Panthier Christophe, Moran Sarah, Bourges Jean Louis
Department of Ophthalmology, School of medicine of Paris Descartes, Hôpital Cochin-Hôtel-Dieu, Sorbonne Paris Cité University, Paris, France.
Department of Anterior Segment and Refractive Surgery, Rothschild Foundation, 25 rue Manin, 75019, Paris, France.
Graefes Arch Clin Exp Ophthalmol. 2020 Jul;258(7):1459-1468. doi: 10.1007/s00417-020-04680-1. Epub 2020 Apr 15.
To evaluate vision-related quality of life in keratoconus patients and associated impact of keratoconus severity indicators using the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25).
This was a prospective cross-sectional study carried out from November 1, 2014, to April 30, 2015, in the corneal service of the Hôtel-Dieu hospital, Paris, France. A hundred and one keratoconus patients were consecutively enrolled. Participants completed a French-validated version of the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25). Manifest refraction, maximum keratometry value, and corneal thinnest point were recorded. Associations between clinical and demographic factors, previous medical or surgical treatment, and NEI-VFQ-25 scale scores were evaluated.
Vision-related quality of life was no better in patients managed with rigid gas permeable contact lens, collagen cross-linking, or intracorneal ring segment implantation, compared with untreated patients. In advanced keratoconus (stages II, III, and IV of Amsler-Krumeich classification), rigid gas permeable contact lens wearers had better general vision but more ocular pain. Distance-corrected visual acuity worse than 20/40, mean refractive cylinder > 2.5 diopters, and corneal thinnest point < 460 μm in the better eye were associated with a lower vision-related quality of life. In multivariate analysis, only the uncorrected and distance-corrected visual acuity of the better eye remained significantly correlated with vision-related quality of life.
Low distance-corrected visual acuity in the better eye was the strongest predictor of low vision-related quality of life.
使用美国国立眼科研究所视觉功能问卷（NEI-VFQ-25）评估圆锥角膜患者与视力相关的生活质量以及圆锥角膜严重程度指标的相关影响。
这是一项前瞻性横断面研究，于2014年11月1日至2015年4月30日在法国巴黎迪厄医院的角膜科进行。连续纳入了101例圆锥角膜患者。参与者完成了一份经法语验证的美国国立眼科研究所视觉功能问卷（NEI-VFQ-25）。记录了显验光、最大角膜曲率值和角膜最薄点。评估了临床和人口统计学因素、既往药物或手术治疗与NEI-VFQ-25量表评分之间的关联。
与未治疗的患者相比, 使用硬性透气性角膜接触镜、角膜交联或角膜内环植入术治疗的患者，其与视力相关的生活质量并无改善。在晚期圆锥角膜（Amsler-Krumeich分类的II、III和IV期）中，佩戴硬性透气性角膜接触镜的患者有更好的总体视力，但眼部疼痛更多。较好眼的矫正远视力低于20/40、平均等效球镜度>2.5屈光度以及角膜最薄点<460μm与较低的视力相关生活质量相关。在多变量分析中，只有较好眼的未矫正和矫正远视力与视力相关生活质量仍显著相关。
较好眼的低矫正远视力是低视力相关生活质量的最强预测因素。
