Rheumatology, St. Vincent's University Hospital, Elm Park, Dublin; University Hospital Kerry, Tralee, Kerry, Ireland.,M. O'Rourke, MB, MRCSI (Ophth), FEBO, PhD, Higher Surgical Trainee, Department of Ophthalmology, Royal Victoria Eye and Ear Hospital; M. Haroon, MB, MRCPI, MMedSc, PhD, Consultant Rheumatologist, University Hospital Kerry; S. Alfaresy, MB, Ophthalmology Trainee, Department of Ophthalmology, Royal Victoria Eye and Ear Hospital; P. Ramasamy, MB, MRCSI (Ophth), MD, Higher Surgical Trainee, Department of Ophthalmology, Royal Victoria Eye and Ear Hospital; O. FitzGerald, MB, MRCPI, MRCP, FRCPI, MD, Professor of Rheumatology (University College, Dublin), Department of Rheumatology, St Vincent's University Hospital; C.C. Murphy, MB, MMedSc, FRCSI, FRCOphth ( UK), PhD, Professor of Ophthalmology (Royal College of Surgeons in Ireland), Department of Ophthalmology, Royal Victoria Eye and Ear Hospital
| | - Oliver FitzGerald
- From the Department of Ophthalmology, Royal Victoria Eye and Ear Hospital; Department of Rheumatology, St. Vincent's University Hospital, Elm Park, Dublin; University Hospital Kerry, Tralee, Kerry, Ireland.,M. O'Rourke, MB, MRCSI (Ophth), FEBO, PhD, Higher Surgical Trainee, Department of Ophthalmology, Royal Victoria Eye and Ear Hospital; M. Haroon, MB, MRCPI, MMedSc, PhD, Consultant Rheumatologist, University Hospital Kerry; S. Alfaresy, MB, Ophthalmology Trainee, Department of Ophthalmology, Royal Victoria Eye and Ear Hospital; P. Ramasamy, MB, MRCSI (Ophth), MD, Higher Surgical Trainee, Department of Ophthalmology, Royal Victoria Eye and Ear Hospital; O. FitzGerald, MB, MRCPI, MRCP, FRCPI, MD, Professor of Rheumatology (University College, Dublin), Department of Rheumatology, St Vincent's University Hospital; C.C. Murphy, MB, MMedSc, FRCSI, FRCOphth ( UK), PhD, Professor of Ophthalmology (Royal College of Surgeons in Ireland), Department of Ophthalmology, Royal Victoria Eye and Ear Hospital
| | - Conor C Murphy
- From the Department of Ophthalmology, Royal Victoria Eye and Ear Hospital; Department of Rheumatology, St. Vincent's University Hospital, Elm Park, Dublin; University Hospital Kerry, Tralee, Kerry, Ireland.,M. O'Rourke, MB, MRCSI (Ophth), FEBO, PhD, Higher Surgical Trainee, Department of Ophthalmology, Royal Victoria Eye and Ear Hospital; M. Haroon, MB, MRCPI, MMedSc, PhD, Consultant Rheumatologist, University Hospital Kerry; S. Alfaresy, MB, Ophthalmology Trainee, Department of Ophthalmology, Royal Victoria Eye and Ear Hospital; P. Ramasamy, MB, MRCSI (Ophth), MD, Higher Surgical Trainee, Department of Ophthalmology, Royal Victoria Eye and Ear Hospital; O. FitzGerald, MB, MRCPI, MRCP, FRCPI, MD, Professor of Rheumatology (University College, Dublin), Department of Rheumatology, St Vincent's University Hospital; C.C. Murphy, MB, MMedSc, FRCSI, FRCOphth ( UK), PhD, Professor of Ophthalmology (Royal College of Surgeons in Ireland), Department of Ophthalmology, Royal Victoria Eye and Ear Hospital
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Onal S, Oray M, Yasa C, Akman M, Uludag G, Koc Akbay A, Tugal-Tutkun I. Screening for Depression and Anxiety in Patients with Active Uveitis. Ocul Immunol Inflamm 2017; 26:1078-1093. [DOI: 10.1080/09273948.2017.1319959] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Sumru Onal
- School of Medicine, Department of Ophthalmology, Koc University, Istanbul, Turkey
- Department of Ophthalmology, V.K. Foundation, American Hospital, Istanbul, Turkey
| | - Merih Oray
- Istanbul Faculty of Medicine, Department of Ophthalmology, Istanbul University, Istanbul, Turkey
| | - Cagla Yasa
- School of Medicine, Koc University, Istanbul, Turkey
| | - Mehmet Akman
- School of Medicine, Department of Family Medicine, Marmara University, Istanbul, Turkey
| | - Gunay Uludag
- Department of Ophthalmology, Koc University Hospital, Istanbul, Turkey
| | - Aylin Koc Akbay
- Department of Ophthalmology, Koc University Hospital, Istanbul, Turkey
| | - Ilknur Tugal-Tutkun
- Istanbul Faculty of Medicine, Department of Ophthalmology, Istanbul University, Istanbul, Turkey
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Reynaud C, Rousseau A, Kaswin G, M'garrech M, Barreau E, Labetoulle M. Persistent Impairment of Quality of Life in Patients with Herpes Simplex Keratitis. Ophthalmology 2017; 124:160-169. [DOI: 10.1016/j.ophtha.2016.10.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Revised: 09/29/2016] [Accepted: 10/02/2016] [Indexed: 11/29/2022] Open
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Sunam Gamal N, Kharel Sitaula R, Shah DN. Change in Visual Function in Uveitis Patients after Treatment: An Experience from Nepal. Ocul Immunol Inflamm 2016; 26:747-752. [PMID: 28010155 DOI: 10.1080/09273948.2016.1264610] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To assess the change in visual function in uveitis patients after treatment. MATERIALS AND METHODS This one and a half year prospective study was conducted among 180 new uveitis patients. A questionnaire was used to assess the visual function in uveitis cases and analysis of effect size change was also done. RESULTS The male to female ratio was 1.3:1. The mean vision at presentation was 0.49 logMAR units, which improved to 0.39 logMAR units and 0.35 logMAR units by the 1st and 4th week but deteriorated to 0.62 logMAR units at the 6th week. Anterior uveitis and posterior uveitis patients had significant improvement (p≤0.001) in all three scales but panuveitis and intermediate uveitis had significant improvement (p<0.05) in two scales. The effect size showed small to large change in all three scales. CONCLUSIONS Visual function is adversely affected by uveitis, which can be improved after treatment.
