Abstract
Purpose :
This study aimed to investigate the association between keratoconus and mental health. The primary objective was to understand the prevalence of mental health symptoms among individuals with keratoconus and explore potential associations with both patient-reported outcomes and clinical parameters.
Methods :
A cross-sectional, real-world study was conducted utilising the prospective, web-based, international Save Sight Keratoconus Registry data, collected from the routine clinical practice, including validated patient-reported outcome measures: Keratoconus Outcomes Research Questionnaire (KORQ) and the Patient Health Questionnaire-4 (PHQ-4) and corneal parameters. Rasch analysis was conducted on the PHQ and KORQ data to obtain interval-level scores. Associations of PHQ scores were evaluated with Pearson’s correlation coefficient, with statistical significance set at a p-value < 0.05.
Results :
209 keratoconus patients (mean age was 33.1±13.9 years; male 141(67.4%); White or Caucasians 113 (54.1%)) from Australia and Nepal were included. At the presentation, 128(61.2%) patients wore glasses and 10(4.8%) used contact lenses. 98(46.9%) patients had undergone corneal cross-linking (CXL) and 11(5.3%) had a history of corneal grafting.
Of the participants, 119(56.9%) reported experiencing various levels of at least one mental health symptom. The patients were classified into normal 134(64.1%), mild 42(20.1%), moderate 17(8.1%), and severe 16(7.7%) groups based on the PHQ scores. The correlation between the mental health scores (Overall, Anxiety and Depression) and both patient-reported outcomes (activity limitation, r = 0.40 to 0.45; symptoms, r = 0.36 to 42) and visual acuity (r = 0.19 to 0.22) were statistically significant (all p < 0.05; Figure 1). Whereas the correlations between mental health and corneal parameters (Kmax, K2, and minimum corneal thickness) were not statistically significant (r = -0.11 to 0.07; all p>0.05).
Conclusions :
In the real-world setting, mental health symptoms were common in keratoconus and correlated with patient-reported outcomes and visual acuity. The findings highlighted the value of evaluating patient-reported outcomes in routine clinical practice.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.