Creating a Health Utility Value for Birdshot Chorioretinopathy

Abstract

Purpose : Birdshot chorioretinopathy (BCR) is a rare subgroup of chronic posterior uveitis. We wished to provide the first utility analysis estimate for BCR using the direct Health Related QoL (HRQoL) Time Trade-Off (TTO) and Standard Gamble (SG) utilities.

Methods : TTO asks a patient how many years they expect to live and then asks how many of those remaining years they would be willing to give up if they could be guaranteed perfect vision in both eyes for the remainder of life. SG presents a hypothetical situation where the patient is offered a treatment that will restore perfect vision to both eyes but there is a risk of immediate death. The patient is asked what the highest risk of death they would be willing to take if accepting treatment. Utility values are rated 0.0 - 1.0, with 0 representing blindness and 1 perfect vision.

Results : A total of 29 BCR patients (9M, 20F; mean age 61 yrs, range 40-83) completed the questionnaires. Mean TTO was 0.844 (range 0 - 1.0) and mean SG 0.928 (range 0.5-1.0). There appeared no correlation with visual acuity in the better eye (26/29 saw 6/12 or better), disease activity, 30Hz flicker ERG or therapy. TTO values in BCR are worse than e.g. breast carcinoma after radiotherapy (0.89) and a mild cerebrovascular accident (0.87).

Conclusions : HRQoL, as reflected by TTO values, is affected in BCR patients comparable to a number of debilitating systemic conditions. SG values were higher than TTO meaning less patients would take a risk of immediate death to achieve perfect vision and may reflect that many patients maintain good visual acuity.

This is a 2020 ARVO Annual Meeting abstract.