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Cheng MJ, Rohan EMF, Rai BB, Sabeti F, Maddess T, Lane J. The experience of visual art for people living with mild-to-moderate vision loss. Arts Health 2024; 16:147-166. [PMID: 37012640 DOI: 10.1080/17533015.2023.2192741] [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: 06/08/2022] [Accepted: 03/04/2023] [Indexed: 04/05/2023]
Abstract
BACKGROUND Visual art can enhance wellbeing and quality-of-life; however, the experience of visual art for people with mild-to-moderate vision loss has not been examined. METHODS Eight participants (6 females, 2 males; Mean age = 81 years, SD = 7.9, range 70-91 years; 4 with mild vision loss and 4 with moderate vision loss based on binocular visual acuity) completed a mixed-methods study comprising: a semi-structured interview on visual art experience; an eye examination; and questionnaires about visual functioning and quality-of-life. RESULTS Various themes were identified: visual perception of art (e.g. altered colours, visual distortions, etc.), viewing conditions, elements of art, personal preference, deriving meaning, appreciation of art, impact of impaired visual perception, and social aspects of art. CONCLUSIONS The overall experience of art is influenced by how an individual sees, perceives, and makes meaning from art. Even mild vision loss can impair this experience and impact emotional and social wellbeing.
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Affiliation(s)
- Meredith J Cheng
- Australian National University Medical School, College of Health and Medicine, Canberra, ACT, Australia
| | - Emilie M F Rohan
- Eccles Institute for Neuroscience, The John Curtin School of Medical Research, The Australian National University, Canberra, ACT, Australia
| | - Bhim B Rai
- Eccles Institute for Neuroscience, The John Curtin School of Medical Research, The Australian National University, Canberra, ACT, Australia
| | - Faran Sabeti
- Eccles Institute for Neuroscience, The John Curtin School of Medical Research, The Australian National University, Canberra, ACT, Australia
- Discipline of Optometry, Faculty of Health, University of Canberra, ACT, Australia
| | - Ted Maddess
- Eccles Institute for Neuroscience, The John Curtin School of Medical Research, The Australian National University, Canberra, ACT, Australia
| | - Jo Lane
- National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
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Zuroff LR, Green AJ. The Study of Remyelinating Therapies in Multiple Sclerosis: Visual Outcomes as a Window Into Repair. J Neuroophthalmol 2024; 44:143-156. [PMID: 38654413 DOI: 10.1097/wno.0000000000002149] [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: 04/26/2024]
Abstract
INTRODUCTION Amelioration of disability in multiple sclerosis requires the development of complementary therapies that target neurodegeneration and promote repair. Remyelination is a promising neuroprotective strategy that may protect axons from damage and subsequent neurodegeneration. METHODS A review of key literature plus additional targeted search of PubMed and Google Scholar was conducted. RESULTS There has been a rapid expansion of clinical trials studying putative remyelinating candidates, but further growth of the field is limited by the lack of consensus on key aspects of trial design. We have not yet defined the ideal study population, duration of therapy, or the appropriate outcome measures to detect remyelination in humans. The varied natural history of multiple sclerosis, coupled with the short time frame of phase II clinical trials, requires that we develop and validate biomarkers of remyelination that can serve as surrogate endpoints in clinical trials. CONCLUSIONS We propose that the visual system may be the most well-suited and validated model for the study potential remyelinating agents. In this review, we discuss the pathophysiology of demyelination and summarize the current clinical trial landscape of remyelinating agents. We present some of the challenges in the study of remyelinating agents and discuss current potential biomarkers of remyelination and repair, emphasizing both established and emerging visual outcome measures.
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Affiliation(s)
- Leah R Zuroff
- Department of Neurology (LZ), Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania; and Department of Neurology (AJG), University of California San Francisco, San Francisco, California
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Karuntu JS, Nguyen XTA, Talib M, van Schooneveld MJ, Wijnholds J, van Genderen MM, Schalij-Delfos NE, Klaver CCW, Meester-Smoor MA, van den Born LI, Hoyng CB, Thiadens AAHJ, Bergen AA, van Nispen RMA, Boon CJF. Quality of life in patients with CRB1-associated retinal dystrophies: A longitudinal study. Acta Ophthalmol 2024; 102:469-477. [PMID: 37749859 DOI: 10.1111/aos.15769] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 08/30/2023] [Indexed: 09/27/2023]
Abstract
PURPOSE To assess the longitudinal vision-related quality of life among patients with CRB1-associated inherited retinal dystrophies. METHODS In this longitudinal questionnaire study, the National Eye Institute Visual Function Questionnaire (39 items, NEI VFQ-39) was applied at baseline, two-year follow-up, and 4-year follow-up in patients with pathogenic CRB1 variants. [Correction added on 20 November 2023, after first online publication: The preceding sentence has been updated in this version.] Classical test theory was performed to obtain subdomain scores and in particular 'near activities' and 'total composite' scores. The Rasch analysis based on previous calibrations of the NEI VFQ-25 was applied to create visual functioning and socio-emotional subscales. RESULTS In total, 22 patients with a CRB1-associated retinal dystrophy were included, […] with a median age of 25.0 years (interquartile range: 13-31 years) at baseline and mean follow-up of 4.0 ± 0.3 years. [Correction added on 20 November 2023, after first online publication: The preceding sentence has been updated in this version.] A significant decline at 4 years was observed for 'near activities' (51.0 ± 23.8 vs 35.4 ± 14.7, p = 0.004) and 'total composite' (63.0 ± 13.1 vs 52.0 ± 12.1, p = 0.001) subdomain scores. For the Rasch-scaled scores, the 'visual functioning' scale significantly decreased after 2 years (-0.89 logits; p = 0.012), but not at 4-year follow-up (+0.01 logits; p = 0.975). [Correction added on 20 November 2023, after first online publication: In the preceding sentence, "…after 4 years…" has been corrected to "…after 2 years…" in this version.] The 'socio-emotional' scale also showed a significant decline after 2 years (-0.78 logits, p = 0.033) and 4 years (-0.83 logits, p = 0.021). CONCLUSION In the absence of an intervention, a decline in vision-related quality of life is present in patients with pathogenic CRB1 variants at 4-year follow-up. Patient-reported outcome measures should be included in future clinical trials, as they can be a potential indicator of disease progression and treatment efficacy.
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Affiliation(s)
- Jessica S Karuntu
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
| | - Xuan-Thanh-An Nguyen
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
| | - Mays Talib
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
| | - Mary J van Schooneveld
- Department of Ophthalmology, Amsterdam UMC, Academic Medical Center, Amsterdam, The Netherlands
| | - Jan Wijnholds
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
- The Netherlands Institute for Neuroscience (NIN-KNAW), Amsterdam, The Netherlands
| | - Maria M van Genderen
- Bartiméus, Diagnostic Centre for complex visual disorders, Zeist, The Netherlands
- Department of Ophthalmology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | | | - Caroline C W Klaver
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, The Netherlands
- Institute for Molecular and Clinical Ophthalmology, Basel, Switzerland
| | | | | | - Carel B Hoyng
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Arthur A Bergen
- Department of Clinical Genetics, Amsterdam UMC, Academic Medical Center, Amsterdam, The Netherlands
| | - Ruth M A van Nispen
- Department of Ophthalmology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Camiel J F Boon
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Ophthalmology, Amsterdam UMC, Academic Medical Center, Amsterdam, The Netherlands
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Vingopoulos F, Bannerman A, Zhou P, Koch T, Wescott HE, Kim L, Vavvas D, Miller JW, Miller JB. Towards the validation of quantitative contrast sensitivity as a clinical endpoint: correlations with vision-related quality of life in bilateral AMD. Br J Ophthalmol 2024; 108:846-851. [PMID: 37857454 DOI: 10.1136/bjo-2023-323507] [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: 03/07/2023] [Accepted: 07/23/2023] [Indexed: 10/21/2023]
Abstract
AIM To investigate if active learning of contrast sensitivity (CS) in bilateral age-related macular degeneration (AMD) correlates better than visual acuity (VA) with vision-related quality of life (VRQoL) using factor analysis-calibrated National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25). METHODS Prospective cross-sectional observational study in 93 patients (186 eyes) with bilateral AMD. CS was measured in one eye at a time with the quantitative CS function (qCSF) method (Adaptive Sensory Technology). Same-day VRQoL was assessed with factor analysis-calibrated NEI VFQ-25 visual function and socioemotional scales. Mixed-effects multiple linear regression analyses evaluated the associations of the qCSF outcomes and VA with the NEI VFQ-25 scales. A subgroup analysis on patients with AMD with VA more than 20/25 in both eyes was performed. RESULTS Compared with VA, CS outcomes were associated with larger effect on both visual function scale (standardised beta coefficients (β*) for area under the logarithm of CSF (AULCSF) curve and CS thresholds at 1.5, 3 and 6 cycles per degree (cpd): β*=0.50, 0.48, 0.52, 0.46, all p<0.001, respectively, vs β*=-0.45 for VA, all p<0.001) and socioemotional scale (β* for AULCSF and CS threshold at 6 cpd: β*=0.44, 0.44 vs β*=-0.42 for VA, all p<0.001). In patients with AMD with VA more than 20/25 in both eyes (N=20), both VFQ-25 scales and all CS outcomes were significantly reduced. CONCLUSIONS qCSF-measured CS strongly correlates with patient-reported VRQoL in bilateral AMD, even stronger than VA does. This study further validates qCSF-measured CS as a promising functional endpoint for future clinical trials in AMD.
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Affiliation(s)
- Filippos Vingopoulos
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Augustine Bannerman
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Paul Zhou
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Thomas Koch
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Hannah E Wescott
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Leo Kim
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Demetrios Vavvas
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Joan W Miller
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - John B Miller
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
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Abraham AG, Tong W, Stosor V, Friedman MR, Detels R, Plankey M. Vision Problems As a Contributor to Lower Engagement in Care Among Aging Men Living with HIV. Ophthalmic Epidemiol 2024:1-10. [PMID: 38771594 DOI: 10.1080/09286586.2024.2346894] [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: 08/22/2023] [Accepted: 04/20/2024] [Indexed: 05/22/2024]
Abstract
PURPOSE To investigate vision impairment as a barrier to engagement in medical care among aging persons living with HIV (PLWH) who experience multimorbidity and complex care needs. SETTING Multicenter AIDS Cohort Study (MACS), a prospective observational cohort of aging PLWH men. METHODS We examined relationships of self-reported vision difficulty with indicators of care engagement: 1) adherence to HIV antiretroviral therapy (ART; defined as taking ≥95% of medications); 2) self-reported avoidance of medical care; 3) self-reported tendency to ask a doctor questions about care (>2 questions at a medical visit), as well as with quality of life. A modified version of the National Eye Institute Vision Function Questionnaire was administered at three semi-annual visits (from October 2017 to March 2019) to assess difficulty performing vision-dependent tasks. RESULTS We included 1063 PLWH (median age 57 years, 31% Black). Data on care engagement outcomes were analyzed using repeated measures logistic regression with generalized estimating equations adjusted for race, and at visit values for age, education level, depressive symptoms, alcohol use, and smoking status. Compared to no vision difficulty, those reporting moderate to extreme vision difficulty on at least one task had 2.2 times higher odds (95% CI: 1.4, 3.4) of having less than optimal ART adherence, 1.9 times higher odds (95% CI: 1.1, 3.4) of avoiding necessary medical care and median quality of life scores 8 points lower. CONCLUSION These findings suggest vision impairment decreases medical care engagement including HIV care and quality of life among aging PLWH.
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Affiliation(s)
- Alison G Abraham
- Department of Epidemiology, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
- Department of Ophthalmology, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Weiqun Tong
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Valentina Stosor
- Division of Infectious Diseases, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
| | - M Reuel Friedman
- Department of Infectious Diseases and Microbiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Roger Detels
- Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, California, USA
| | - Michael Plankey
- Department of Medicine, Division of General Internal Medicine, Georgetown University, Washington, DC, USA
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Mohamed Z, Vankudre GS, Ayyappan JP, Noushad B, Alzeedi AN, Alazzani SS, Alkaabi AJ. Vision-Related Quality of Life Among Diabetic Retinopathy Patients in a Hospital-Based Population in the Sultanate of Oman. CLINICAL OPTOMETRY 2024; 16:123-129. [PMID: 38784861 PMCID: PMC11114135 DOI: 10.2147/opto.s462498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 05/03/2024] [Indexed: 05/25/2024]
Abstract
Background The global prevalence of diabetic retinopathy (DR) among individuals with diabetes is 22.27%. This highlights the likelihood of developing burden of retinopathy within the at risk population and can have a detrimental impact on an individual's quality of life (QoL). The aim of this study is to assess the vision-related QoL in individuals with (DR) in a hospital-based population in the Al-Buraimi governorate, Sultanate of Oman. Methods The study was conducted in the Ophthalmology Outpatient Department of Al Buraimi Hospital and Polyclinic. This study enrolled 218 patients (114 males, 104 females) diagnosed with DR. The NEI-VFQ-25 questionnaire was adopted in this study. The patients were classified into different groups according to their type of diabetes and other relevant demographic information. Results A total of 218 patients responded to the NEI-VFQ-25 questionnaire. The mean age of the participants was 57.49 ± 12.3 years, 52.3% were male, and 47.7% were female. The overall QoL score was 41.53± 20.8. Patients aged more than 75 years had the lowest QoL scores compared with the other age groups (p = 0.02). The results showed that the duration of diabetes had no significant impact on the overall QoL scores (p = 0.06). A higher QoL score was observed among patients with type II diabetes mellitus (DM) than with type I diabetes mellitus (p = 0.01). Patients diagnosed with proliferative DR (PDR) had a significantly lower QoL score than those diagnosed at other stages (p < 0.001). Conclusion The QoL of the population with DR is negatively affected by various factors, including demographics, disease severity, and in patients with DM type II. It is important to consider these factors to enhance QoL in patients with DR. Regular evaluation of an individual's QoL is beneficial for both physicians and healthcare teams.
