Abstract
Purpose:
To study the vision-related quality of life in a clinic-based cohort of patients with ocular Graft-Versus-Host Disease (GVHD).
Methods:
One hundred patients were included in the study. Mean outcome measures included: the vision-related quality of life (QOL) score measured by the National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25); dry eye symptoms measured by the Ocular Surface Disease Index (OSDI©) and the Symptom Assessment in Dry Eye (SANDE) questionnaires; and clinical signs of dry eye, including corneal fluorescein staining, tear break up time (TBUT), Schirmer test, and meibomian gland dysfunction scores. We evaluated the degree of correlation between the scores of the different domains measured by the QOL questionnaire and the symptoms and clinical signs of dry eye.
Results:
The mean composite NEI-VFQ score, which includes the domains evaluated in the questionnaire, was 75±18 ranging from 16 to 98 (where a score of 100 represents the best quality of life). The results of the NEI-VFQ revealed lower scores when compared to those reported for healthy controls. The most affected domains were: ocular pain 60 (healthy controls: 90), role functioning 63 (healthy controls: 93), mental health 66 (healthy controls: 92), and general health 47 (healthy controls: 69). There was a statistically significant correlation between the composite QOL score and the OSDI (R= -0.83; P<0.001), SANDE (R= -0.51; P<0.001), and corneal fluorescein staining (R= -0.36; P<0.001) scores. However, the QOL did not correlate with TBUT (R=0.17; P=0.1), Schirmer test (R=0.19; P=0.06) or meibomian gland dysfunction (lid margin telangiectasia [R=-0.08; P=0.5]; meibum quality [R=-0.05; P=0.7]) scores.
Conclusions:
Patients with ocular GVHD present a reduction in their vision-related quality of life, particularly affecting the spheres of ocular pain, role functioning, mental health, and general health. Furthermore, symptoms of dry eye and corneal fluorescein staining are associated with the vision-related quality of life in these patients.
Keywords: 486 cornea: tears/tear film/dry eye