Quality of life in stable and progressive 'early-stage' keratoconus patients

TY - JOUR

T1 - Quality of life in stable and progressive 'early-stage' keratoconus patients

AU - Steinberg, Johannes

AU - Bußmann, Nils

AU - Frings, Andreas

AU - Katz, Toam

AU - Druchkiv, Vasyl

AU - Linke, Stephan J

N1 - © 2020 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

PY - 2021/3

Y1 - 2021/3

N2 - PURPOSE: To analyse the vision-related quality of life (vr-QoL) in stable and progressive keratoconus (KC) patients with a still good visual acuity.METHODS: Combined prospective/cross-sectional study design. The Refractive Status and Vision Profile (RSVP) and the National Eye Institute Visual Functioning - 25 (NEI-25) questionnaire were used in 16 emmetropic, 32 myopic and 56 KC patients, whereby KC patients with a stable (n = 26) and patients with a progressive stage (n = 30) and some of them before and after corneal cross-linking (CXL; n = 10) were included. All patients had a DCVA in at least one eye of ≥0.7 (decimal chart).RESULTS: The analyses revealed a minor decline of the vr-QoL from emmetropes to myopes to early KC patients with a stable disease. Nonetheless, sociological subscales (i.e. 'social functioning', 'role difficulties' and 'dependency') did not display statistically significant differences comparing these groups. In progressive KC, we could demonstrate a statistically significant decline also of these sociological subscales, which did not improve after CXL.CONCLUSION: Due to a still high and almost unaffected vr-QoL in early KC patients and the distinct decline after progression without rehabilitation after CXL, a reconsideration of current strategies to perform CXL only after a progression is diagnosed should be re-evaluated.

AB - PURPOSE: To analyse the vision-related quality of life (vr-QoL) in stable and progressive keratoconus (KC) patients with a still good visual acuity.METHODS: Combined prospective/cross-sectional study design. The Refractive Status and Vision Profile (RSVP) and the National Eye Institute Visual Functioning - 25 (NEI-25) questionnaire were used in 16 emmetropic, 32 myopic and 56 KC patients, whereby KC patients with a stable (n = 26) and patients with a progressive stage (n = 30) and some of them before and after corneal cross-linking (CXL; n = 10) were included. All patients had a DCVA in at least one eye of ≥0.7 (decimal chart).RESULTS: The analyses revealed a minor decline of the vr-QoL from emmetropes to myopes to early KC patients with a stable disease. Nonetheless, sociological subscales (i.e. 'social functioning', 'role difficulties' and 'dependency') did not display statistically significant differences comparing these groups. In progressive KC, we could demonstrate a statistically significant decline also of these sociological subscales, which did not improve after CXL.CONCLUSION: Due to a still high and almost unaffected vr-QoL in early KC patients and the distinct decline after progression without rehabilitation after CXL, a reconsideration of current strategies to perform CXL only after a progression is diagnosed should be re-evaluated.

KW - Adult

KW - Collagen/therapeutic use

KW - Cornea/pathology

KW - Corneal Topography

KW - Cross-Linking Reagents/therapeutic use

KW - Cross-Sectional Studies

KW - Female

KW - Humans

KW - Keratoconus/diagnosis

KW - Male

KW - Photochemotherapy/methods

KW - Photosensitizing Agents/therapeutic use

KW - Prospective Studies

KW - Quality of Life

KW - Riboflavin/therapeutic use

KW - Visual Acuity

U2 - 10.1111/aos.14564

DO - 10.1111/aos.14564

M3 - SCORING: Journal article

C2 - 32914586

VL - 99

SP - e196-e201

JO - ACTA OPHTHALMOL

JF - ACTA OPHTHALMOL

SN - 1755-375X

IS - 2

ER -