Abstract
Purpose::
To determine prevalence and functional significance of glare in a large cohort of patients with Schnyder's Crystalline Corneal Dystrophy (SCCD).
Methods::
This was a prospective study approved by the Institutional Review Board of Wayne State University. Appropriate consent and HIPAA disclosures were made. Telephone contact was attempted with 60 affected members of 18 previously identified families with SCCD living in the United States. Patients were asked about subjective decrease in vision when reading, watching television (TV) or driving. Glare during day and nighttime, specifically when driving was also addressed. Functional limitation was assessed by asking patients if they had to stop or limit reading, using a computer, watching TV, or driving during the day or at night because of visual problems.
Results::
Glare information was successfully obtained from 41 patients (22 male, 19 female) representing 11 families. Mean patient age was 43.8 ± 21.0 years (range 6-83). Subjective decrease in near and distance vision was reported by 6 patients (14.6%). Daytime glare was reported by 11 patients (26.8%), one of whom stopped watching television. Nighttime glare was reported by 26 patients (63.4%), of whom 9 (34.6%, mean age 45.89 ± 14.4) stopped or limited night driving. Prevalence of reported glare increased with age both in daytime (Pearson Chi-Square (PCS), p = 0.008), and nighttime (PCS, p = 0.0002).Prevalence of glare reports was compared between three age groups. Daytime glare increased insignificantly from 0% (0/8 patients) in those < 25 years of age to 8.3% (1/12) in the 25-45 group (PCS, p = 0.40) and to 47.6% (10/21) in those ≥ 45. There was a statistically significant difference between the two older groups (PCS, p = 0.0213). Reports of nighttime glare rose from 0% in the youngest group to 83.3% (10/12) in patients between 25 and 45, which was a statistically significant increase (PCS, p = 0.0003). 76.2% (16/21) patients ≥ 45 reported nighttime glare, which was similar to the second group (PCS, p = 0.63).
Conclusions::
This was the first study examining prevalence and impact of glare in a large cohort of SCCD patients of different ages. Daytime glare was reported most commonly in the oldest age group, affecting nearly 50% of those ≥ 45. Nighttime glare became most prevalent earlier, affecting 83% of patients between third and fifth decades. Nighttime glare appeared to significantly affect the quality of life in patients with SCCD. More than 34% of those with glare had to cease or limit their nighttime driving at an average age of 46 years. Further studies will be undertaken correlating subjective symptoms with clinical findings in patients with SCCD.
Keywords: cornea: clinical science • degenerations/dystrophies • quality of life