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T.A. Hall, G. McGwin, Jr, K. Searcey, A. Xie, S.L. Hupp, C. Owsley, L.B. Kline; Health–Related Quality of Life and Psychosocial Characteristics in Patients With Primary Blepharospasm . Invest. Ophthalmol. Vis. Sci. 2005;46(13):618.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To assess health–related quality of life and psychosocial characteristics in persons with primary blepharospasm (BSP) as compared to those with hemifacial spasm (HFS), 2 disorders with similar symptoms but different etiology. Methods: Patients with BSP (N=159) or HFS (N=91) were identified through 2 neuro–ophthalmology clinics. Information on demographics, vision–targeted health–related quality of life (NEI VFQ–25), life satisfaction, presence of depressive symptoms and symptoms of generalized anxiety disorder, BSP or HFS disease duration, and types of treatment utilized were obtained through a phone survey. Chart abstraction was used to determine disease severity according to frequency of clinic visits and by number and dose of botulinum toxin type–A treatment received (BTX–A). Results: In both groups the majority of persons were over 50 yo, white, and female. The vast majority were receiving BTX–A treatment on a routine basis. NEI VFQ–25 subscale scores for both groups were depressed with most scales averaging in the 50s–80s. Compared to those with HFS, persons with BSP had lower scores on the subscales of general vision (p=0.0288), ocular pain (p=0.0001), distance activities (p=0.0013), driving (p=0.0001), and all subscales addressing psychosocial issues: social functioning (p=0.0012), mental health (p=0.0022), role difficulties (p=0.0001), and dependency (p=0.0013). Persons with BSP reported more depressive symptoms (p=0.0265) and met the criteria for generalized anxiety disorder (p=0.0072) more often than did those with HFS. There was no group difference in life satisfaction score, duration of self–reported symptoms, duration of physician diagnosis, or severity of disease as determined by the frequency of clinic visits or BTX–A treatments. Persons with BSP reported ever having used oral medications (p=0.0011), eye drop medication (p=0.0002), and surgery (p=0.0020) more often than those with HFS. There was no group difference in the percent of subjects ever having been treated with BTX–A. Conclusions: Persons with BSP have reduced health–related quality of life especially in psychosocial domains, ocular pain, and driving and distance activities, and are more prone to depressive and anxiety symptoms when compared to those with HFS who have similar symptoms but whose disease has a different etiology than BSP. Decreased quality of life in BSP underscores the inadequacy of current treatment options given that these patients had been undergoing standard of care treatment for some time.
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