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Affiliation(s)
- Zoelfigar Mohamed
- Department of Optometry, College of Health Sciences, University of Buraimi, Al Buraimi, Sultanate of Oman
| | - Gopi Suesh Vankudre
- Department of Optometry, College of Health Sciences, University of Buraimi, Al Buraimi, Sultanate of Oman
| | - Janitha Plackal Ayyappan
- Department of Optometry, College of Health Sciences, University of Buraimi, Al Buraimi, Sultanate of Oman
| | - Babu Noushad
- Department of Optometry, College of Health Sciences, University of Buraimi, Al Buraimi, Sultanate of Oman
| | | | | | - Aisha Juma Alkaabi
- Department of Optometry, College of Health Sciences, University of Buraimi, Al Buraimi, Sultanate of Oman
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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 2024:2818816. [PMID: 38753336 PMCID: PMC11099841 DOI: 10.1001/jamaophthalmol.2024.1482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [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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Portela-Camino JA, Sanchez I, Gutierrez C, Martín-González S. Successful treatment of diplopia using prism correction combined with vision therapy/orthoptics improves health-related quality of life. PeerJ 2024; 12:e17315. [PMID: 38737743 PMCID: PMC11088820 DOI: 10.7717/peerj.17315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 04/08/2024] [Indexed: 05/14/2024] Open
Abstract
Background To track improvement in diplopia symptoms with strabismus-specific health-related quality of life (HRQOL) questionnaire across a treatment consisting of prism correction followed by vision therapy/orthoptics when prism treatment alone has not succeeded. Methods Forty-eight participants with diplopia and a mean age of 62.45 were asked to complete an Adult Strabismus-20 (AS-20) questionnaire and a Diplopia Questionnaire (DQ) before and after prism correction. Inclusion criteria were diplopia reported on the DQ as "sometimes", "often" or "always" at reading or straight-ahead distance. The prism correction was classified as successful if the participant reported "never" or "rarely" on the DQ for reading and straight-ahead distance; and unsuccessful if the perceived diplopia worsened or remained the same. For all participants, mean initial AS-20 scores were compared with mean post-prism correction scores, taking into account AS-20 subscales (reading and general functions, and self-perception and interaction). Participants in the failed prism treatment subgroup subsequently underwent a programme of vision therapy wearing their prism correction, the results of which were again determined by participants' responses on the AS-20 questionnaire, completed before and after the vision therapy. Results Five of the 48 participants dropped out of the study. Prism correction was classified as successful in 22 of 43 participants (51%), and unsuccessful in 21 (49%). Those participants for whom the prism correction was classified as a success showed a statistically significant improvement (p = 0.01) in both reading and general functions. In the failed treatment subgroup, no significant change in AS-20 score was recorded for any of the domains (p = 0.1). After treatment with vision therapy/orthoptics, however, 13 of the 20 participants in the unsuccessful prism correction subgroup (one of them dropped out the study) achieved binocular vision and statistically significant improvement in reading and general functions (p = 0.01). Conclusions Although effective prism correction of diplopia is correlated with enhanced HRQOL, prism correction alone is frequently not sufficient to achieve this objective. In these cases, vision therapy/orthoptics treatment as a coadjutant to prism correction is shown to improve HRQOL.
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Affiliation(s)
| | - Irene Sanchez
- Departamento de Física Teórica Atómica y Óptica, Universidad de Valladolid, Valladolid, Spain
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain
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Pierce EA, Aleman TS, Jayasundera KT, Ashimatey BS, Kim K, Rashid A, Jaskolka MC, Myers RL, Lam BL, Bailey ST, Comander JI, Lauer AK, Maguire AM, Pennesi ME. Gene Editing for CEP290-Associated Retinal Degeneration. N Engl J Med 2024. [PMID: 38709228 DOI: 10.1056/nejmoa2309915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
BACKGROUND CEP290-associated inherited retinal degeneration causes severe early-onset vision loss due to pathogenic variants in CEP290. EDIT-101 is a clustered regularly interspaced short palindromic repeats (CRISPR)-CRISPR-associated protein 9 (Cas9) gene-editing complex designed to treat inherited retinal degeneration caused by a specific damaging variant in intron 26 of CEP290 (IVS26 variant). METHODS We performed a phase 1-2, open-label, single-ascending-dose study in which persons 3 years of age or older with CEP290-associated inherited retinal degeneration caused by a homozygous or compound heterozygous IVS26 variant received a subretinal injection of EDIT-101 in the worse (study) eye. The primary outcome was safety, which included adverse events and dose-limiting toxic effects. Key secondary efficacy outcomes were the change from baseline in the best corrected visual acuity, the retinal sensitivity detected with the use of full-field stimulus testing (FST), the score on the Ora-Visual Navigation Challenge mobility test, and the vision-related quality-of-life score on the National Eye Institute Visual Function Questionnaire-25 (in adults) or the Children's Visual Function Questionnaire (in children). RESULTS EDIT-101 was injected in 12 adults 17 to 63 years of age (median, 37 years) at a low dose (in 2 participants), an intermediate dose (in 5), or a high dose (in 5) and in 2 children 9 and 14 years of age at the intermediate dose. At baseline, the median best corrected visual acuity in the study eye was 2.4 log10 of the minimum angle of resolution (range, 3.9 to 0.6). No serious adverse events related to the treatment or procedure and no dose-limiting toxic effects were recorded. Six participants had a meaningful improvement from baseline in cone-mediated vision as assessed with the use of FST, of whom 5 had improvement in at least one other key secondary outcome. Nine participants (64%) had a meaningful improvement from baseline in the best corrected visual acuity, the sensitivity to red light as measured with FST, or the score on the mobility test. Six participants had a meaningful improvement from baseline in the vision-related quality-of-life score. CONCLUSIONS The safety profile and improvements in photoreceptor function after EDIT-101 treatment in this small phase 1-2 study support further research of in vivo CRISPR-Cas9 gene editing to treat inherited retinal degenerations due to the IVS26 variant of CEP290 and other genetic causes. (Funded by Editas Medicine and others; BRILLIANCE ClinicalTrials.gov number, NCT03872479.).
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Affiliation(s)
- Eric A Pierce
- From the Ocular Genomics Institute, Department of Ophthalmology, Mass Eye and Ear and Harvard Medical School, Boston (E.A.P., J.I.C.), and Editas Medicine, Cambridge (B.S.A., K.K., A.R., M.C.J., R.L.M.) - both in Massachusetts; the Scheie Eye Institute and the Division of Ophthalmology of the Children's Hospital of Philadelphia, Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (T.S.A., A.M.M.); the University of Michigan Kellogg Eye Center, Ann Arbor (K.T.J.); the Bascom Palmer Eye Institute, University of Miami, Miami (B.L.L.); and the Casey Eye Institute, Oregon Health and Science University, Portland (S.T.B., A.K.L., M.E.P.)
| | - Tomas S Aleman
- From the Ocular Genomics Institute, Department of Ophthalmology, Mass Eye and Ear and Harvard Medical School, Boston (E.A.P., J.I.C.), and Editas Medicine, Cambridge (B.S.A., K.K., A.R., M.C.J., R.L.M.) - both in Massachusetts; the Scheie Eye Institute and the Division of Ophthalmology of the Children's Hospital of Philadelphia, Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (T.S.A., A.M.M.); the University of Michigan Kellogg Eye Center, Ann Arbor (K.T.J.); the Bascom Palmer Eye Institute, University of Miami, Miami (B.L.L.); and the Casey Eye Institute, Oregon Health and Science University, Portland (S.T.B., A.K.L., M.E.P.)
| | - Kanishka T Jayasundera
- From the Ocular Genomics Institute, Department of Ophthalmology, Mass Eye and Ear and Harvard Medical School, Boston (E.A.P., J.I.C.), and Editas Medicine, Cambridge (B.S.A., K.K., A.R., M.C.J., R.L.M.) - both in Massachusetts; the Scheie Eye Institute and the Division of Ophthalmology of the Children's Hospital of Philadelphia, Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (T.S.A., A.M.M.); the University of Michigan Kellogg Eye Center, Ann Arbor (K.T.J.); the Bascom Palmer Eye Institute, University of Miami, Miami (B.L.L.); and the Casey Eye Institute, Oregon Health and Science University, Portland (S.T.B., A.K.L., M.E.P.)
| | - Bright S Ashimatey
- From the Ocular Genomics Institute, Department of Ophthalmology, Mass Eye and Ear and Harvard Medical School, Boston (E.A.P., J.I.C.), and Editas Medicine, Cambridge (B.S.A., K.K., A.R., M.C.J., R.L.M.) - both in Massachusetts; the Scheie Eye Institute and the Division of Ophthalmology of the Children's Hospital of Philadelphia, Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (T.S.A., A.M.M.); the University of Michigan Kellogg Eye Center, Ann Arbor (K.T.J.); the Bascom Palmer Eye Institute, University of Miami, Miami (B.L.L.); and the Casey Eye Institute, Oregon Health and Science University, Portland (S.T.B., A.K.L., M.E.P.)
| | - Keunpyo Kim
- From the Ocular Genomics Institute, Department of Ophthalmology, Mass Eye and Ear and Harvard Medical School, Boston (E.A.P., J.I.C.), and Editas Medicine, Cambridge (B.S.A., K.K., A.R., M.C.J., R.L.M.) - both in Massachusetts; the Scheie Eye Institute and the Division of Ophthalmology of the Children's Hospital of Philadelphia, Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (T.S.A., A.M.M.); the University of Michigan Kellogg Eye Center, Ann Arbor (K.T.J.); the Bascom Palmer Eye Institute, University of Miami, Miami (B.L.L.); and the Casey Eye Institute, Oregon Health and Science University, Portland (S.T.B., A.K.L., M.E.P.)
| | - Alia Rashid
- From the Ocular Genomics Institute, Department of Ophthalmology, Mass Eye and Ear and Harvard Medical School, Boston (E.A.P., J.I.C.), and Editas Medicine, Cambridge (B.S.A., K.K., A.R., M.C.J., R.L.M.) - both in Massachusetts; the Scheie Eye Institute and the Division of Ophthalmology of the Children's Hospital of Philadelphia, Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (T.S.A., A.M.M.); the University of Michigan Kellogg Eye Center, Ann Arbor (K.T.J.); the Bascom Palmer Eye Institute, University of Miami, Miami (B.L.L.); and the Casey Eye Institute, Oregon Health and Science University, Portland (S.T.B., A.K.L., M.E.P.)
| | - Michael C Jaskolka
- From the Ocular Genomics Institute, Department of Ophthalmology, Mass Eye and Ear and Harvard Medical School, Boston (E.A.P., J.I.C.), and Editas Medicine, Cambridge (B.S.A., K.K., A.R., M.C.J., R.L.M.) - both in Massachusetts; the Scheie Eye Institute and the Division of Ophthalmology of the Children's Hospital of Philadelphia, Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (T.S.A., A.M.M.); the University of Michigan Kellogg Eye Center, Ann Arbor (K.T.J.); the Bascom Palmer Eye Institute, University of Miami, Miami (B.L.L.); and the Casey Eye Institute, Oregon Health and Science University, Portland (S.T.B., A.K.L., M.E.P.)
| | - Rene L Myers
- From the Ocular Genomics Institute, Department of Ophthalmology, Mass Eye and Ear and Harvard Medical School, Boston (E.A.P., J.I.C.), and Editas Medicine, Cambridge (B.S.A., K.K., A.R., M.C.J., R.L.M.) - both in Massachusetts; the Scheie Eye Institute and the Division of Ophthalmology of the Children's Hospital of Philadelphia, Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (T.S.A., A.M.M.); the University of Michigan Kellogg Eye Center, Ann Arbor (K.T.J.); the Bascom Palmer Eye Institute, University of Miami, Miami (B.L.L.); and the Casey Eye Institute, Oregon Health and Science University, Portland (S.T.B., A.K.L., M.E.P.)
| | - Byron L Lam
- From the Ocular Genomics Institute, Department of Ophthalmology, Mass Eye and Ear and Harvard Medical School, Boston (E.A.P., J.I.C.), and Editas Medicine, Cambridge (B.S.A., K.K., A.R., M.C.J., R.L.M.) - both in Massachusetts; the Scheie Eye Institute and the Division of Ophthalmology of the Children's Hospital of Philadelphia, Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (T.S.A., A.M.M.); the University of Michigan Kellogg Eye Center, Ann Arbor (K.T.J.); the Bascom Palmer Eye Institute, University of Miami, Miami (B.L.L.); and the Casey Eye Institute, Oregon Health and Science University, Portland (S.T.B., A.K.L., M.E.P.)
| | - Steven T Bailey
- From the Ocular Genomics Institute, Department of Ophthalmology, Mass Eye and Ear and Harvard Medical School, Boston (E.A.P., J.I.C.), and Editas Medicine, Cambridge (B.S.A., K.K., A.R., M.C.J., R.L.M.) - both in Massachusetts; the Scheie Eye Institute and the Division of Ophthalmology of the Children's Hospital of Philadelphia, Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (T.S.A., A.M.M.); the University of Michigan Kellogg Eye Center, Ann Arbor (K.T.J.); the Bascom Palmer Eye Institute, University of Miami, Miami (B.L.L.); and the Casey Eye Institute, Oregon Health and Science University, Portland (S.T.B., A.K.L., M.E.P.)
| | - Jason I Comander
- From the Ocular Genomics Institute, Department of Ophthalmology, Mass Eye and Ear and Harvard Medical School, Boston (E.A.P., J.I.C.), and Editas Medicine, Cambridge (B.S.A., K.K., A.R., M.C.J., R.L.M.) - both in Massachusetts; the Scheie Eye Institute and the Division of Ophthalmology of the Children's Hospital of Philadelphia, Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (T.S.A., A.M.M.); the University of Michigan Kellogg Eye Center, Ann Arbor (K.T.J.); the Bascom Palmer Eye Institute, University of Miami, Miami (B.L.L.); and the Casey Eye Institute, Oregon Health and Science University, Portland (S.T.B., A.K.L., M.E.P.)
| | - Andreas K Lauer
- From the Ocular Genomics Institute, Department of Ophthalmology, Mass Eye and Ear and Harvard Medical School, Boston (E.A.P., J.I.C.), and Editas Medicine, Cambridge (B.S.A., K.K., A.R., M.C.J., R.L.M.) - both in Massachusetts; the Scheie Eye Institute and the Division of Ophthalmology of the Children's Hospital of Philadelphia, Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (T.S.A., A.M.M.); the University of Michigan Kellogg Eye Center, Ann Arbor (K.T.J.); the Bascom Palmer Eye Institute, University of Miami, Miami (B.L.L.); and the Casey Eye Institute, Oregon Health and Science University, Portland (S.T.B., A.K.L., M.E.P.)
| | - Albert M Maguire
- From the Ocular Genomics Institute, Department of Ophthalmology, Mass Eye and Ear and Harvard Medical School, Boston (E.A.P., J.I.C.), and Editas Medicine, Cambridge (B.S.A., K.K., A.R., M.C.J., R.L.M.) - both in Massachusetts; the Scheie Eye Institute and the Division of Ophthalmology of the Children's Hospital of Philadelphia, Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (T.S.A., A.M.M.); the University of Michigan Kellogg Eye Center, Ann Arbor (K.T.J.); the Bascom Palmer Eye Institute, University of Miami, Miami (B.L.L.); and the Casey Eye Institute, Oregon Health and Science University, Portland (S.T.B., A.K.L., M.E.P.)
| | - Mark E Pennesi
- From the Ocular Genomics Institute, Department of Ophthalmology, Mass Eye and Ear and Harvard Medical School, Boston (E.A.P., J.I.C.), and Editas Medicine, Cambridge (B.S.A., K.K., A.R., M.C.J., R.L.M.) - both in Massachusetts; the Scheie Eye Institute and the Division of Ophthalmology of the Children's Hospital of Philadelphia, Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (T.S.A., A.M.M.); the University of Michigan Kellogg Eye Center, Ann Arbor (K.T.J.); the Bascom Palmer Eye Institute, University of Miami, Miami (B.L.L.); and the Casey Eye Institute, Oregon Health and Science University, Portland (S.T.B., A.K.L., M.E.P.)
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10
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Wu W, Yi L, Zhang K, Chen Z, Shi C, Chen C, Cai Y, Hu L, Chen X. Health-related quality of life measurements in children and adolescents with refractive errors: A scoping review. ADVANCES IN OPHTHALMOLOGY PRACTICE AND RESEARCH 2024; 4:84-94. [PMID: 38623588 PMCID: PMC11016581 DOI: 10.1016/j.aopr.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 02/23/2024] [Accepted: 03/05/2024] [Indexed: 04/17/2024]
Abstract
Background Refractive errors, particularly myopia, are the leading visual disorders worldwide, significantly affecting the quality of life (QOL) even after correction. This scoping review focuses on health-related quality of life (HRQOL) measurements for children and adolescents with refractive errors. Main text We explored generic and disease-specific HRQOL tools, examining their content, psychometric properties, and the impact of various interventions on QOL. Two English databases-PubMed, Embase, and one Chinese database, CNKI, were searched for relevant studies published from January 2001 to October 2023. Inclusion criteria encompassed studies using standardized instruments to assess the QOL of children aged 0-18 with refractive errors. The review compares prevalent HRQOL measurements, analyzes children's refractive error assessments, and discusses intervention effects on patient QOL. Conclusions The study underlines the necessity of developing disease-specific QOL instruments for very young children and serves as a practical guide for researchers in this field. The findings advocate for a targeted approach in HRQOL assessment among the pediatric population, identifying critical gaps in current methodologies.
