Tan Jeremy C K, Nguyen Vuong, Fenwick Eva, Ferdi Alex, Dinh Amanda, Watson Stephanie L
Save Sight Institute, University of Sydney, Sydney, Australia.
Duke-NUS Medical School, National University of Singapore, Singapore.
Cornea. 2019 May;38(5):600-604. doi: 10.1097/ICO.0000000000001899.
To assess vision-related quality of life using the Impact of Vision Impairment Questionnaire (IVI) in patients with keratoconus enrolled in the Save Sight Keratoconus Registry.
In this cross-sectional study, data on 107 keratoconic patients were collected through a prospectively designed web-based registry from a quaternary referral eye hospital and 2 corneal subspecialty practices. Vision-related quality of life was evaluated using the IVI. Rasch analysis was used to transform the IVI responses into interval-level measures comprising reading, mobility, and emotional well-being subscales. Associations between best-corrected visual acuity (BCVA), maximum simulated keratometry (Kmax), steep keratometry (K2), and pachymetry for each eye and IVI subscale scores were evaluated with univariate (Pearson correlations) and multivariable regression adjusted for age and gender.
Of the 107 patients, 37 (34.5%), 41 (38.0%) and 29 (26.9%) had mild, moderate, and severe keratoconus, respectively. On uni- and multivariable analysis, BCVA in the better eye had the strongest association with reading [r = 0.51; 95% confidence interval (CI), 0.35-0.64, P = 0.004] and mobility (r = 0.55; 95% CI, 0.41-0.67, P < 0.001) subscale scores. BCVA in the better and worse eye, both had the joint strongest associations with emotional scores on univariate analysis, but only the latter was significant on multivariable analysis (r = 0.37; 95% CI, 0.20-0.53, P < 0.001). K2 and Kmax in the better eye also displayed significant associations with reading and mobility scores.
In patients with keratoconus, BCVA in the better eye had the strongest correlation with reading and mobility scores, whereas BCVA in the worse eye was significantly correlated with emotional scores.
使用视力损害影响问卷（IVI）评估圆锥角膜登记处登记的圆锥角膜患者与视力相关的生活质量。
在这项横断面研究中，通过前瞻性设计的基于网络的登记系统，从一家四级转诊眼科医院和2个角膜专科诊所收集了107例圆锥角膜患者的数据。使用IVI评估与视力相关的生活质量。采用Rasch分析将IVI的回答转化为区间水平的测量值，包括阅读、活动能力和情绪健康子量表。通过单变量（Pearson相关性）和调整年龄和性别的多变量回归，评估每只眼睛的最佳矫正视力（BCVA）、最大模拟角膜曲率（Kmax）、陡峭角膜曲率（K2）和角膜厚度与IVI子量表得分之间的关联。
107例患者中，分别有37例（34.5%）、41例（38.0%）和29例（26.9%）患有轻度、中度和重度圆锥角膜。在单变量和多变量分析中，较好眼的BCVA与阅读[r = 0.51；95%置信区间（CI），0.35 - 0.64，P = 0.004]和活动能力（r = 0.55；95% CI，0.41 - 0.67，P < 0.001）子量表得分的相关性最强。在单变量分析中，较好眼和较差眼的BCVA与情绪得分的相关性均最强，但在多变量分析中只有后者显著（r = 0.37；95% CI，0.20 - 0.53，P < 0.001）。较好眼的K2和Kmax也与阅读和活动能力得分显示出显著相关性。
在圆锥角膜患者中，较好眼的BCVA与阅读和活动能力得分的相关性最强，而较差眼的BCVA与情绪得分显著相关。
