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Karin M. Oliver, Laurence Jaworski, Elodie Samson, Ellen Freeman, Marie-Lyne Bélair, Marie-Josée Aubin, Éric Fortin; Visual Impairment, Visual Function And Quality Of Life Among Uveitis Patients In A North American Population. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4280.
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To evaluate the epidemiology and course of uveitis in a North American tertiary care center and to determine the relationship between visual impairment, visual functioning and the global quality of life in patients with uveitis.
A detailed chart review, best corrected Snellen acuity and 2 validated questionnaires were performed on 194 randomly selected consenting patients with a clinical diagnosis of uveitis at a Montreal-based tertiary care uveitis clinic between February and May 2010. All subjects were administered the Visual Function 14 (VF-14) and the Medical Outcomes Study 36-item short-form (SF-36) surveys validated for the French language. Kruskal-Wallis tests, Wilcoxon rank-sum tests, and Spearman correlation analysis were used to test for statistical significance.
The uveitis was classified as anterior(37%), anterior/intermediate(19%), intermediate(9%), posterior(11%) and panuveitis(19%). The course of disease was chronic in 79% of patients and the mean duration of follow-up was 54.8 months. Significant ocular complications associated with uveitis were cataract(68%), cystoid macular edema(37%) and glaucoma(22%). Patients who had a persistent duration of disease scored significantly lower (p<0.05) than those with limited disease duration on the VF-14 and social functioning domain of the SF-36 questionnaire. Of particular importance, patients who were taking 1 or more systemic immunosuppressants scored significantly lower (p<0.05) on several SF-36 subscales than non-immunosuppressed patients. Those with a history of intravitreal triamcinolone or bevacizumab injections had lower VF-14 and certain SF-36 subscale scores. Logmar visual acuity in the better eye correlated with VF-14, SF-36 role physical, vitality, and social functioning subscales (P<0.05).
Patients with uveitis who have a persistent duration of disease, who require systemic immunosuppression and/or intravitreal injections report more functional impairment than other uveitis patients. As uveitis often affects individuals during the most productive years of their adult lives, the use of these questionnaires along with demographic and disease-specific data may help clinicians to better establish the impact of disease severity on uveitis patients’ quality of life.
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