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Affiliation(s)
- Wei Wu
- Eye Center of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Zhejiang Provincial Key Lab of Ophthalmology, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Lisha Yi
- Department of Nephrology, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, Queensland, Australia
- School of Biomedical Sciences, University of Queensland, St Lucia Campus, Brisbane, Australia
| | - Kai Zhang
- Zhejiang Provincial Key Lab of Ophthalmology, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Zipei Chen
- Department of Nephrology, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Caiping Shi
- Department of Nephrology, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Chen Chen
- School of Biomedical Sciences, University of Queensland, St Lucia Campus, Brisbane, Australia
| | - Yilu Cai
- Department of Nephrology, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Lidan Hu
- Department of Nephrology, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Xiangjun Chen
- Eye Center of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Institute of Translational Medicine, Zhejiang University School of Medicine, Hangzhou, China
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11
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Britten-Jones AC, McGuinness MB, Chen FK, Grigg JR, Mack HG, Ayton LN. A multinational survey of potential participant perspectives on ocular gene therapy. Gene Ther 2024; 31:314-323. [PMID: 38565634 DOI: 10.1038/s41434-024-00450-4] [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: 12/11/2023] [Revised: 03/15/2024] [Accepted: 03/19/2024] [Indexed: 04/04/2024]
Abstract
Amidst rapid advancements in ocular gene therapy, understanding patient perspectives is crucial for shaping future treatment choices and research directions. This international cross-sectional survey evaluated knowledge, attitudes, and perceptions of ocular genetic therapies among potential recipients with inherited retinal diseases (IRDs). Survey instruments included the Attitudes to Gene Therapy-Eye (AGT-Eye), EQ-5D-5L, National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25), and Patient Attitudes to Clinical Trials (PACT-22) instruments. This study included 496 participant responses (89% adults with IRDs; 11% parents/guardians/carers) from 35 countries, with most from the United States of America (USA; 69%) and the United Kingdom (11%). Most participants (90%) indicated they would likely accept gene therapy if it was available, despite only 45% agreeing that they had good knowledge of gene therapy. The main sources of information were research registries (60% of participants) and the internet (61%). Compared to data from our recently published Australian national survey of people with IRDs (n = 694), USA respondents had higher knowledge of gene therapy outcomes, and Australian respondents indicated a higher perceived value of gene therapy treatments. Addressing knowledge gaps regarding outcomes and financial implications will be central to ensuring informed consent, promoting shared decision-making, and the eventual clinical adoption of genetic therapies.
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Affiliation(s)
- Alexis Ceecee Britten-Jones
- Department of Optometry and Vision Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, VIC, Australia
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
| | - Myra B McGuinness
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, VIC, Australia
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Fred K Chen
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, VIC, Australia
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
- Centre for Ophthalmology and Visual Sciences (incorporating Lions Eye Institute), The University of Western Australia, Perth, WA, Australia
- Royal Perth Hospital and Perth Children's Hospital, Perth, WA, Australia
| | - John R Grigg
- Save Sight Institute, The University of Sydney, Sydney, NSW, Australia
- Eye Genetics Research Unit, Sydney Children's Hospitals Network, Save Sight Institute, Children's Medical Research Institute, University of Sydney, Sydney, NSW, Australia
| | - Heather G Mack
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, VIC, Australia
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
| | - Lauren N Ayton
- Department of Optometry and Vision Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia.
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, VIC, Australia.
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia.
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12
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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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13
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Souto FMS, Missaka RFBG, Lavezzo MM, Nóbrega PFC, Sakata VM, Oyamada MK, Hirata CE, Yamamoto JH. Quality of Life (QoL) in Non-Acute Vogt-Koyanagi-Harada Disease (VKHD) at Two Time Points 24 Months Apart. Ocul Immunol Inflamm 2024; 32:384-390. [PMID: 36637906 DOI: 10.1080/09273948.2022.2152697] [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: 04/25/2022] [Revised: 12/01/2022] [Accepted: 11/11/2022] [Indexed: 01/14/2023]
Abstract
AIMS To investigate the changes in quality-of-life (QoL) metrics at a 24-month interval in non-acute VKHD patients and their association with inflammation, treatment, and visual function. METHODS SF-36 and VFQ-25 questionnaires were administered at two 24-month-apart moments to 22 non-acute VKHD patients followed for ≥12 months since acute disease onset. "Improvement," "unchanged," or "worsening" in questionnaires scores (difference >5-point) between M1 and M2 and their associations were sought. RESULTS Absence of systemic treatment or optic disc hyperfluorescence was associated with improved general health (SF-36). Improvement in binocular contrast sensitivity resulted in better ocular pain score; absence of anterior uveitis relapse, stable fundus findings, no use of cyclosporine or no intravitreal injections resulted in unchanged/better dependency score; no intravitreal injections resulted in unchanged/better mental health score (VFQ-25). CONCLUSION Stability/improvement in QoL scores was associated with controlled inflammation, better visual function, and no need for treatment. Subclinical inflammatory signs did not impact QoL scores.
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Affiliation(s)
| | | | - Marcelo Mendes Lavezzo
- Department of Ophthalmology, LIM-33, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | | | | | - Maria Kiyoko Oyamada
- Department of Ophthalmology, LIM-33, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Carlos Eduardo Hirata
- Department of Ophthalmology, LIM-33, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Joyce Hisae Yamamoto
- Department of Ophthalmology, LIM-33, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
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14
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von Arenstorff MM, Ahmadzadeh A, Schmidt BS, Kessel L, Bach-Holm D. Vision-related quality of life in patients with glaucoma before and after trabeculectomy. Acta Ophthalmol 2024. [PMID: 38655879 DOI: 10.1111/aos.16697] [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: 02/14/2023] [Accepted: 04/11/2024] [Indexed: 04/26/2024]
Abstract
PURPOSE To determine vision-related quality of life (VR-QoL) and functional and structural parameters associated with VR-QoL in patients with glaucoma before and 12 months after trabeculectomy. METHODS Fifty-eight patients undergoing trabeculectomy were included. Participants completed the 25-item National Eye Institute Visual Function Questionnaire (VFQ-25) prior to and 12 months after trabeculectomy. Functional (visual acuity and visual fields) and structural (ganglion cell layer volume) parameters were evaluated for their association with VR-QoL using multiple linear regression of VFQ-25 subscale scores. Intraocular pressure and the number of glaucoma medications were also included in the analyses. RESULTS The VFQ-25 composite score did not change after trabeculectomy (before: 74.9; 12 months: 74.0; p = 0.512). The subscale mental health had a significantly higher score 12 months after trabeculectomy (before: 65.6; 12 months: 71.4; p = 0.017). The VFQ-25 scores for general health (before: 68.5; 12 months: 62.5; p = 0.009) and role difficulties (before: 78.9; 12 months: 53.7; p < 0.001) were significantly lower 12 months after trabeculectomy. No functional or structural parameters were associated with VFQ-25 composite score. CONCLUSION Overall, VR-QoL in glaucoma patients was similar before and after trabeculectomy, reflecting the procedure's stabilizing effect on both objective and subjective visual function. The absence of correlations between VR-QoL and clinical parameters emphasizes the multifaceted nature of VR-QoL and highlights the limitations of depending solely on objective clinical metrics to evaluate patients' subjective experiences. Using both objective measures and VR-QoL, clinicians can better understand the challenges patients face due to glaucoma and trabeculectomy, potentially leading to better solutions.
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Affiliation(s)
- Mathilde M von Arenstorff
- Department of Ophthalmology, Copenhagen University Hospital-Rigshospitalet Copenhagen, Glostrup, Denmark
| | - Afrouz Ahmadzadeh
- Department of Ophthalmology, Copenhagen University Hospital-Rigshospitalet Copenhagen, Glostrup, Denmark
| | | | - Line Kessel
- Department of Ophthalmology, Copenhagen University Hospital-Rigshospitalet Copenhagen, Glostrup, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Daniella Bach-Holm
- Department of Ophthalmology, Copenhagen University Hospital-Rigshospitalet Copenhagen, Glostrup, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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15
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Castle-Kirszbaum M, Biermasz N, Kam J, Goldschlager T. Quality of life in Prolactinoma: A systematic review. Pituitary 2024:10.1007/s11102-024-01392-1. [PMID: 38656635 DOI: 10.1007/s11102-024-01392-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/30/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Prolactinomas are common tumours that significantly reduce quality-of-life (QOL) due to sellar mass effect, secondary hypogonadism, and the peripheral effects of prolactin. Understanding the factors that influence QOL would provide insights into therapeutic targets to optimise patient outcomes and improve wellbeing in prolactinoma. METHODS A systematic review was performed in accordance with the PRISMA statement. Studies that reported patient QoL using validated metrics were included. Bias and methodological rigour were assessed using the MINORS criteria. RESULTS A total of 18 studies were identified studies were available for review, comprising 877 patients. Most were small cross-sectional studies at high risk of bias. Prolactinoma exhibit worse QOL than healthy controls, particularly mental and psychosocial wellbeing. QOL is also worse than patients with non-functional adenomas, but better than those with Cushing's disease and acromegaly. QOL correlates with prolactin levels, and approaches population baseline with prolonged biochemical control. Dopamine agonists and surgery both improve overall QOL, however improvements are more rapid with surgery. CONCLUSION Poor quality of life in prolactinoma is multifactorial, related to biochemical control, side effects of therapy, and sellar mass effect. Targeting persistent symptoms, reducing healthcare costs, and reducing side-effects of therapy are avenues to improving QOL in patients with prolactinoma.
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Affiliation(s)
- Mendel Castle-Kirszbaum
- Department of Neurosurgery, Monash Health, 246 Clayton Road, Clayton, VIC, 3168, Australia.
- Department of Surgery, Monash University, Melbourne, Australia.
| | - Nienke Biermasz
- Department of Medicine, Division of Endocrinology, Center for Endocrine Tumors Leiden, Leiden University Medical Center, Leiden, The Netherlands
| | - Jeremy Kam
- Department of Neurosurgery, Monash Health, 246 Clayton Road, Clayton, VIC, 3168, Australia
- Department of Surgery, Monash University, Melbourne, Australia
| | - Tony Goldschlager
- Department of Neurosurgery, Monash Health, 246 Clayton Road, Clayton, VIC, 3168, Australia
- Department of Surgery, Monash University, Melbourne, Australia
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16
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Tol S, de Haan GA, Postuma EMJL, Jansen JL, Heutink J. Reading Difficulties in Individuals with Homonymous Visual Field Defects: A Systematic Review of Reported Interventions. Neuropsychol Rev 2024:10.1007/s11065-024-09636-4. [PMID: 38639880 DOI: 10.1007/s11065-024-09636-4] [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: 05/25/2023] [Accepted: 02/20/2024] [Indexed: 04/20/2024]
Abstract
Reading difficulties are amongst the most commonly reported problems in individuals with homonymous visual field defects (HVFDs). To be able to provide guidance for healthcare professionals considering offering reading training, researchers in this field and interested individuals with HVFDs, this systematic review aims to (1) provide an overview of the contextual and intervention characteristics of all published HVFD interventions and (2) generate insights into the different reading outcome measures that these studies adopted. A search on PsycINFO, MEDLINE and Web of Science was conducted up to February 2, 2023. All intervention studies for HVFD in which reading was measured were included. Data was collected about the intervention type, session duration, number of sessions, the intensity, duration, circumstance of the interventions, country in which the intervention was studied and reading measures. Sixty records are included, describing 70 interventions in total of which 21 are specifically reading interventions. Overall, adjusted saccadic behaviour interventions occur most in the literature. A wide range within all intervention characteristics was observed. Forty-nine records reported task-performance reading measures, and 33 records reported self-reported reading measures. The majority of task-performance measures are based on self-developed paragraph reading tasks with a time-based outcome measure (e.g. words per minute). Future research could benefit from making use of validated reading tests, approaching the measurement of reading mixed-methods and providing participants the possibility to supply outcomes relevant to them.
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Affiliation(s)
- S Tol
- Clinical and Developmental Neuropsychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands.
| | - G A de Haan
- Clinical and Developmental Neuropsychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
- Royal Dutch Visio, Centre of Expertise for Blind and Partially Sighted People, Amersfoortsestraatweg 180, 1272 RR, Huizen, The Netherlands
| | - E M J L Postuma
- Clinical and Developmental Neuropsychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
| | - J L Jansen
- Clinical and Developmental Neuropsychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
| | - J Heutink
- Clinical and Developmental Neuropsychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
- Royal Dutch Visio, Centre of Expertise for Blind and Partially Sighted People, Amersfoortsestraatweg 180, 1272 RR, Huizen, The Netherlands
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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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Jurkiewicz T, Marty AS, Febvay C, Burillon C. [Effect of keratoplasty on the quality of life of keratoconus patients]. J Fr Ophtalmol 2024; 47:104185. [PMID: 38608625 DOI: 10.1016/j.jfo.2024.104185] [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: 07/19/2023] [Revised: 10/10/2023] [Accepted: 11/21/2023] [Indexed: 04/14/2024]
Abstract
Corneal deformations caused by keratoconus produce high levels of optical aberration (OA). Despite appropriate optical correction, these alter the quality of vision and diminish the patient's quality of life, especially since the affected population is predominantly young and of working age. When thinning is too severe or corneal transparency too impaired, a corneal transplant may be considered. In this study, we compare the quality of life of patients with keratoconus in the early (stages 1 and 2) or advanced (stages 3 and 4) stages of the Krumeich classification, as well as patients who have had keratoconus treated by keratoplasty. Quality of life was assessed using the NEI-VFQ 25 questionnaire, the most widely used for keratoconus. An aberrometric examination (OQAS®; HD Analyser, Visiometrics, Terrassa, Spain) was also performed to assess patients' quality of vision. Our results show that keratoplasty provides an improvement in quality of life compared with advanced-stage keratoconus in the areas of distance (p=0.0083) and near vision (p=0.029) activities. This improvement also applies to Best-Corrected Visual Acuity (BCVA) (p=0.032) and transparency (OSI) (p=0.049). Our study shows that keratoplasty improves corneal transparency, and it is interesting to note that it improves patients' quality of life over the long term.
