Changes in quality of life (QoL) in a 24-month interval in patients with non-acute Vogt-Koyanagi-Harada disease (VKHD)

Abstract

Purpose : To analyze the changes in self-reported QoL metrics in a 24-month interval in non-acute VKHD patients and to correlate these changes with visual function, inflammation and treatment

Methods : 22 patients, participants of a prospective ongoing study with a minimum 12-month follow-up since acute disease onset, were evaluated at two 24-month apart time points. They had systematic clinical, multimodal imaging and electroretinogram (ERG) exams with predefined treatment protocols. After acute phase, anterior uveitis and/or macular edema defined clinical inflammation; optic disc or perivascular leakage, dark dots and/or increase in subfoveal choroidal thickness were defined as subclinical inflammation. Visual function was measured by best corrected visual acuity, visual field, contrast sensitivity (CS) and ERG. Self-reported health-related and vision-related QoL were assessed by SF36 and VFQ25 questionnaires, respectively. Visual function and QoL data were collected at 2 moments 24mo apart: Jul-Dec 2017 (M1) and Jul-Dec 2019 (M2). Questionnaire scores were classified as an improvement, unchanged or worsening considering a difference >5 points between M1 and M2 results. Changes in visual function, inflammation and treatment data and significant changes between QoL scores at the 2 time points were compared with likelihood ratio test. This study was approved by Institutional Ethics Committee and followed the Helsinki declaration.

Results : Table represents QoL scores at M1 and M2. Figure shows clinical associations with change on QoL scores. In general health domain on SF-36 questionnaire, patients who remained without systemic treatment or absence of optic disk hyperfluorescence had unchanged or better score at M2. In VFQ25 questionnaire, improvement in binocular CS resulted in better ocular pain score at M2; absence of anterior uveitis relapse, stable fundus findings and absence of intravitreal injections resulted in unchanged or better dependency score, while use of cyclosporin resulted in worse results at M2; absence of intravitreal injection resulted in unchanged or better mental health score.

Conclusions : After 24mo, improvement in QoL scores was associated with less inflammation, better visual function and less need of treatment, reinforcing our previous results (2019, Ocular Immunol Inflamm).

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

 

QoL scores at M1 and M2 and controls

 

Clinical associations with change on QoL scores