Impact of neurotrophic keratopathy on quality of life: A utility study

Abstract

Purpose : Neurotrophic keratopathy (NK) is a rare disease leading to impaired corneal sensation and function. This cross-sectional study measured the utility values of NK in an effort to better understand the impact of this disease on patients.

Methods : Patients with a clinical diagnosis of NK were recruited from an urban ophthalmology clinic. Utility was assessed with the time trade off (TTO) and standard reference gamble (SRG) methods; the anchor points were defined as 0 being death and 1 being perfect health (ph) or perfect eye function (pf). Visual acuity, comorbidities, and responses to the 25-question Vision Function Questionnaire (VFQ-25) were also collected.

Mean, standard deviation, and 95% confidence interval were calculated for each measure of utility and compared to an anchor of 1.0 using a one sample t-test. Simple linear regressions were used to predict the relationship between utility values of NK and variables investigated in this study.

Results : A total of 24 patients (mean age 66.5 ± 14.8 years; 12 males, 12 females) were recruited for this study. The utility values for NK ranged from 0.69 to 0.86 depending on the TTO/SRG method and pf/ph anchor points (Table 1). Patients were willing to trade approximately 3 years of an additional 10-year life expectancy in return for perfect eye function or health. Subcategories of VFQ related to activity limitation (role difficulty and dependence) were found to be significantly associated with NK utility (Table 2). Utility values for NK were not significantly associated with age, gender, comorbidities, visual acuity, or severity of NK disease.

Conclusions : Our study found that NK has a significant impact on quality of life measured as health utility. The TTO utility values for patients with NK are similar to those with a hand amputation (0.70). Utility values for NK appear to be directly related to the functional loss from the disease rather than the degree of vision loss. Participants who felt limited in what they could accomplish, required more help, or felt a loss of control due to their ocular condition reported lower utility. As treatment options for NK are expanding and increasing in efficacy, this study can provide a foundation for future cost-effectiveness analyses on the various treatments for NK.

This is a 2021 ARVO Annual Meeting abstract.

 

Table 1. Mean and standard deviation of utility values of NK.

 

Table 2. VFQ associations with the utility values of NK.