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Affiliation(s)
- T Jurkiewicz
- Centre d'exploration de la rétine Kléber (CERK), 50, cours Franklin-Roosevelt, 69006 Lyon, France; Centre de recherche en neurosciences de Lyon (CRNL), université de Lyon, 69500 Bron, France.
| | - A-S Marty
- Clinique ophtalmologique Thiers, 144, avenue Thiers, 33100 Bordeaux, France
| | - C Febvay
- Cabinet d'ophtalmologie De La Vallée, 8, route de Besançon, 25290 Ornans, France
| | - C Burillon
- Service d'ophtalmologie, Pavillon C, hôpital Edouard-Herriot, 5, place d'Arsonval, 69003 Lyon, France; Faculté de médecine Lyon Sud, Charles-Mérieux, rue du Grand-Revoyet, 69006 Oullins, France
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19
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Xiong Y, Nemargut JP, Bradley C, Wittich W, Legge GE. Development and validation of a questionnaire for assessing visual and auditory spatial localization abilities in dual sensory impairment. Sci Rep 2024; 14:7911. [PMID: 38575713 PMCID: PMC10994906 DOI: 10.1038/s41598-024-58363-6] [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: 01/16/2024] [Accepted: 03/28/2024] [Indexed: 04/06/2024] Open
Abstract
Spatial localization is important for social interaction and safe mobility, and relies heavily on vision and hearing. While people with vision or hearing impairment compensate with their intact sense, people with dual sensory impairment (DSI) may require rehabilitation strategies that take both impairments into account. There is currently no tool for assessing the joint effect of vision and hearing impairment on spatial localization in this large and increasing population. To this end, we developed a novel Dual Sensory Spatial Localization Questionnaire (DS-SLQ) that consists of 35 everyday spatial localization tasks. The DS-SLQ asks participants about their difficulty completing different tasks using only vision or hearing, as well as the primary sense they rely on for each task. We administered the DS-SLQ to 104 participants with heterogenous vision and hearing status. Rasch analysis confirmed the psychometric validity of the DS-SLQ and the feasibility of comparing vision and hearing spatial abilities in a unified framework. Vision and hearing impairment were associated with decreased visual and auditory spatial abilities. Differences between vision and hearing abilities predicted overall sensory reliance patterns. In DSI rehabilitation, DS-SLQ may be useful for measuring vision and hearing spatial localization abilities and predicting the better sense for completing different spatial localization tasks.
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Affiliation(s)
- Yingzi Xiong
- Lions Vision Research and Rehabilitation Center, Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA.
- Center for Applied and Translational Sensory Sciences, University of Minnesota, Minneapolis, USA.
| | | | - Chris Bradley
- Lions Vision Research and Rehabilitation Center, Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA
| | - Walter Wittich
- School of Optometry, Université de Montréal, Montreal, Canada
| | - Gordon E Legge
- Center for Applied and Translational Sensory Sciences, University of Minnesota, Minneapolis, USA
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Chattopadhyay A, Rathinam SR, Gonzales JA, Kelly NK, Thundikandy R, Kanakath A, Murugan SB, Vedhanayaki R, Lim LL, Suhler EB, Al-Dhibi HA, Doan T, Ebert CD, Porco TC, Acharya NR. Association between Quality of Life and Visual Acuity in a Randomized Clinical Trial of Patients with Uveitis Taking Antimetabolites. Ocul Immunol Inflamm 2024; 32:301-309. [PMID: 36749914 PMCID: PMC10404633 DOI: 10.1080/09273948.2023.2169714] [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: 06/15/2022] [Revised: 01/10/2023] [Accepted: 01/12/2023] [Indexed: 02/09/2023]
Abstract
PURPOSE To evaluate how changes in visual acuity are associated with changes in quality of life (QoL) among patients with non-infectious uveitis taking antimetabolites. METHODS This secondary analysis of the multicenter First-line Antimetabolites as Steroid-sparing Treatment (FAST) Uveitis Trial involves 216 participants randomized to methotrexate or mycophenolate mofetil. Vision-related (NEI-VFQ and IND-VFQ) and health-related (PCS and MCS SF-36v2) QoL and visual acuity were measured at baseline and 6-month primary endpoint. RESULTS Visual acuity was significantly associated and correlated with all QoL measures (Spearman correlation coefficients = 0.5, 0.5, 0.3, and 0.4 for NEI-VFQ, IND-VFQ, SF-36v2 MCS and PCS, respectively). All observed changes in QoL met or exceeded the minimal clinically important difference definition on each scale. Treatment group was not significantly associated with any QoL measure. CONCLUSION By adding insight beyond visual acuity, QoL provides a more comprehensive picture of the patient experience during uveitis treatment.Abbreviations and Acronyms: QoL = quality of life; VR-QoL = vision-related quality of life; HR-QoL = health-related quality of life; FAST = First-line Antimetabolites as Corticosteroid Sparing Treatment; NEI-VFQ = National Eye Institute Visual Functioning Questionnaire; IND-VFQ = Indian Visual Functioning Questionnaire; SF-36v2 = Medical Outcomes Study 36-Item Short Form Survey; PCS = physical component score; MCS = mental component score; 95% CI = 95% confidence interval; MCID = minimal clinically important difference.
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Affiliation(s)
- Aheli Chattopadhyay
- F.I. Proctor Foundation, University of California, San Francisco, California, USA
| | - S R Rathinam
- Uvea Services, Aravind Eye Hospitals and Postgraduate Institute of Ophthalmology, Madurai, India
| | - John A Gonzales
- F.I. Proctor Foundation, University of California, San Francisco, California, USA
- Department of Ophthalmology, University of California, San Francisco, California, USA
| | - Nicole K Kelly
- F.I. Proctor Foundation, University of California, San Francisco, California, USA
| | - Radhika Thundikandy
- Uvea Services, Aravind Eye Hospitals and Postgraduate Institute of Ophthalmology, Madurai, India
| | - Anuradha Kanakath
- Uvea Services, Aravind Eye Hospitals and Postgraduate Institute of Ophthalmology, Coimbatore, India
| | - S Bala Murugan
- Uvea Services, Aravind Eye Hospitals and Postgraduate Institute of Ophthalmology, Pondicherry, India
| | - R Vedhanayaki
- Uvea Services, Aravind Eye Hospitals and Postgraduate Institute of Ophthalmology, Madurai, India
| | - Lyndell L Lim
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia
| | - Eric B Suhler
- Casey Eye Institute, Oregon Health and Science University, OHSU-PSU School of Public Health, and Portland Veterans' Affairs Health Care System, Portland, Oregon, USA
| | - Hassan A Al-Dhibi
- Division of Vitreoretinal Surgery and Uveitis, King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia
| | - Thuy Doan
- F.I. Proctor Foundation, University of California, San Francisco, California, USA
- Department of Ophthalmology, University of California, San Francisco, California, USA
| | - Caleb D Ebert
- F.I. Proctor Foundation, University of California, San Francisco, California, USA
| | - Travis C Porco
- F.I. Proctor Foundation, University of California, San Francisco, California, USA
- Department of Ophthalmology, University of California, San Francisco, California, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Nisha R Acharya
- F.I. Proctor Foundation, University of California, San Francisco, California, USA
- Department of Ophthalmology, University of California, San Francisco, California, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
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Hussein M, Abdelghaffar M, Ali M, Yassein AM, Khalil DM, Magdy R. Impact of Ramadan fasting on vision and headache-related quality of life in women with idiopathic intracranial hypertension: A prospective observational study. Headache 2024; 64:352-360. [PMID: 38525797 DOI: 10.1111/head.14707] [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: 09/13/2023] [Revised: 01/26/2024] [Accepted: 01/31/2024] [Indexed: 03/26/2024]
Abstract
BACKGROUND Ramadan fasting is an obligatory religious practice for Muslims. However, research data on the effect of Ramadan on idiopathic intracranial hypertension (IIH) symptoms are lacking. This study aimed to study the effect of Ramadan fasting on the severity of headache and visual symptoms and related quality-of-life activities. METHODS This prospective cohort study targeted females diagnosed with IIH (n = 102) who were eligible to fast for Ramadan in 2023. The patients were recruited from the Neurology Clinic in Beni-Suef University Hospital, Egypt. Body mass index (BMI), monthly headache days and intensity of headache attacks, six-item Headache Impact Test (HIT-6), and the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) scores during Ramadan were compared to those during the (non-fasting) month of Shaaban, the preceding month to Ramadan. RESULTS There was a significant increase in the BMI of patients with IIH in Ramadan compared to the (non-fasting) month of Shaaban, at a median (interquartile range [IQR]) of 30.5 (26.6-35.8) kg/m2 and 30.1 (26.6-35.2) kg/m2, respectively (p = 0.002). The median (IQR) value of monthly headache days was significantly increased during Ramadan in comparison to the (non-fasting) month of Shaaban, at 20 (11.5-30) vs. 15 (10-25) (p < 0.001). There was a statistically significant worsening in the visual analog scale (VAS) scores (median [IQR] 7 [5-8] vs. 6.5 [5-8]), HIT-6 scores (median [IQR] 61 [58-67] vs. 59 [53-61.5]), and NEI-VFQ-25 total scores (median [IQR] 1312.5 [1238.8-1435] vs 1290 [1165-1417.5]) during Ramadan in comparison to the (non-fasting) month of Shaaban (p < 0.001 for all comparisons). The change in BMI in Ramadan was positively correlated with the change in monthly headache days (r = 0.24, p = 0.014), VAS (r = 0.20, p = 0.043), HIT-6 (r = 0.25, p = 0.010) and NEI-VFQ-25 scores (r = 0.24, p = 0.016). CONCLUSION Ramadan fasting had an aggravating effect on headache, visual symptoms, and related quality-of-life activities, which might be attributed to weight gain during this month. Whether proper nutritional management to prevent weight gain during Ramadan may help mitigate this worsening effect is a mission of future studies.
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Affiliation(s)
- Mona Hussein
- Department of Neurology, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Mohamed Abdelghaffar
- Department of Neurology, Faculty of Medicine, El-Fayoum University, El-Fayoum, Egypt
| | - Mona Ali
- Department of Neurology, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Abdelhady M Yassein
- Department of Ophthalmology, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Doaa M Khalil
- Department of Public Health and Community Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Rehab Magdy
- Department of Neurology, Faculty of Medicine, Cairo University, Cairo, Egypt
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Baby B, McKinnon A, Patterson K, Patel H, Sharma R, Carter C, Griffin R, Burns C, Chang F, Guilcher SJ, Lee L, Fadaleh SA, Patel T. Tools to measure barriers to medication management capacity in older adults: a scoping review. BMC Geriatr 2024; 24:285. [PMID: 38532328 DOI: 10.1186/s12877-024-04893-7] [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: 09/18/2023] [Accepted: 03/13/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Medication management capacity is a crucial component of medication adherence, particularly among older adults. Various factors, including physical abilities, cognitive functions, sensory capabilities, motivational, and environmental factors, influence older adults' ability to manage medications. It is, therefore, crucial to identify appropriate tools that allow clinicians to determine which factors may impact medication management capacity and, consequently, nonadherence to medications. PURPOSE 1)To identify tools that measure physical, cognitive, sensory (vision, hearing, touch), motivational, and environmental barriers to medication self-management in older adults, and 2) to understand the extent to which these tools assess various barriers. METHODS The scoping review was conducted using Arksey and O'Malley's scoping review framework and the PRISMA Extension for Scoping Reviews checklist. In June 2022, the relevant literature was identified by searching PubMed (MEDLINE), Ovid Embase, Ovid IPA, EBSCOhost CINAHL, APA PsycINFO, and Scopus. RESULTS AND DISCUSSION In total, 7235 studies were identified. Following the removal of duplicates, 4607 articles were screened by title and abstract, of which 4253 did not meet the inclusion criteria. Three reviewers reviewed the full texts of the remaining 354 articles; among them, 41 articles, 4 theses and 1 conference abstract met the inclusion criteria. From the included studies, 44 tools were identified that measured a combination of physical, cognitive, sensory, motivational, and environmental barriers (n=19) or only cognition (n=13), vision (n=5), environmental factors (n=3), auditory (n=1), and motivational factors (n=1). The review also examined the psychometric properties of the identified tools and found that most of them had reported validity and reliability data. Several tools have demonstrated promise in assessing a combination of barriers with validity and reliability. These tools include the Self-Medication Assessment Tool (SMAT), ManageMed Screening (MMS), Self-Medication Risk Assessment Tool (RAT), HOME-Rx revised, and Medication Management Ability Assessment (MMAA). CONCLUSION This scoping review identified 44 validated tools to measure various challenges that older adults encounter with medication management. However, no tool measures all five barriers (physical, cognitive, sensory, motivational, and environmental) to medication-taking at home. Therefore, utilizing a combination of tools would be most appropriate to measure these different aspects comprehensively. Further research is needed to develop a new comprehensive tool that simultaneously measures various barriers to medication self-management.
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Affiliation(s)
- Bincy Baby
- School of Pharmacy, University of Waterloo, Waterloo, ON, Canada
| | | | | | - Hawa Patel
- School of Pharmacy, University of Waterloo, Waterloo, ON, Canada
| | - Rishabh Sharma
- School of Pharmacy, University of Waterloo, Waterloo, ON, Canada
| | - Caitlin Carter
- School of Pharmacy, University of Waterloo, Waterloo, ON, Canada
| | - Ryan Griffin
- National Research Council Canada, Ottawa, ON, Canada
| | - Catherine Burns
- Faculty of Engineering, University of Waterloo, Waterloo, ON, Canada
| | - Feng Chang
- School of Pharmacy, University of Waterloo, Waterloo, ON, Canada
| | - Sara Jt Guilcher
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - Linda Lee
- Department of Family Medicine, McMaster University, Hamilton, Canada
| | - Sara Abu Fadaleh
- School of Pharmacy, University of Waterloo, Waterloo, ON, Canada
| | - Tejal Patel
- School of Pharmacy, University of Waterloo, Waterloo, ON, Canada.
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Nuzzi A, Becco A, Boschiroli A, Coletto A, Nuzzi R. Blindness and visual impairment: quality of life and accessibility in the city of Turin. Front Med (Lausanne) 2024; 11:1361631. [PMID: 38576717 PMCID: PMC10991693 DOI: 10.3389/fmed.2024.1361631] [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: 12/26/2023] [Accepted: 02/27/2024] [Indexed: 04/06/2024] Open
Abstract
Purpose Despite the increase in socio-health conditions and, in general, the focus on health worldwide, many diseases still adversely affect the quality of life (QoL), including those causing vision loss. The main purpose of this study was to evaluate the QoL of people with visual impairments through a questionnaire and identify issues concerning everyday life in the urban and extra-urban areas of Turin. Patients and methods A personalized questionnaire including 25 questions was distributed to 100 enrolled patients. It was designed by integrating the most widely used questionnaires related to the QoL of people with visual impairment with questions concerning the city of Turin. The inclusion criteria were any degree of visual impairment (from mild defect to complete blindness), according to Law n. 138/2001 classification. The exclusion criteria were mental disability and residence in care homes. Finally, statistical analysis was performed. Pearson's Chi-Square test was used to evaluate the strength of the association between two qualitative variables in different sections of the questionnaire. The results were classified as statistically significant with a p-value of ≤0.05 or borderline (0.05 < p-value<0.10). Results Based on responses to question 7 (Q7), 67% of selected patients stated that sight markedly influences their QoL. Moreover, 49% of patients responding to question 12 considered themselves almost completely dependent on other people regarding mobility and movement in and around Turin. In total, 57% used public transport (Q13); however, 50% of them found it challenging to access (Q14). Personal aids (e.g., white cane and magnifying glasses) were adopted only by 51% (Q15), and 63% of patients responding to question 18 suggested a refinement of urban aids (e.g., road signs). Of the 53 patients, 30 patients (56.6%) considered Turin a livable city for visually impaired people (Q19); however, 44 patients (84.6%) reported no significant improvements in Turin's urban logistics during the last 5 years and highlighted the urgent need to improve urban aids (Q21). Furthermore, the statistical associations studied showed that the loss of vision plays a significant role in influencing the perception of one's QoL (association of questions 7 and 8, X2 = 112.119, Cramer's V = 0.548, p-value <0.001). In addition, it is more difficult for visually impaired patients living outside the city to move outdoors (Chi-Square = 10.637, Cramer's V = 0.326, p - 245 value = 0.031) and to cross the street (Chi-Square = 14.102, Cramer's V = 0.376, p-250 value = 0.007). Finally, those who feel independent perceive their lives to be more fulfilling (Chi-Square = 268, X2 = 37.433; Cramer's V = 0.306, p value = 0.002). Conclusion Our study showed how vision loss plays a remarkable role in influencing the perception of one's QoL. Furthermore, it highlighted how the implementation of mobility and the use of personal aids for living in a city, such as Turin, were associated with a better perception of QoL by visually impaired patients. However, it is necessary to improve urban technological development according to the needs of people with visual disability.
