TY - JOUR
T1 - Changes in the Quality-of-Life of People with Keratoconus
AU - Kymes, Steven M.
AU - Walline, Jeffrey J.
AU - Zadnik, Karla
AU - Sterling, John
AU - Gordon, Mae O.
N1 - Funding Information:
This study was supported by Grants EY10419, EY10069, EY10077, EY12656, and EY2687 from the National Eye Institute, National Institutes of Health, Bethesda, Maryland; Conforma Contact Lenses, Norfolk, Virginia; Paragon Vision Sciences, Mesa, Arizona; CIBA Vision Corp, Duluth, Georgia; and the Ohio Lions Eye Research Foundation, Columbus, Ohio. The Department of Ophthalmology and Visual Science at Washington University is supported by awards from Research to Prevent Blindness, Inc, New York, New York. Dr Kymes is a consultant for and receives research support from Pfizer Pharmaceuticals and Allergan Pharmaceuticals. Involved in design of study (S.M.K., J.J.W., K.Z., J.S., M.O.G.); conduct of study (S.M.K., J.J.W., K.Z., M.O.G.); collection of data (K.Z., J.S., M.O.G.); management of data (K.Z., M.O.G.); analysis and interpretation of data (S.M.K., J.J.W., K.Z., M.O.G.); and preparation, review, and approval of manuscript (S.M.K., J.J.W., K.Z., M.O.G.). The Collaborative Longitudinal Evaluation of Keratoconus (CLEK) was conducted with the approval of the institutional review boards at all clinic sites, including review of the overall protocol by the Ohio State Institutional Review Board for the Chair’s office. Consent was received from all CLEK participants for inclusion this trial, and all CLEK sites and the coordinating center were compliant with all Health Insurance Portability and Accountability Act requirements in the handling of participant data. The CLEK was an observational study and was initiated before the initiative for trial registration.
PY - 2008/4
Y1 - 2008/4
N2 - Purpose: The Collaborative Longitudinal Evaluation of Keratoconus Study (CLEK) previously showed that people with keratoconus report significantly impaired vision-related quality-of-life (V-QoL), as measured on the National Eye Institute Visual Function Questionnaire (NEI-VFQ), similar to that of people who have severe macular degeneration. For this study, we evaluated changes that occurred in V-QoL over seven years of follow-up. Design: In this prospective cohort study of 1,166 participants followed up for seven years, we estimated change in V-QoL by projecting the slope of a minimum of three reports on 11 scales of the NEI-VFQ. Correlation with clinical indicators was evaluated, and differences were assessed between those who had clinically significant changes in clinical factors and those who did not. Logistic regression was used to assess factors associated with a decline in 10 points or more in a scale score over seven years. Results: All scales showed modest decline except ocular pain and mental health. Baseline factors were not associated with longitudinal change in NEI-VFQ scores. A 10-letter decline in high-contrast binocular visual acuity or a 3.00-diopter increase in corneal curvature were associated with significantly larger declines in V-QoL. In multivariate analysis, these factors also were found to be associated with a 10-point decline in NEI-VFQ scale scores. Conclusions: Keratoconus is associated with significantly impaired V-QoL that continues to decline over time. For a substantial plurality of patients, these declines are significant.
AB - Purpose: The Collaborative Longitudinal Evaluation of Keratoconus Study (CLEK) previously showed that people with keratoconus report significantly impaired vision-related quality-of-life (V-QoL), as measured on the National Eye Institute Visual Function Questionnaire (NEI-VFQ), similar to that of people who have severe macular degeneration. For this study, we evaluated changes that occurred in V-QoL over seven years of follow-up. Design: In this prospective cohort study of 1,166 participants followed up for seven years, we estimated change in V-QoL by projecting the slope of a minimum of three reports on 11 scales of the NEI-VFQ. Correlation with clinical indicators was evaluated, and differences were assessed between those who had clinically significant changes in clinical factors and those who did not. Logistic regression was used to assess factors associated with a decline in 10 points or more in a scale score over seven years. Results: All scales showed modest decline except ocular pain and mental health. Baseline factors were not associated with longitudinal change in NEI-VFQ scores. A 10-letter decline in high-contrast binocular visual acuity or a 3.00-diopter increase in corneal curvature were associated with significantly larger declines in V-QoL. In multivariate analysis, these factors also were found to be associated with a 10-point decline in NEI-VFQ scale scores. Conclusions: Keratoconus is associated with significantly impaired V-QoL that continues to decline over time. For a substantial plurality of patients, these declines are significant.
UR - http://www.scopus.com/inward/record.url?scp=40849137727&partnerID=8YFLogxK
U2 - 10.1016/j.ajo.2007.11.017
DO - 10.1016/j.ajo.2007.11.017
M3 - Article
C2 - 18226798
AN - SCOPUS:40849137727
SN - 0002-9394
VL - 145
SP - 611-617.e1
JO - American journal of ophthalmology
JF - American journal of ophthalmology
IS - 4
ER -