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Affiliation(s)
| | - Ranju Kharel Sitaula
- b Ophthalmology, B. P. Koirala Lions Centre for Ophthalmic Studies , Tribhuvan University, Institute of Medicine , Kathmandu , Nepal
| | - Dev Narayan Shah
- b Ophthalmology, B. P. Koirala Lions Centre for Ophthalmic Studies , Tribhuvan University, Institute of Medicine , Kathmandu , Nepal
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20
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Hoeksema L, Los LI. Vision-Related Quality of Life in Patients with Inactive HLA-B27-Associated-Spectrum Anterior Uveitis. PLoS One 2016; 11:e0146956. [PMID: 26808922 PMCID: PMC4725670 DOI: 10.1371/journal.pone.0146956] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 12/22/2015] [Indexed: 11/18/2022] Open
Abstract
We investigated the vision-related quality of life (VR-QOL) in patients with HLA-B27 associated anterior uveitis (AU). The study was conducted in 2012 at the ophthalmology department of the University Medical Center of Groningen. We included AU patients who were HLA-B27 positive and/or were diagnosed by a rheumatologist with an HLA-B27 associated systemic disease. Sixty-one of 123 (50%) adult patients participated. All patients filled-out the National Eye Institute Visual Functioning Questionnaire-25 (NEI VFQ-25), Beck Depression Inventory (BDI-II), social support lists and an additional questionnaire for gathering general information. Medical records were reviewed for clinical characteristics. Analyses were conducted on various patient and ocular characteristics. We compared our NEI VFQ-25 scores with those previously found in the literature. Our main outcome measures were VR-QOL scores and their associations with various general patient and ocular characteristics. We found that the NEI VFQ-25 mean overall composite score was 88.9±8.8, which is relatively high, but lower than that found in a normal working population. The mean general health score was 47.4±20.8, which is lower than in patients with other ocular diseases. Patients with a systemic disease scored significantly lower on general health and VR-QOL, compared to patients without a systemic disease. Patients with a depression (6/59 (10%)) frequently had ankylosing spondylitis (5/6 patients) and they scored significantly worse on VR-QOL. We concluded that patients with HLA-B27 associated AU have a relatively high VR-QOL. However, the presence of a systemic disease is associated with lower VR-QOL and general health scores. In addition, depression is associated with a lower VR-QOL.
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Affiliation(s)
- Lisette Hoeksema
- Department of Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
- W.J. Kolff Institute, Graduate School of Medical Sciences, University of Groningen, Groningen, the Netherlands
- * E-mail:
| | - Leonoor I. Los
- Department of Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
- W.J. Kolff Institute, Graduate School of Medical Sciences, University of Groningen, Groningen, the Netherlands
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Saboo US, Amparo F, Abud TB, Schaumberg DA, Dana R. Vision-Related Quality of Life in Patients with Ocular Graft-versus-Host Disease. Ophthalmology 2015; 122:1669-74. [PMID: 26001816 DOI: 10.1016/j.ophtha.2015.04.011] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Revised: 04/07/2015] [Accepted: 04/09/2015] [Indexed: 01/19/2023] Open
Abstract
PURPOSE To assess the vision-related quality of life (QOL) in a cohort of patients with ocular graft-versus-host disease (GVHD). DESIGN Prospective study. PARTICIPANTS Eighty-four patients diagnosed with chronic ocular GVHD. METHODS We assessed the vision-related QOL with the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25). The symptoms of ocular GVHD were assessed using the Ocular Surface Disease Index (OSDI) and Symptom Assessment in Dry Eye (SANDE) questionnaires. MAIN OUTCOME MEASURES We assessed vision-related QOL with the NEI-VFQ-25 and compared the scores obtained from patients with ocular GVHD with those from a healthy population. In the ocular GVHD population, we also evaluated the associations between the NEI-VFQ-25 and the dry eye symptoms measured by the OSDI and SANDE questionnaires, age, duration of disease, best-corrected visual acuity (BCVA), corneal fluorescein staining (CFS), tear break-up time, and Schirmer test. RESULTS The mean composite NEI-VFQ-25 score in patients with ocular GVHD was 76.5±17. Compared with healthy subjects, patients with ocular GVHD reported reduced scores on all NEI-VFQ-25 subscales (each P < 0.001) with the exception of color vision (P = 0.11). The NEI-VFQ-25 composite scores significantly correlated with OSDI (R = -0.81, P < 0.001), SANDE (R = -0.56, P < 0.001), CFS (R = -0.36, P = 0.001), and BCVA (R = -0.30, P = 0.004). CONCLUSIONS Patients with ocular GVHD experience measurable impairment of vision-related QOL. This study highlights the impact of ocular GVHD on the vision-related QOL, and thus the importance of comprehensive diagnosis and treatment of this condition.
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Affiliation(s)
- Ujwala S Saboo
- Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Francisco Amparo
- Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Tulio B Abud
- Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Debra A Schaumberg
- Moran Center for Translational Medicine, John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City, Utah; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Reza Dana
- Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts.
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