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Affiliation(s)
- Alessia Nuzzi
- Eye Clinic, San Luigi Gonzaga University Hospital, University of Turin, Turin, Italy
| | - Alice Becco
- Eye Clinic, Città della Salute e della Scienza University Hospital, University of Turin, Turin, Italy
| | - Andrea Boschiroli
- Eye Clinic, Città della Salute e della Scienza University Hospital, University of Turin, Turin, Italy
| | - Andrea Coletto
- Eye Clinic, San Luigi Gonzaga University Hospital, University of Turin, Turin, Italy
| | - Raffaele Nuzzi
- Eye Clinic, Department of Neuroscience, San Luigi Gonzaga University Hospital, University of Turin, Turin, Italy
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Trinh M, Kalloniatis M, Khuu SK, Nivison-Smith L. Retinal sensitivity changes in early/intermediate AMD: a systematic review and meta-analysis of visual field testing under mesopic and scotopic lighting. Eye (Lond) 2024:10.1038/s41433-024-03033-0. [PMID: 38499857 DOI: 10.1038/s41433-024-03033-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 01/22/2024] [Accepted: 03/08/2024] [Indexed: 03/20/2024] Open
Abstract
Visual fields under mesopic and scotopic lighting are increasingly being used for macular functional assessment. This review evaluates its statistical significance and clinical relevance, and the optimal testing protocol for early/intermediate age-related macular degeneration (AMD). PubMed and Embase were searched from inception to 14/05/2022. All quality assessments were performed according to GRADE guidelines. The primary outcome was global mean sensitivity (MS), further meta-analysed by: AMD classification scheme, device, test pattern, mesopic/scotopic lighting, stimuli size/chromaticity, pupil dilation, testing radius (area), background luminance, adaptation time, AMD severity, reticular pseudodrusen presence, and follow-up visit. From 1489 studies screened, 42 observational study results contributed to the primary meta-analysis. Supported by moderate GRADE certainty of the evidence, global MS was significantly reduced across all devices under mesopic and scotopic lighting with large effect size (-0.9 [-1.04, -0.75] Hedge's g, P < 0.0001). The device (P < 0.01) and lighting (P < 0.05) used were the only modifiable factors affecting global MS, whereby the mesopic MP-1 and MAIA produced the largest effect sizes and exceeded test-retest variabilities. Global MS was significantly affected by AMD severity (intermediate versus early AMD; -0.58 [-0.88, -0.29] Hedge's g or -2.55 [3.62, -1.47] MAIA-dB) and at follow-up visit (versus baseline; -0.62 [-0.84, -0.41] Hedge's g or -1.61[-2.69, -0.54] MAIA-dB). Magnitudes of retinal sensitivity changes in early/intermediate AMD are clinically relevant for the MP-1 and MAIA devices under mesopic lighting within the central 10° radius. Other factors including pupil dilation and dark adaptation did not significantly affect global MS in early/intermediate AMD.
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Affiliation(s)
- Matt Trinh
- School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, Australia
| | - Michael Kalloniatis
- School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, Australia
- School of Medicine (Optometry), Deakin University, Geelong, VIC, Australia
| | - Sieu K Khuu
- School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, Australia
| | - Lisa Nivison-Smith
- School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, Australia.
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Hepworth LR, Kirkham JJ, Perkins E, Helliwell B, Howard C, Liptrot M, Tawana S, Wilson E, Rowe FJ. Validation of the brain injury associated visual impairment - impact questionnaire (BIVI-IQ). Qual Life Res 2024; 33:777-791. [PMID: 38112864 PMCID: PMC10894123 DOI: 10.1007/s11136-023-03565-0] [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] [Accepted: 11/11/2023] [Indexed: 12/21/2023]
Abstract
PURPOSE The Brain Injury associated Visual Impairment - Impact Questionnaire (BIVI-IQ) was developed to assess the impact of post-stroke visual impairment. The development of the questionnaire used robust methods involving stroke survivors and clinicians. The aim of this study was to assess the validity of the BIVI-IQ in a stroke population. METHODS Stroke survivors with visual impairment were recruited from stroke units, outpatient clinics and non-healthcare settings. Participants were asked to complete questionnaire sets on three separate occasions; the BIVI-IQ at each visit with additional questionnaires at baseline and visit 2. Vision assessment and anchor questions from participants and clinicians were collected. The analysis included assessment of missing data, acceptability, Rasch model analysis, test-retest reliability, construct validity (NEI VFQ-25, EQ-5D-5L) and responsiveness to change. RESULTS 316 stroke survivors completed at least one questionnaire of the 326 recruited. Mean age was 67 years and 64% were male. Adequate fit statistics to the Rasch model were reached (χ2 = 73.12, p = 0.02) with two items removed and thresholds of two adjusted, indicating validity and unidimensionality. Excellent test-retest reliability was demonstrated (ICC = 0.905) with a 3-month interval. Construct validity was demonstrated with a strong significant correlation to the NEI VFQ-25 (r = 0.837, p < 0.01). The BIVI-IQ also demonstrated responsiveness to change with significant differences identified between groups based on participant and clinician anchor questions (X2 = 23.29, p < 0.001; X2 = 24.56, p < 0.001). CONCLUSION The BIVI-IQ has been shown to be valid and practical for 'everyday' use by clinicians and researchers to monitor vision-related quality of life in stroke survivors with visual impairment.
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Affiliation(s)
- L R Hepworth
- Institute of Population Health, University of Liverpool, Waterhouse Building, Block B, First Floor, 1-5 Brownlow Street, Liverpool, L69 3GL, UK.
- Northern Care Alliance NHS Foundation Trust, Salford, UK.
- Mersey and West Lancashire Teaching Hospitals NHS Trust, Prescot, UK.
| | - J J Kirkham
- Centre for Biostatistics, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - E Perkins
- Institute of Population Health, University of Liverpool, Waterhouse Building, Block B, First Floor, 1-5 Brownlow Street, Liverpool, L69 3GL, UK
| | - B Helliwell
- VISable, Patient and Public Representative, Liverpool, UK
| | - C Howard
- Institute of Population Health, University of Liverpool, Waterhouse Building, Block B, First Floor, 1-5 Brownlow Street, Liverpool, L69 3GL, UK
- Northern Care Alliance NHS Foundation Trust, Salford, UK
| | - M Liptrot
- Mersey and West Lancashire Teaching Hospitals NHS Trust, Prescot, UK
| | - S Tawana
- Buckinghamshire Healthcare NHS Trust, High Wycombe, UK
| | - E Wilson
- Wirral University Teaching Hospital NHS Foundation Trust, Wirral, UK
| | - F J Rowe
- Institute of Population Health, University of Liverpool, Waterhouse Building, Block B, First Floor, 1-5 Brownlow Street, Liverpool, L69 3GL, UK
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McGuinness MB, Robman L, Hodgson LAB, Tran C, Woods RL, Owen AJ, McNeil JJ, Makeyeva G, Abhayaratna WP, Guymer RH. Diagnostic accuracy of self-reported age-related macular degeneration in the ASPREE Longitudinal Study of Older Persons. Eye (Lond) 2024; 38:698-706. [PMID: 37731049 PMCID: PMC10920750 DOI: 10.1038/s41433-023-02754-y] [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: 03/10/2023] [Revised: 09/06/2023] [Accepted: 09/12/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND The validity of findings from epidemiological studies using self-report of ophthalmic conditions depends on several factors. We assessed the diagnostic accuracy of self-reported age-related macular degeneration (AMD) among older Australians enroled in a primary prevention clinical trial and compared diagnostic accuracy between demographic subgroups. METHODS At baseline (2010-2015), Australian sub-study participants of the ASPirin in Reducing Events in the Elderly (ASPREE) trial, underwent bilateral two-field, 45° non-mydriatic colour retinal photography. Beckman classification of any-stage AMD was used as the reference standard diagnosis. Participants were asked whether a doctor had ever diagnosed them with "macular degeneration" (the index test) via a paper-based questionnaire as part of the ASPREE Longitudinal Study of Older Persons (ALSOP) within the first year of enrolment. RESULTS In total, 4193 participants were included (aged 70-92 years, 50.8% female). Of those, 262 (6.3%) reported having AMD and 92 (2.2%) were unsure. Retinal grading detected 2592 (61.8%) with no AMD, 867 (20.7%) with early, 686 (16.4%) with intermediate and 48 (1.1%) with late AMD (n = 1601 with any-stage AMD, 38.2%). Self-reported AMD had 11.4% sensitivity (95% CI 9.9-13.1) and 96.9% specificity (95% CI 96.2-97.6) for any-stage AMD, with 69.8% and 63.9% positive and negative predictive values. Sensitivity was higher among participants with late-stage AMD (87.5%), older participants (26.8%), and those with poorer vision (41.0%). CONCLUSIONS Although most participants with late-stage AMD were aware of having AMD, the majority with early and intermediate AMD were not. Therefore, findings from studies that rely on disease self-report should be interpreted with caution.
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Affiliation(s)
- Myra B McGuinness
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia.
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, VIC, Australia.
| | - Liubov Robman
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventative Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Lauren A B Hodgson
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
| | - Cammie Tran
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventative Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Robyn L Woods
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventative Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Alice J Owen
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventative Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - John J McNeil
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventative Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Galina Makeyeva
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
| | - Walter P Abhayaratna
- College of Health and Medicine, The Australian National University, Canberra, ACT, 0200, Australia
| | - Robyn H Guymer
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, VIC, Australia
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Gothwal VK, Muthineni VV, Pesudovs K. Measurement of visual functioning following first and second eye cataract surgery using Vision-Related Activity Limitation Item Bank. Graefes Arch Clin Exp Ophthalmol 2024; 262:857-864. [PMID: 37725146 DOI: 10.1007/s00417-023-06235-6] [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: 05/16/2023] [Revised: 08/10/2023] [Accepted: 09/07/2023] [Indexed: 09/21/2023] Open
Abstract
PURPOSE This study aims to compare visual functioning (VF) after first or second eye cataract surgery using the vision-related activity limitation (VRAL) item bank. METHODS This prospective, interventional study included 787 patients (mean age, 58.2 years) with cataract undergoing cataract surgery (first eye surgery with/out ocular comorbidity, second eye surgery with/out ocular comorbidity) at a tertiary eye care center, South India, who were administered the item bank pre- and at 6 weeks postoperatively to assess change in VF. Rasch analysis was used to estimate VF at both time points, and responsiveness to cataract surgery was calculated as effect size (ES) which was interpreted as small (≤ 0.2), moderate (0.3-0.7), and large (≥ 0.8). RESULTS Mean best-corrected logMAR VA in surgical eye improved significantly postoperatively compared to preoperative VA (0.20 ± 0.40 vs. 1.19 ± 0.96; P < 0.0001) across all groups. Patients reported significant and large improvements in VF postoperatively across all groups: largest ES for first eye surgery without comorbidity (1.87 [95% CI, 1.61, 2.13]) and smallest for second eye without ocular comorbidity (1.55 [95% CI, 1.22, 1.88]). Compared to patients undergoing second eye surgery, first eye surgery patients reported significantly lower VF preoperatively (-0.72 ± 2.39 vs. 0.17 ± 2.34 logits; P < 0.0001), and a larger change in VF postoperatively (3.71 ± 2.33 logits vs. 4.27 ± 2.83 vs.; P = 0.004). CONCLUSIONS Cataract surgery resulted in large and significant improvements in VF, regardless of ocular comorbidity and first or second eye surgery. The VRAL item bank is a useful tool to measure responsiveness to cataract surgery.
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Affiliation(s)
- Vijaya K Gothwal
- Brien Holden Eye Research Centre - Patient-Reported Outcomes Unit, L V Prasad Eye Institute, L V Prasad Marg, Banjara Hills, Hyderabad, Telangana, India.
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia.
| | - Vani V Muthineni
- Kallam Anji Reddy Molecular Genetics Laboratory, Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India
| | - Konrad Pesudovs
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
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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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Kantor NB, Tovar A, Wang T, Galor A. How does ocular graft-versus-host disease fit under the dry eye umbrella? A review. Clin Exp Ophthalmol 2024; 52:167-185. [PMID: 38204146 PMCID: PMC10939887 DOI: 10.1111/ceo.14347] [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: 10/07/2023] [Revised: 11/28/2023] [Accepted: 12/11/2023] [Indexed: 01/12/2024]
Abstract
Graft-versus-host disease (GVHD) is a systemic disease that can affect multiple organs as a consequence of an allogeneic haematopoietic stem cell transplant. One organ system that is often affected in GVHD is the eyes. Ocular GVHD (oGVHD) may involve various structures within the eye including the lacrimal glands, eyelids, conjunctiva, cornea, and nasolacrimal ducts, and is a source of morbidity in patients with GVHD. Common presenting features of GVHD overlap with dry eye disease (DED), including decreased tear production, epithelial disruption, and Meibomian gland dysfunction (MGD). In this review, we aim to compare oGVHD and DED to better understand the similarities and differences between the conditions, with a focus on pathophysiology, risk factors, clinical features, and treatments.
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Affiliation(s)
- Nicole B. Kantor
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA
- Surgical Services, Miami Veterans Affairs Medical Center, Miami, FL, USA
| | | | - Trent Wang
- Division of Transplantation and Cellular Therapy, Sylvester Comprehensive Cancer Center, Adult Stem Cell Transplant Program, University of Miami Hospital and Clinics, Miami, FL, USA
| | - Anat Galor
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA
- Surgical Services, Miami Veterans Affairs Medical Center, Miami, FL, USA
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Zajner C, Leung B, Sheidow T, Malvankar-Mehta MS. Quality of Life after Pars Plana Vitrectomy, Scleral Buckle, or Pneumatic Retinopexy for Rhegmatogenous Retinal Detachment: A Meta-Analysis. Curr Eye Res 2024; 49:295-302. [PMID: 37937863 DOI: 10.1080/02713683.2023.2280440] [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: 01/17/2023] [Accepted: 11/02/2023] [Indexed: 11/09/2023]
Abstract
PURPOSE Comparisons of the surgical and anatomic results of rhegmatogenous retinal detachment surgery have been investigated previously. A systematic evaluation of the available evidence comparing quality of life outcomes of either pars plana vitrectomy, scleral buckling, or pneumatic retinopexy has not been evaluated to date. This article analyzes whether pars plana vitrectomy, scleral buckling, or pneumatic retinopexy for the treatment of rhegmatogenous retinal detachment results in differing quality of life outcomes. METHODS In February of 2022, a comprehensive search of MEDLINE, EMBASE, CINHAL, and Cochrane Library was conducted for studies on patients treated surgically for rhegmatogenous retinal detachment and included follow-up measurements of quality of life outcomes. Meta-analysis was completed using STATA v. 14.0. The main outcomes of interest were the mean vision-related quality of life score (VRQOL) and SD of VRQOL of each type of surgical procedure. RESULTS In this systematic review of 13 distinct trials including follow-up of patient quality of life after rhegmatogenous retinal detachment surgery (n = 1063), a better correlation was found between higher quality of life outcomes with scleral buckling than with pars plana vitrectomy (SMD = 0.62, CI: [0.31, 0.93]). There was also no signficant difference in quality of life outcomes between pneumatic retinopexy and pars plana vitrectomy (SMD = 0.08, CI: [-0.07, 0.22]). CONCLUSIONS Scleral buckling results in better quality of life outcomes for patients when compared to pars plana vitrectomy. Pneumatic retinopexy did not show a difference in quality of life outcomes compared to pars plana vitrectomy.
