Patient Reported Outcomes Unit, Brien Holden Eye Research Centre, LV Prasad Eye Institute, Hyderabad, India.
Centre for Ocular Regeneration, LV Prasad Eye Institute, Hyderabad, India.
Ophthalmic Physiol Opt. 2022 Sep;42(5):986-997. doi: 10.1111/opo.13010. Epub 2022 May 30.
To identify the factors affecting the quality of life (QoL) in adults with keratoconus, using the disease-specific Keratoconus Outcomes Research Questionnaire (KORQ).
In this cross-sectional study, 574 patients with keratoconus completed the 29-item KORQ (18-item activity limitations and 11-item symptoms subscales) and demographic information. Based on mean corneal curvature to grade keratoconus severity, participants were categorised into four groups: mild <48 dioptres [D]; moderate: 48 to 53 D; advanced: 54 to 55 D and severe: >55D. Rasch analysis was used to assess the psychometric properties and to score the KORQ. Multivariable regression was performed to determine the independent impact of age, sex, laterality, severity and duration of keratoconus, education, employment status and mode of treatment for keratoconus on activity limitations and symptoms.
Mean (SD) age was 24.5 (5.1) years. 304 (53%), 160 (28%), 26 (4%) and 84 (15%) belonged to keratoconus groups 1, 2, 3 and 4, respectively. Rasch analysis demonstrated the 'activity limitations' and 'symptoms' KORQ subscales to possess good psychometric properties. Statistically significant associations were found between activity limitation score and the following measures: visual acuity (VA) in the better-seeing eye (r = -0.10, p = 0.01); VA in the worse-seeing eye (r = -0.09, p = 0.04) and ocular aberrations (r = -0.13, p = 0.008) in the worse-seeing eye. Statistically significant associations were also found between symptoms score and mean corneal curvature in the better-seeing eye (r = -0.10, p = 0.02). In regression models, female sex was associated with 21% worse symptom score than male (β = -0.33, 95% CI, -0.09, -0.59, p = 0.01) and working people experienced clinically and statistically significantly greater trouble from symptoms compared to those not working (β =0.44, 95% CI, 0.17, 0.70, p = 0.001).
People with keratoconus have poorer QoL in terms of activity limitations if they have poorer VA and greater wavefront aberrations, and in terms of symptoms if they are female and employed.
使用特定于疾病的角膜混浊结局研究问卷（KORQ），确定影响圆锥角膜患者生活质量（QoL）的因素。
在这项横断面研究中，574 名圆锥角膜患者完成了 29 项 KORQ（18 项活动受限和 11 项症状子量表）和人口统计学信息。根据平均角膜曲率来分级圆锥角膜的严重程度，参与者被分为四组：轻度<48 屈光度[D]；中度：48 至 53 D；中重度：54 至 55 D；重度：>55 D。Rasch 分析用于评估心理测量特性并对 KORQ 进行评分。进行多变量回归以确定年龄、性别、侧别、圆锥角膜的严重程度和持续时间、教育、就业状况以及圆锥角膜治疗方式对活动受限和症状的独立影响。
平均（SD）年龄为 24.5（5.1）岁。分别有 304 名（53%）、160 名（28%）、26 名（4%）和 84 名（15%）患者属于圆锥角膜 1 组、2 组、3 组和 4 组。Rasch 分析表明，“活动受限”和“症状”KORQ 子量表具有良好的心理测量特性。活动受限评分与以下指标之间存在统计学显著关联：较好眼的视力（VA）（r=-0.10，p=0.01）；较差眼的 VA（r=-0.09，p=0.04）和较差眼的眼像差（r=-0.13，p=0.008）。症状评分与较好眼的平均角膜曲率之间也存在统计学显著关联（r=-0.10，p=0.02）。在回归模型中，与男性相比，女性的症状评分差 21%（β=-0.33，95%CI：-0.09，-0.59，p=0.01），与不工作的人相比，工作的人经历的症状困扰更大（β=0.44，95%CI：0.17，0.70，p=0.001）。
如果圆锥角膜患者的 VA 较差且波前像差较大，则其活动受限的 QoL 较差；如果为女性且就业，则其症状的 QoL 较差。
