Functional And Symptomatic Patient-Reported Impact Of Keratoconus In A Portuguese Population
Published 2022
- 40th Congress of the ESCRS
Reference: PO305
| Type: Free paper
| DOI:
10.82333/r7j3-3314
Authors:
Mariana Portela* 1
, João Gil 2
, Ana Catarina Silva 3
, Bruna Cunha 4
, Pedro Gil 5
, Esmeralda Costa 6
, Andreia Rosa 2
, João Feijão 4
, Maria João Quadrado 2
, Joaquim Murta 2
1Ophthalmology,Centro Hospitalar de Lisboa Ocidental (CHLO),Lisbon,Portugal, 2Ophthalmology,Coimbra Hospital and University Center (CHUC),Coimbra,Portugal;Faculty of Medicine, University of Coimbra (FMUC),Coimbra,Portugal;Clinical Academic Center of Coimbra (CACC),Coimbra,Portugal, 3Faculty of Medicine, University of Coimbra (FMUC),Coimbra,Portugal, 4Ophthalmology,Centro Hospitalar e Universitário de Lisboa Central (CHULC),Lisbon,Portugal, 5Ophthalmology,Centro Hospitalar e Universitário de Lisboa Central (CHULC),Lisbon,Portugal;Faculty of Medicine, University of Coimbra (FMUC),Coimbra,Portugal, 6Ophthalmology,Coimbra Hospital and University Center (CHUC),Coimbra,Portugal;Clinical Academic Center of Coimbra (CACC),Coimbra,Portugal
Purpose
Keratoconus (KC) is a corneal disease with its onset in adolescence and a progressive course. The degradation of visual function in these patients can profoundly affect their ability to perform daily activities and overall quality of life (QoL). Specific tools are needed for this assessment, as typical clinical metrics do not fully reflect the global impact of KC on QoL. The Keratoconus Outcomes Research Questionnaire (KORQ) is the only KC questionnaire that is translated and validated in Portuguese. It measures 2 domains of vision-related-QoL – daily activity limitations and symptoms – and was specifically developed for individuals with KC. We used the KORQ to assess the QoL of patients with KC in a Portuguese multicentric cohort.
Setting
Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal and Department of Ophthalmology, Centro Hospitalar e Universitário de Lisboa Central (CHULC), Lisbon, Portugal
Methods
In a multicentric study, we included 128 patients, aged 18 years and older, with a diagnosis of KC, regardless of disease severity. Patients who had other significant ocular or systemic disease, who had been submitted to ocular surgery other than for KC or who were unable to understand the KORQ were excluded. Each patient's score was obtained using ready-to-use Microsoft Excel scoring spreadsheets for the two KORQ scales (activity-related and symptomatic). Associations between the KORQ score and demographic data, prior treatments and surgical interventions, BCVA, and tomographic features assessed with Pentacam (ABCD stage, K1, K2, Kmax, and pachymetry) were explored.
Results
The mean age was 30.8±8.0 years [18-66] with 77 males (60%). QoL scores correlated positively with BCVA in the better eye, although not in a statistically significant way (p=0.069). Higher K1, K2 and Kmax values and a grade 3 or higher in the item A of ABCD classification in the best eye were associated with worse activity scores (p=0.002, p=0.047, p<0.001 and p=0.003 respectively). Patient gender or age, contact lens wear, previous surgical interventions or a longer duration of disease did not influence QoL scores. The most common individual limitation was driving at night and the most common complaint was distorted vision. Activity-limitation and symptomatic scores were not significantly correlated (p=0.18).
Conclusions
In conclusion, our study suggests that tomographic severity is a good predictor of worse QoL in KC patients. These findings support the importance of strict follow-up programs and the need to actively prevent progression in order to maintain optimal QoL. Patients showed independent scores for activity limitations and symptomatic complaints, highlighting the multiple aspects of this disease. The use of a validated questionnaire to assess patient-reported outcomes in KC is a powerful tool to measure the impact of this condition.