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Affiliation(s)
- Chris Zajner
- Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Canada
| | - Bernice Leung
- Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Canada
| | - Tom Sheidow
- Department of Ophthalmology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Canada
| | - Monali S Malvankar-Mehta
- Department of Ophthalmology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Canada
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Canada
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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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Banc A, Kedar S. Interpretation of the Visual Field in Neuro-ophthalmic Disorders. Curr Neurol Neurosci Rep 2024; 24:67-81. [PMID: 38289405 DOI: 10.1007/s11910-024-01332-3] [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] [Accepted: 01/08/2024] [Indexed: 02/24/2024]
Abstract
PURPOSE OF REVIEW In this review, we will describe current methods for visual field testing in neuro-ophthalmic clinical practice and research, develop terminology that accurately describes patterns of field deficits, and discuss recent advances such as augmented or virtual reality-based perimetry and the use of artificial intelligence in visual field interpretation. RECENT FINDINGS New testing strategies that reduce testing times, improve patient comfort, and increase sensitivity for detecting small central or paracentral scotomas have been developed for static automated perimetry. Various forms of machine learning-based tools such as archetypal analysis are being tested to quantitatively depict and monitor visual field abnormalities in optic neuropathies. Studies show that the combined use of optical coherence tomography and standard automated perimetry to determine the structure-function relationship improves clinical care in neuro-ophthalmic disorders. Visual field assessment must be performed in all patients with neuro-ophthalmic disorders affecting the afferent visual pathway. Quantitative visual field analysis using standard automated perimetry is critical in initial diagnosis, monitoring disease progression, and guidance of therapeutic plans. Visual field defects can adversely impact activities of daily living such as reading, navigation, and driving and thus impact quality of life. Visual field testing can direct appropriate occupational low vision rehabilitation in affected individuals.
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Affiliation(s)
- Ana Banc
- Department of Ophthalmology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Sachin Kedar
- Neuro-Ophthalmology Service, Department of Ophthalmology, Emory University School of Medicine, 1365B Clifton Rd NE, Atlanta, GA, 30322, USA.
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA.
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Vujosevic S, Chew E, Labriola L, Sivaprasad S, Lamoureux E. Measuring Quality of Life in Diabetic Retinal Disease: A Narrative Review of Available Patient-Reported Outcome Measures. OPHTHALMOLOGY SCIENCE 2024; 4:100378. [PMID: 37868790 PMCID: PMC10585645 DOI: 10.1016/j.xops.2023.100378] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 07/21/2023] [Accepted: 08/02/2023] [Indexed: 10/24/2023]
Abstract
Topic Several patient-reported outcome measures (PROMs) are available to measure health-related quality of life (HRQoL) in patients with late-stage clinical diabetic retinal diseases (DRDs). However, an understanding of the psychometric properties of PROMs is needed to assess how they could relate to severity levels of a revised DRD grading system. This narrative review assessed the available generic-, vision-, and DRD-related PROMs used in DRD research and highlights areas for improvement. Clinical Relevance Diabetic retinal disease is a common complication of diabetes and can lead to sight-threatening complications with a devastating effect on HRQoL. Methods The Quality of Life working group is one of 6 working groups organized for the DRD Staging System Update Effort, a project of the Juvenile Diabetes Research Foundation Mary Tyler Moore Vision Initiative. PubMed, Cochrane Library, Embase, and Google Scholar databases were searched using core keywords to retrieve ophthalmology-related review articles, randomized clinical trials, and prospective, observational, and cross-sectional studies in the English language. A detailed review of 12 PROMs (4 QoL questionnaires and 8 utilities) that met a minimum level of evidence (LOE) was conducted. The relevance of each PROM to DRD disease stage and Biomarker Qualification guidelines (Biomarkers, EndpointS, and other Tools) categories was also defined. Results The National Eye Institute 25-item Visual Function Questionnaire (NEI VFQ-25), Impact of vision impairment-computerized adaptive testing, and Diabetic Retinopathy and Macular Edema Computerized Adaptive Testing System had a LOE of II in detecting change due to late-stage DRD (diabetic macular edema), although several areas for improvement (e.g., psychometrics and generalizability) were identified. Other PROMs, particularly the utilities, had a LOE of III due to cross-sectional evidence in late-stage clinical DRD. Although the NEI VFQ-25 has been the most widely used PROM in late-stage DRD, more work is required to improve its multidimensional structure and other psychometric limitations. No PROM was deemed relevant for subclinical or early/mid-DRD. Conclusion This narrative review found that the most commonly used PROM is NEI VFQ-25, but none meets the ideal psychometric, responsiveness, and clinical setting digital administration requirements that could be included in an updated DRD staging system for diagnosis and monitoring of DRD progression. Financial Disclosures Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Stela Vujosevic
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Eye Clinic, IRCCS MultiMedica, Milan, Italy
| | - Emily Chew
- Division of Epidemiology and Clinical Applications, Clinical Trials Branch, National Eye Institute, National Institutes of Health, Bethesda, Maryland
| | - Leanne Labriola
- Ophthalmology Department, Carle Foundation Hospital, Urbana, Illinois
- Surgery Department, University of Illinois College of Medicine, Urbana, Illinois
| | - Sobha Sivaprasad
- Moorfields Biomedical Research Centre, Moorfields Eye Hospital, London, United Kingdom
| | - Ecosse Lamoureux
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Duke-NUS Medical School, National University of Singapore, Singapore
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Dol VL, Fuermaier ABM, Roelofs TAJ, Vrijling ACL, Heutink J, Jansonius NM. The 6-Item Vision-Related Quality of Life and Limitations Questionnaire: Evaluation of Psychometric Properties. Transl Vis Sci Technol 2024; 13:5. [PMID: 38470321 PMCID: PMC10941999 DOI: 10.1167/tvst.13.3.5] [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: 03/23/2023] [Accepted: 01/27/2024] [Indexed: 03/13/2024] Open
Abstract
Purpose We developed the Vision-related Quality of life and Limitations Questionnaire (VQL-6), a screening instrument to signal a need for additional care resulting from reduced vision-related quality of life in patients with chronic ophthalmic diseases. The aim of the present study was to evaluate psychometric properties. Methods A Dutch population-based sample of 2032 participants (mean age, 55 ± 19 years) completed the VQL-6 and other questionnaires on vision-related quality of life, executive functioning, attention, mental health, and symptom validity. In addition, we recruited a sample of 208 ophthalmic patients (mean age, 72 ± 12 years) and 98 age and gender similar controls (mean age, 69 ± 11 years) who completed the VQL-6 and the National Eye Institute Visual Function Questionnaire-25. We studied the factor structure, internal consistency, convergent and divergent validity, and known-groups validity. Results For the factor analyses, the population-based sample was split randomly in two subsamples. Exploratory factor analysis on the first subsample suggested a two-factor model (visual limitations and general health and quality of life), which was supported by confirmatory factor analyses on the second subsample, and on the patients. The VQL-6 demonstrated good internal consistency within each factor (0.78-0.89), sufficient convergent (r2= 55%) and divergent validity (r2 = 11%-24%), and good known-groups validity (Cohen's r = 0.57; P < 0.001). Conclusions The VQL-6 has a robust two-factor structure and seems to be a valid tool to assess vision-related quality of life. Additional validation is needed in patients with chronic ophthalmic diseases. Translational Relevance Future research is needed to determine if the VQL-6 can be used to identify patients with chronic ophthalmic diseases who are in need of additional care.
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Affiliation(s)
- Vera Linde Dol
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, the Netherlands
- Royal Dutch Visio, Center of Expertise for Blind and Partially Sighted People, Huizen, the Netherlands
| | - Anselm B M Fuermaier
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, the Netherlands
| | - Ton A J Roelofs
- Royal Dutch Visio, Center of Expertise for Blind and Partially Sighted People, Huizen, the Netherlands
| | - Anne C L Vrijling
- Royal Dutch Visio, Center of Expertise for Blind and Partially Sighted People, Huizen, the Netherlands
| | - Joost Heutink
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, the Netherlands
- Royal Dutch Visio, Center of Expertise for Blind and Partially Sighted People, Huizen, the Netherlands
| | - Nomdo M Jansonius
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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Johansson LH, Kalaboukhova L, Erhag HF, Skoog I, Zetterberg M. Vision-related quality of life among 70-year-olds diagnosed with glaucoma. Acta Ophthalmol 2024; 102:201-207. [PMID: 37533157 DOI: 10.1111/aos.15737] [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: 07/04/2023] [Accepted: 07/12/2023] [Indexed: 08/04/2023]
Abstract
PURPOSE To evaluate the effect of glaucoma on vision-related quality of life (VRQoL), lifestyle, physical factors and socioeconomic status in a 70-year-old population in Gothenburg, Sweden. METHODS Responses to questionnaires (N = 1182) between groups with and without self-reported glaucoma were analysed. Questionnaires included National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25), Short-Form Health Survey (SF-36), physical activity, socioeconomics, alcohol and tobacco consumption. Balance test and body mass index were also included. About half of the participants were randomized to ophthalmic examination (N = 560), variables were analysed separately according to known and confirmed glaucoma, ocular hypertension and/or cases of previously unknown glaucoma. RESULTS Both conventional and Rasch analysis of the NEI VFQ-25 showed that VRQoL was lower for individuals self-reporting glaucoma (p = 0.003/p = 0.024). Regarding general QoL, the participants did not differ apart from people self-reporting glaucoma reported worse general health (p = 0.01). Using logistic regression with lower VRQoL as the dependent variable glaucoma was not a significant predictor of poor VRQoL, odds ratio (OR) 1.83 (95% confidence interval (CI) 0.76-4.39, p = 0.18). Low household income was associated with lower VRQoL (OR 1.63, 95% CI 1.14-2.33, p = 0.01). Socioeconomics, physical activity and lifestyle factors were comparable between the groups (N = 915). Among participants who underwent ophthalmic examination no significant differences were found between glaucoma cases and non-glaucoma cases in relation to VRQoL (N = 560). CONCLUSIONS Patients with self-reported glaucoma assessed a lower VRQoL but not lower general quality of life. Poorer household income was associated with worse VRQoL. General health was reported low in the glaucoma population but lifestyle or physical factors did not diverge.
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Affiliation(s)
- Lena Havstam Johansson
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Ophthalmology, Sahlgrenska University Hospital, Region Västra Götaland, Mölndal, Sweden
| | - Lada Kalaboukhova
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Ophthalmology, Sahlgrenska University Hospital, Region Västra Götaland, Mölndal, Sweden
| | - Hanna Falk Erhag
- Department of Psychiatry and Neurochemistry, Centre for Ageing and Health (AgeCap), Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ingmar Skoog
- Department of Psychiatry and Neurochemistry, Centre for Ageing and Health (AgeCap), Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Madeleine Zetterberg
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Ophthalmology, Sahlgrenska University Hospital, Region Västra Götaland, Mölndal, Sweden
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Stingl JV, Ortolano LC, Azuara-Blanco A, Hoffmann EM. Systematic Review of Instruments for the Assessment of Patient-Reported Outcomes and Quality of Life in Patients with Childhood Glaucoma. Ophthalmol Glaucoma 2024:S2589-4196(24)00036-X. [PMID: 38423388 DOI: 10.1016/j.ogla.2024.02.009] [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: 08/20/2023] [Revised: 02/06/2024] [Accepted: 02/20/2024] [Indexed: 03/02/2024]
Abstract
TOPIC To identify patient-reported outcome measures (PROMs) that have been used in children and adolescents with glaucoma and to evaluate their methodologic quality. CLINICAL RELEVANCE Childhood glaucoma impairs vision and quality of life (QoL) throughout all stages of life. Thus, a PROM needs to cover many different age groups and topics. Various instruments have been used to evaluate patient-reported outcomes (PROs) in patients with childhood glaucoma, however, it is unclear which PROM has the highest methodologic quality and complies best with the needs of patients with childhood glaucoma. METHODS A systematic literature review was performed searching MEDLINE (PubMed), the Cochrane Library, Web of Science, and PsycINFO (EBSCO). We included peer-reviewed full-text articles of the past 10 years in English, German, or Spanish language that reported PROMs in children with glaucoma. The study selection and methodologic quality assessment of the identified PROMs was performed by 2 independent reviewers using a 7-point checklist. The content was mapped onto the World Health Organization International Classification of Functioning, Disability and Health. The systematic review was prospectively registered in PROSPERO (ID CRD42022353936). RESULTS The search strategy retrieved 3295 matches. A total of 2901 studies were screened, and 11 relevant articles were identified using 10 different instruments. The instruments addressed functional visual ability, vision-related QoL, health-related QoL, and life satisfaction. Six instruments were applicable for the use in children. Seven of the questionnaires received the highest number of positive ratings (5/7). None of the instruments considered the views of patients with childhood glaucoma during their development. CONCLUSION This systematic review provides a descriptive catalog of vision-specific and generic health PRO instruments that have been used in childhood glaucoma cohorts. An instrument specifically developed for childhood glaucoma is lacking which might result in missing important factors, such as permanent treatment with eye drops, repeated surgeries, and heritability of the disease, when investigating the QoL in children with glaucoma. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Julia V Stingl
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Lorena Cascant Ortolano
- Departmental Library, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | | | - Esther M Hoffmann
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
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Gkioka M, Almpanidou S, Lioti N, Almaliotis D, Karampatakis V. Daily Functionality of People with Low Vision: The Impact of Visual Acuity, Depression, and Life Orientation-A Cross-Sectional Study. Behav Neurol 2024; 2024:4366572. [PMID: 38440066 PMCID: PMC10911879 DOI: 10.1155/2024/4366572] [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: 05/12/2023] [Revised: 01/31/2024] [Accepted: 02/03/2024] [Indexed: 03/06/2024] Open
Abstract
Background Low vision (LV) has a significant negative impact on the activities of daily life as well as on the psychological health of patients. Objectives The objective of this study is to investigate psychological, clinical, and demographic factors that may impact the daily functionality of patients with LV. Methods A convenience sample of 53 patients, meeting the WHO criteria for LV, was recruited. Questionnaires on daily functionality, depression, and life orientation (in terms of optimism/pessimism) were administered along with a semistructured personal interview. Key Findings. The main results revealed a significant negative correlation between daily functionality and depression (r = -0.423, p < 0.001). Conversely, there is a positive correlation between daily functionality and visual acuity (r = 0.415, p < 0.001), while years since diagnosis were negatively correlated with depression (r = -0.345, p < 0.001). Depression seems to be a moderate predictor of a person's daily functionality (β = -0.389, p < 0.002), followed by visual acuity (β = -0.344, p = 0.006), explaining the 31.1% of the total variance. Conclusions The study supports a correlation between daily functionality and both depression and visual acuity. Optimism as a personality characteristic did not factor into the prediction model for daily functionality, but it showed a strong correlation with lower levels of depressive symptoms. This highlights the potential for developing coping strategies for chronic disease management. Recommendations. The study could serve as a useful guide and may urge clinicians to pay attention to the psychological evaluation of these patients, supporting their unique emotional needs. Mental health professionals can use patients' positive resources to provide appropriate counseling and embrace the coping skills that encourage their engagement in activities of daily life.
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Affiliation(s)
- Mara Gkioka
- Laboratory of Experimental Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stavroula Almpanidou
- Laboratory of Experimental Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Niki Lioti
- Laboratory of Experimental Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Diamantis Almaliotis
- Laboratory of Experimental Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vasileios Karampatakis
- Laboratory of Experimental Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Ramin S, Rostami F, Ahmadieh H, Daftarian N, Nourinia R, Abbasi A, Kheiri B, Sabbaghi H, Sheibani K. Vision-related quality of life in patients with retinal vein occlusion. Int Ophthalmol 2024; 44:114. [PMID: 38409518 DOI: 10.1007/s10792-024-02916-1] [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: 06/03/2023] [Accepted: 12/24/2023] [Indexed: 02/28/2024]
Abstract
PURPOSE This study aims to assess the vision-related quality of life in patients with retinal vein occlusion (RVO) among those referred to Labbafinejad Medical Center and Imam Hossein Hospital between 2019 and 2021. METHODS This comparative study included 37 eligible patients diagnosed with various types of RVO, with an average age of 61 ± 9. To ensure data validity, we included 74 age- and sex-matched healthy individuals. Only cases with a definitive diagnosis of RVO, confirmed by two retina specialists (ND and RN), were included. We assessed the vision-related quality of life of our participants using the National Eye Institute Visual Functioning Questionnaire-25 (NEI-VFQ-25). All participants underwent interviews. RESULTS In our study, we examined the vision-related quality of life in different subgroups of RVO patients. Overall, RVO patients had a significantly lower total VRQoL score compared to healthy individuals (P < 0.001), except in the subscale analysis of specific factors such as ocular pain, color vision, and driving, where no statistically significant difference was observed. A statistically significant difference was found in the comparison of subgroups, indicating lower VRQoL in central retinal vein occlusion (CRVO) patients (P = 0.010). Furthermore, a significant correlation was observed between lower VRQoL and decreased vision (P = 0.009) as well as longer disease duration (P = 0.011). CONCLUSION Retinal vein occlusion can significantly reduce vision-related quality of life, particularly in more severe cases.
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Affiliation(s)
- Shahrokh Ramin
- Department of Optometry, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- NanoBaran Lab, Incubation Center for Pharmaceutical Technology (ICPT), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Rostami
- Department of Optometry, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Ahmadieh
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Narsis Daftarian
- Experimental Medicine, Department of Medicine, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Ramin Nourinia
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Abbasi
- NanoBaran Lab, Incubation Center for Pharmaceutical Technology (ICPT), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahareh Kheiri
- Department of Epidemiology and Biostatistics, School of Medicine and Dentistry, Western University, Ontario, Canada
| | - Hamideh Sabbaghi
- Department of Optometry, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Ophthalmic Epidemiology Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, 23 Paidar Fard, Bostan 9, Pasdaran Ave., Tehran, 16666, Iran.
| | - Kourosh Sheibani
- Basir Eye Health Research Center, Iran University of Medical Sciences, Tehran, Iran
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Kanellopoulos AJ. Ray-Tracing Customization in Myopic and Myopic Astigmatism LASIK Treatments for Low and High Order Aberrations Treatment: 2-Year Visual Function and Psychometric Value Outcomes of a Consecutive Case Series. Clin Ophthalmol 2024; 18:565-574. [PMID: 38410630 PMCID: PMC10896098 DOI: 10.2147/opth.s444174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 01/25/2024] [Indexed: 02/28/2024] Open
Abstract
Purpose The safety and long-term efficacy of automated ray-tracing customized myopic and myopic astigmatic femtosecond laser-assisted LASIK. Methods This consecutive case series retrospective analysis, of 20 subjects (40 eyes) treated with automated raytracing named Wavelight Plus, to include low and high order aberrations based on a three-dimensional custom virtual eye for each case-calculated from interferometry data-obtained from a single diagnostic device that also provides Hartman-Shack Wavefront and Scheimpflug tomography data. We evaluated before and after the customized LASIK procedure: visual acuity, refractive error, high order aberrations, contrast sensitivity, and psychometric post-operative visual function data. Results At 24 months, the comparison of the pre-operative to the post-operative refractive and visual function value changes in average were: subjective manifest refraction from -4.38 ± 2.54 diopters (D) (range -9.75 to -1.25 D) to +0.11 ± 0.19 D; subjective manifest refractive astigmatism from -0.76 ± 0.91 D (range -2.75 to 0 D) to -0.13 ± 0.16 D, corneal astigmatism from -1.16 ± 0.64 D (range -0.2 to -2.8) to -0.47 ± 0.11 D. 65% of the eyes studied demonstrated an increase of at least one line of vision, while from the same group 38% demonstrated 2 lines of increase. High order aberrations, contrast sensitivity as well as the subjective psychometric input based on the VFQ-25 questionnaire demonstrated actual improvement. Conclusion This longer-term follow-up, single-arm retrospective consecutive case series documents LASIK treatment customization that appears to be safe and effective in the correction of myopia and myopic astigmatism. Markedly improved objective and subjective visual function post-operatively, underlying the potential importance of simultaneously attempting to correct high order aberrations and improving the spatial alignment of total, measured human eye optics.
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Affiliation(s)
- Anastasios John Kanellopoulos
- Medical Director: The Laservision Clinical and Research Institute, Athens, Greece
- Clinical Professor, Department of Ophthalmology, NYU Grossman Medical School, Department of Ophthalmology, New York City, NY, USA
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Van Vu K, Mitchell P, Detaram HD, Burlutsky G, Liew G, Gopinath B. Prevalence and risk factors for impaired activities of daily living in patients with neo-vascular age-related macular degeneration who present for anti-VEGF treatment. Eye (Lond) 2024:10.1038/s41433-024-02983-9. [PMID: 38374365 DOI: 10.1038/s41433-024-02983-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 01/15/2024] [Accepted: 02/01/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND/OBJECTIVES To assess the prevalence and correlates of impaired activities of daily living (ADLs) in patients with neovascular age-related macular degeneration (nAMD) who present for anti-vascular endothelial growth factor (VEGF) therapy. METHODS In a clinic-based cohort of 437 patients with nAMD who presented for anti-VEGF therapy, the Older American Resources and Services Scale (OARS) was administered to assess for impairments in basic, instrumental and total ADL. Logistic regression analyses were conducted to determine odds ratios (OR) and 95% confidence intervals (CI) for factors associated with ADL impairment. RESULTS The prevalence of impaired basic, instrumental and total ADL was 37.76%, 67.82% and 39.59%, respectively. In multivariate-adjusted models, moderate visual impairment [OR 5.65, 95% CI (2.31-13.83) and blindness [OR 5.43, 95% CI (2.09-14.12)] were associated with greater odds of impaired total ADL. Depressive symptoms [OR 2.08, 95% CI (1.08-4.00)], the presence of any disability [OR 3.16, 95% CI (1.64-0.07)] and never driving [OR 4.00, 95% CI (1.60-10.00)] were also positively associated with total ADL impairment. Better vision-related quality of life (QoL) was inversely associated with impaired instrumental ADL whilst higher health-related QoL scores were associated with decreased odds of total ADL impairment. CONCLUSIONS There is a high prevalence rate of ADL impairment among nAMD patients presenting for therapy. Visual impairment, never driving, poor physical and mental health increased the odds of experiencing ADL impairment whilst better VRQoL and HRQoL reduced the odds of impairment.
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Affiliation(s)
- Kim Van Vu
- Centre for Vision Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia
| | - Paul Mitchell
- Centre for Vision Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia
| | - Harshil Dharamdasani Detaram
- Centre for Vision Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia
| | - George Burlutsky
- Macquarie University Hearing, Department of Health Sciences, Macquarie University, Sydney, NSW, Australia
| | - Gerald Liew
- Centre for Vision Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia
| | - Bamini Gopinath
- Macquarie University Hearing, Department of Health Sciences, Macquarie University, Sydney, NSW, Australia.
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Nisanova A, Barrios L, Chokshi T, Mannis M, Bloch O, Liu YA. A Feasibility Study on a Portable Vision Device for Patients with Stroke and Brain Tumours. Neuroophthalmology 2024; 48:3-12. [PMID: 38357627 PMCID: PMC10863346 DOI: 10.1080/01658107.2023.2273471] [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: 06/29/2023] [Accepted: 10/09/2023] [Indexed: 02/16/2024] Open
Abstract
This prospective, single-centre cohort study aimed to evaluate the impact of a portable vision reading device, OrCam Read, on vision-related quality-of-life and independent functional status in patients with low vision due to stroke or brain tumours. Six patients with poor visual acuity or visual field defects due to a stroke or a brain tumour were enrolled at a U.S. Ophthalmology Department. Participants were trained to use OrCam Read and given a loaner device for the 1 month duration of the study. Various assessments, including daily function tests, the National Eye Institute Visual Function Questionnaire-25, and the 10-item neuro-ophthalmic supplement, were administered at the first and last visits. Patients' experience with the device was evaluated with weekly telephone and end-of-study satisfaction surveys. The main outcome measures were the patient satisfaction with OrCam and the mean assessment scores between enrolment and final visits. The intervention with OrCam significantly improved patients' ability to complete daily tasks and participants reported good satisfaction with the device. The results also show non-significant improvement with distant activities, dependency, and role difficulties. Our findings demonstrate the feasibility of studying vision-related quality-of-life using a portable vision device in this patient population and pave the way for a larger study to validate the results of this study.
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Affiliation(s)
- Arina Nisanova
- School of Medicine, University of California, Davis, California, USA
| | - Laurel Barrios
- School of Medicine, University of California, Davis, California, USA
| | - Tanvi Chokshi
- College of Medicine, California Northstate University, Elk Grove, California, USA
| | - Mark Mannis
- Department of Ophthalmology & Vision Science, University of California, Davis, California, USA
| | - Orin Bloch
- Department of Neurological Surgery, University of California, Davis, California, USA
| | - Yin Allison Liu
- Department of Ophthalmology & Vision Science, University of California, Davis, California, USA
- Department of Neurological Surgery, University of California, Davis, California, USA
- Department of Neurology, University of California, Davis, California, USA
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Albero-Ros E, Lorente-Velázquez A, González-Pérez M. Content development for a new item-bank for measuring multifocal contact lens performance. J Patient Rep Outcomes 2024; 8:16. [PMID: 38329635 PMCID: PMC10853121 DOI: 10.1186/s41687-024-00689-w] [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: 07/04/2023] [Accepted: 01/18/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Presbyopia is an age-related condition that causes a decreased ability to focus on nearby objects. Multifocal contact lenses are commonly used to address this issue. However, there seems to be a notable dissatisfaction among multifocal contact lens wearers. The absence of a reliable instrument to measure the patient's perspective, despite the widespread use of this method, highlights the need for further research in this area. OBJECTIVE The objective of this study is to develop an item-bank integrating all domains necessary to assess the patient's perspective on multifocal contact lens performance, offering a comprehensive measure. The item-bank will ensure a high level of content validity, be self-administered, and will initially be available in Spanish. The aim of this tool is to serve as a valuable resource for research and optometric clinics, facilitating the follow-up of patients with presbyopia who wear multifocal contact lenses or those who are newly starting to use them. METHODOLOGY The MCL-PRO item bank, followed a systematic and step-wise inductive approach to gather information, following the recommendations outlined in the COSMIN guidelines and similar studies. The process involved the following steps: (1) Literature review and relevant existing items identification (2) Social media review, (3) Semi-structured focus groups, (4) performing qualitative analysis, (5) refining and revising the items, and (6) generating the content of the item bank. RESULTS A total of 575 items were included in the item-bank hosted under 8 different domains that were found to be important for presbyopic population: visual symptoms (213), activity limitation (111), ocular symptoms (135), convenience (36), emotional well-being (33), general symptoms (16), cognitive issues (21) and economic issues (10). CONCLUSION The item-bank created has followed standardised methodology for its development and encloses all the aspects for MCL performance evaluation from patients perspective.
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Affiliation(s)
- Elsa Albero-Ros
- Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Arcos de Jalón, 118, 28037, Madrid, Spain.
- Alain Afflelou Óptico, Portugal, Av. António Augusto de Aguiar, 11, 1050-016, Lisbon, Portugal.
| | - Amalia Lorente-Velázquez
- Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Arcos de Jalón, 118, 28037, Madrid, Spain
- Clinical and Experimental Research Group (CEER), Faculty of Optics and Optometry, Universidad Complutense de Madrid, Arcos de Jalón, 118, 28037, Madrid, Spain
| | - Mariano González-Pérez
- Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Arcos de Jalón, 118, 28037, Madrid, Spain
- Clinical and Experimental Research Group (CEER), Faculty of Optics and Optometry, Universidad Complutense de Madrid, Arcos de Jalón, 118, 28037, Madrid, Spain
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Gazanchian M, Jansonius NM. Effect of Nonoverlapping Visual Field Defects on Vision-related Quality of Life in Glaucoma. Ophthalmol Glaucoma 2024:S2589-4196(24)00026-7. [PMID: 38311108 DOI: 10.1016/j.ogla.2024.01.007] [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: 07/19/2023] [Revised: 01/25/2024] [Accepted: 01/25/2024] [Indexed: 02/06/2024]
Abstract
PURPOSE Glaucoma patients may be considered to have normal vision as long as each point of visual space is perceived by at least 1 eye, that is, with an intact binocular visual field (VF). We aimed to investigate the effect of nonoverlapping VF defects on vision-related quality of life (VR-QoL) in glaucoma. METHODS We evaluated VR-QoL of glaucoma patients (n = 269) and controls (n = 113) using 4 different questionnaires (National Eye Institute visual function questionnaire [NEI-VFQ-25], NEI-VFQ neuro-ophthalmology supplement, Glaucoma Quality of Life-15, and a luminance-specific questionnaire). We defined "differential VF" (DVF) as a measure of location-specific differences in the VFs of both eyes. Within the group of glaucoma patients, we analyzed the relationship between different aspects of VR-QoL and DVF using ordinal multiple regression analysis. Analyses were adjusted for age, sex, integrated VF (IVF; an estimate of the binocular VF from the monocular VFs), and higher visual acuity of both eyes, and corrected for multiple hypothesis testing. RESULTS Glaucoma patients had lower VR-QoL than controls. Among the glaucoma patients, DVF was significantly associated with general vision (odds ratio [OR], 0.69; 95% confidence interval [CI], 0.54-0.89), peripheral vision (OR, 0.68; 95% CI, 0.54-0.86), walking on uneven ground (OR, 0.73; 95% CI, 0.58-0.93), crossing the street (OR, 0.61; 95% CI, 0.46-0.83), seeing other road users coming from the side (OR, 0.67; 95% CI, 0.52-0.85), cycling during the day (OR, 0.64; 95% CI, 0.46-0.89) and seeing outside on a sunny day (OR, 0.73; 95% CI, 0.57-0.94). In general, IVF was a stronger predictor of VR-QoL than DVF. CONCLUSIONS Nonoverlapping VF defects affect VR-QoL. Although IVF is strongly associated with VR-QoL, basing clinical decisions only on IVF leads to overlooking vision problems that patients may have. FINANCIAL DISCLOSURE(S) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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Affiliation(s)
- Mehrdad Gazanchian
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Graduate School of Medical Sciences (Research School of Behavioural and Cognitive Neurosciences), University of Groningen, Groningen, The Netherlands
| | - Nomdo M Jansonius
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Graduate School of Medical Sciences (Research School of Behavioural and Cognitive Neurosciences), University of Groningen, Groningen, The Netherlands.
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Künzel SH, Broadbent E, Möller PT, Lindner M, Goerdt L, Czauderna J, Schmitz-Valckenberg S, Holz FG, Pfau M, Fleckenstein M. Association of lesion location and functional parameters on vision-related quality of life in geographic atrophy secondary to AMD. Ophthalmol Retina 2024:S2468-6530(24)00057-5. [PMID: 38311207 DOI: 10.1016/j.oret.2024.01.025] [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: 11/10/2023] [Revised: 01/19/2024] [Accepted: 01/22/2024] [Indexed: 02/10/2024]
Abstract
OBJECTIVE The primary goal of this study was to determine how structural and functional parameters influence the vision-related quality of life (VRQoL) in patients suffering from geographic atrophy (GA) secondary to age-related macular degeneration. DESIGN This study was designed as a prospective, non-interventional, natural-history study (Directional Spread in Geographic-Atrophy study, NCT02051998). SUBJECTS The research involved 82 patients with bilateral GA. METHODS The study examined parameters including GA location as assessed by the Early Treatment Diabetic Retinopathy Study grid, best-corrected visual acuity (BCVA), low-luminance visual acuity (LLVA), reading acuity, and speed. These parameters were then correlated with VRQoL, which was gauged using the National Eye Institute Visual Function Questionnaire 25 (NEI VFQ-25). The analysis method employed was the least absolute shrinkage and selection operator with linear mixed-effects models. MAIN OUTCOME MEASURES The central parameters measured in this study encompassed GA area, VRQoL scores associated with different GA subfields, and the significance of LLVA for foveal-sparing patients. RESULTS On average, patients showed a total GA area of 2.9 ± 1.2 mm2 in the better eye and 3.1 ± 1.3 mm2 in the worse eye. The most significant associations with VRQoL scores for distance and near activities were observed in the inner lower and inner left subfields of the better eye, respectively. For patients with foveal-sparing GA, the LLVA of the better eye stood out as the most influential variable across all VRQoL scales. CONCLUSIONS The study's findings point towards the pivotal role of GA location, especially the inner lower and inner left subfields of the better eye, in relation to VRQoL in GA patients. The LLVA's importance becomes even more pronounced for foveal-sparing patients. These observations highlight the need for healthcare professionals to better understand the association between lesion location and patient-reported outcomes. This is critical for informing treatment decisions and refining the planning of interventional trials.
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Affiliation(s)
| | - Eliza Broadbent
- Department of Ophthalmology & Visual Sciences, John A. Moran Eye Center, University of Utah, 65 North Mario Capecchi Drive, Salt Lake City, 84312, UT, United States
| | | | - Moritz Lindner
- Institute of Physiology and Pathophysiology, Department of Neurophysiology, Philipps University, Deutschhausstr. 1-2, Marburg 35037, Germany; Nuffield Laboratory of Ophthalmology, Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, South Parks Road, Oxford OX1 3QU, UK
| | - Lukas Goerdt
- Department of Ophthalmology, University of Bonn, Bonn, Germany
| | | | - Steffen Schmitz-Valckenberg
- Department of Ophthalmology, University of Bonn, Bonn, Germany; Department of Ophthalmology & Visual Sciences, John A. Moran Eye Center, University of Utah, 65 North Mario Capecchi Drive, Salt Lake City, 84312, UT, United States
| | - Frank G Holz
- Department of Ophthalmology, University of Bonn, Bonn, Germany
| | - Maximilian Pfau
- Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland
| | - Monika Fleckenstein
- Department of Ophthalmology & Visual Sciences, John A. Moran Eye Center, University of Utah, 65 North Mario Capecchi Drive, Salt Lake City, 84312, UT, United States
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Sleath B, Beznos B, Carpenter DM, Budenz DL, Muir KW, Romero MS, Lee C, Tudor G, Garcia N, Robin AL. African American patient-provider communication about glaucoma vision quality-of-life. Eye (Lond) 2024; 38:343-348. [PMID: 37580416 PMCID: PMC10810853 DOI: 10.1038/s41433-023-02693-8] [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: 01/21/2023] [Revised: 07/22/2023] [Accepted: 08/02/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND/OBJECTIVES Little is known about African American patient-provider communication about glaucoma-related quality-of-life. The objectives of this study were to: (a) examine associations between patient socio-demographics and vision quality-of-life, (b) describe the extent to which eye care providers and patients discuss glaucoma-related quality-of-life, and (c) examine associations between patient and provider characteristics, whether the patient was in the intervention or usual care group, and whether the patient and provider discuss one or more glaucoma-related quality-of-life domains. METHODS Adult African American patients with glaucoma who reported non-adherence to glaucoma medications were enrolled from three sites. Patients completed a vision quality-of-life VFQ-25 assessment. Patients were randomized into intervention and control groups with intervention group members receiving a glaucoma question prompt list and watching a video before a provider visit. Audio recordings from these visits were transcribed and assessed for glaucoma-related quality-of-life discussions. RESULTS One hundred and eighty-nine patients were enrolled. Glaucoma-related quality-of-life was discussed during 12.3% of visits (N = 23). Patients initiated discussion 56.5% (N = 13) of the time and providers 43.5% (N = 10) of the time. Patients with worse health literacy (p < 0.001), more depressive symptoms (p < 0.05), and more severe glaucoma (p < 0.001) were significantly more likely to have worse vision-related quality-of-life. Glaucoma-related quality-of-life was significantly more likely to be discussed when African American patients saw African American providers (p < 0.05). CONCLUSION Patients and providers rarely discussed the patient's glaucoma-related quality-of-life. The intervention did not significantly increase communication about glaucoma-related quality-of-life. Residency programs should consider enhancing training regarding discussing patients' quality-of-life.
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Affiliation(s)
- Betsy Sleath
- Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Bethany Beznos
- Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Delesha M Carpenter
- Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Donald L Budenz
- Department of Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kelly W Muir
- Department of Ophthalmology, School of Medicine, Duke University, Durham, NC, USA
- Durham VA Medical Center, Health Services Research and Development, Durham, NC, USA
| | | | | | - Gail Tudor
- Southern New Hampshire University, Manchester, NH, USA
| | - Nacire Garcia
- Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Alan L Robin
- Wilmer Institute, Johns Hopkins University, Baltimore, MD, USA
- American Glaucoma Society, San Francisco, CA, USA
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Dogan L, Tanriverdi D, Gungor K. Assessment of vision-related quality of life and depression in patients with age-related macular degeneration. Indian J Ophthalmol 2024; 72:S293-S297. [PMID: 38271426 DOI: 10.4103/ijo.ijo_2327_23] [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: 08/25/2023] [Accepted: 12/12/2023] [Indexed: 01/27/2024] Open
Abstract
PURPOSE To evaluate the effect of age-related macular degeneration (AMD) on vision-related quality of life (VRQOL) and depression levels. METHODS This cross-sectional study included 143 patients who are being followed up with a diagnosis of AMD. The Turkish versions of the National Eye Institute Visual Functioning Questionnaire-25 (NEI VFQ-25) and Geriatric Depression Scale-15 (GDS-15) were directed to the patients. The questionnaire results were analyzed based on the severity, treatment procedures for AMD, and sociodemographic characteristics of patients. RESULTS The subscale scores obtained from the NEI VFQ-25 ranged from 47.54 for "near activities" to 84.02 for "color vision." Of the patients, 59.4% (85/143) were compatible with depression according to the GDS-15 questionnaire. There was no significant difference in the NEI VFQ-25 subscale scores between the gender groups (P > 0.05), whereas females were statistically significantly more depressive than males (P < 0.05). There were no significant differences between the injection (anti-vascular endothelial growth factors [anti-VEGF]) group and the non-injection group in terms of subscales of the NEI VFQ-25 questionnaire (P > 0.05). The depression ratio in the non-injected group was statistically significantly higher (P < 0.05). CONCLUSION According to the present study, the association between depression and AMD is a fact that should be highlighted. Patients with depression had lower scores on the quality of life (QOL) test. Previous intravitreal injection did not affect NEI VFQ-25 scores. Female patients with AMD had higher rates of depression and lower visual acuity levels.
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Affiliation(s)
- Levent Dogan
- Kilis State Hospital, Department of Ophthalmology, Kilis, Turkey
| | - Derya Tanriverdi
- Gaziantep University, Faculty of Health Sciences, Department of Psychiatric Nursing Gaziantep, Turkey
| | - Kivanc Gungor
- Gaziantep University Hospital Ophthalmology Department, Gaziantep, Turkey
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Aiello F, Gallo Afflitto G, Ceccarelli F, Garzione F, Pocobelli G, Pinci C, Di Lorenzo G, Siracusano A, Nucci C. Keratoconus and Personality Traits: A Case-Control Study. Cornea 2024; 43:237-244. [PMID: 37018764 DOI: 10.1097/ico.0000000000003284] [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: 02/06/2023] [Accepted: 02/26/2023] [Indexed: 04/07/2023]
Abstract
PURPOSE The aim of this study was to delineate the personality traits of patients affected by keratoconus (KC) compared with a group of nonkeratoconic controls matched in age and sex. METHODS In this prospective interventional case-control study, 60 consecutive subjects (30 KC cases and 30 healthy controls), aged 18 to 30, were enrolled at the time of their first encounter at the ophthalmology unit of the Fondazione Policlinico "Tor Vergata", Roma. After completing the ophthalmic evaluation, participants were asked to respond to the National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25). A complete psychiatric assessment was performed, including the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (SCID-5); the Symptom Check List-90-Revised (SCL-90); the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Modified (TEMPS-M); and the NEO Five-Factor Inventory (NEO-FFI). RESULTS Cases had lower quality of life than controls, as demonstrated by lower scores in all NEI VFQ-25 subdomains. Nine patients with KC (30.0%) were diagnosed by the SCID-5 with at least 1 cluster C personality disorder, resulting in a 9-fold increased risk compared with controls. Moreover, keratoconic patients showed a more pronounced psychosomatic symptomatology (SCL-90) and a characteristic neurotic temperament (TEMPS-M and NEO-FFI). CONCLUSIONS Our results support the hypothesis that subjects with KC feature dysfunctional coping mechanisms and personality traits, which might already be present at the first clinical encounter. Ophthalmologists should question the mental and emotional status of patients with KC and be especially careful in managing these patients.
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Affiliation(s)
- Francesco Aiello
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Gabriele Gallo Afflitto
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL; and
| | - Francesca Ceccarelli
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Flavia Garzione
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Giulio Pocobelli
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Carolina Pinci
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Giorgio Di Lorenzo
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Alberto Siracusano
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Carlo Nucci
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
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Linghu W, Niu M, Sun N, Gao F, Li X, Zhang X. Development and Psychometric Properties of the Chronic Uveitis-Specific Quality of Life Instrument for Patients with Chronic Uveitis. Ocul Immunol Inflamm 2024; 32:194-202. [PMID: 36638326 DOI: 10.1080/09273948.2022.2162926] [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: 06/30/2022] [Accepted: 12/21/2022] [Indexed: 01/15/2023]
Abstract
PURPOSE To develop and assess psychometric properties of a disease-specific quality of life (QOL) assessment tool for patients with chronic uveitis. METHODS The initial 42-item chronic uveitis-related QOL questionnaire (CUQOL) was developed by literature review, semi-structured interviews, and expert consultation. Further development and assessment of the CUQOL were performed using Classic Test Theory and Rasch analysis. RESULTS The CUQOL version 1.0 was constructed with 28 items in five dimensions. The five subscales satisfied the requirements of unidimensionality, local independence, and threshold ordering. Cronbach's α coefficient for overall and each scale of the CUQOL 1.0 ranged from 0.75 to 0.94, with test-retest intraclass correlation ranging from 0.95 to 0.99. The CUQOL 1.0 has satisfactory convergent validity (r = 0.41-0.82), reasonable known group validity (p < .05), and good responsiveness (p < .05). CONCLUSIONS The CUQOL 1.0 is reliable and vaild for evaluating the QOL of patients with chronic uveitis.
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Affiliation(s)
- Wenrui Linghu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Mingyan Niu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Nan Sun
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Fei Gao
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Xiaorong Li
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Xiaomin Zhang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 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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Karpecki PM, Findley A, Sloesen BJ, Hodson N, Bentley S, Arbuckle R, O'Brien P, Montecchi-Palmer M, Naujoks C, Hamrah P. Qualitative Research to Understand the Patient Experience and Evaluate Content Validity of the Chronic Ocular Pain Questionnaire (COP-Q). Ophthalmol Ther 2024; 13:615-633. [PMID: 38183618 PMCID: PMC10787728 DOI: 10.1007/s40123-023-00860-4] [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: 11/08/2023] [Accepted: 11/21/2023] [Indexed: 01/08/2024] Open
Abstract
INTRODUCTION Chronic ocular surface pain (COSP) is described as a persistent, moderate-to-severe pain at the ocular surface lasting more than 3 months. Symptoms of COSP have a significant impact on patients' vision-dependent activities of daily living (ADL) and distal health-related quality of life (HRQoL). To adequately capture patient perspectives in clinical trials, patient-reported outcome (PRO) measures must demonstrate sufficient evidence of content validity in the target population. This study aimed to explore the patient experience of living with COSP and evaluate content validity of the newly developed Chronic Ocular Pain Questionnaire (COP-Q) for use in COSP clinical trials. METHODS Qualitative, combined concept elicitation (CE) and cognitive debriefing (CD) interviews were conducted with 24 patients experiencing COSP symptoms in the USA. Interviews were supplemented with real-time data collection via a daily diary app task in a subset of patients (n = 15) to explore the day-to-day patient experience. Three healthcare professionals (HCPs) from the USA, Canada, and France were also interviewed to provide a clinical perspective. CE results were used to further inform development of a conceptual model and to refine PRO items/response options. CD interviews assessed relevance and understanding of the COP-Q. Interviews were conducted across multiple rounds to allow item modifications and subsequent testing. RESULTS Eye pain, eye itch, burning sensation, eye dryness, eye irritation, foreign body sensation, eye fatigue, and eye grittiness were the most frequently reported symptoms impacting vision-dependent ADL (e.g., reading, using digital devices, driving) and wider HRQoL (e.g., emotional wellbeing, social functioning, work). COP-Q instructions, items, and response scales were understood, and concepts were considered relevant. Feedback supported modifications to instruction/item wording and confirmed the most appropriate recall periods. CONCLUSIONS Findings support content validity of the COP-Q for use in COSP populations. Ongoing research to evaluate psychometric validity of the COP-Q will support future use of the instrument in clinical trial efficacy endpoints.
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Affiliation(s)
- Paul M Karpecki
- University of Pikeville Kentucky College of Optometry, Pikeville, KY, USA
- Kentucky Eye Institute, Lexington, KY, USA
| | - Amy Findley
- Patient-Centered Outcomes, Adelphi Values Ltd., Bollington, Cheshire, UK
- Novo Norisk, Copenhagen, Denmark
| | | | - Nicola Hodson
- Patient-Centered Outcomes, Adelphi Values Ltd., Bollington, Cheshire, UK.
| | - Sarah Bentley
- Patient-Centered Outcomes, Adelphi Values Ltd., Bollington, Cheshire, UK
| | - Rob Arbuckle
- Patient-Centered Outcomes, Adelphi Values Ltd., Bollington, Cheshire, UK
| | - Paul O'Brien
- Novartis Ireland Ltd., Dublin, Ireland
- ViiV Healthcare, London, UK
| | | | | | - Pedram Hamrah
- Department of Ophthalmology, New England Eye Center and Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
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