Vision-Related Quality of Life in Patients with Ocular Graft-versus-Host Disease

Ophthalmology. 2015 Aug;122(8):1669-74. doi: 10.1016/j.ophtha.2015.04.011. Epub 2015 May 20.

Abstract

Purpose: To assess the vision-related quality of life (QOL) in a cohort of patients with ocular graft-versus-host disease (GVHD).

Design: Prospective study.

Participants: Eighty-four patients diagnosed with chronic ocular GVHD.

Methods: We assessed the vision-related QOL with the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25). The symptoms of ocular GVHD were assessed using the Ocular Surface Disease Index (OSDI) and Symptom Assessment in Dry Eye (SANDE) questionnaires.

Main outcome measures: We assessed vision-related QOL with the NEI-VFQ-25 and compared the scores obtained from patients with ocular GVHD with those from a healthy population. In the ocular GVHD population, we also evaluated the associations between the NEI-VFQ-25 and the dry eye symptoms measured by the OSDI and SANDE questionnaires, age, duration of disease, best-corrected visual acuity (BCVA), corneal fluorescein staining (CFS), tear break-up time, and Schirmer test.

Results: The mean composite NEI-VFQ-25 score in patients with ocular GVHD was 76.5±17. Compared with healthy subjects, patients with ocular GVHD reported reduced scores on all NEI-VFQ-25 subscales (each P < 0.001) with the exception of color vision (P = 0.11). The NEI-VFQ-25 composite scores significantly correlated with OSDI (R = -0.81, P < 0.001), SANDE (R = -0.56, P < 0.001), CFS (R = -0.36, P = 0.001), and BCVA (R = -0.30, P = 0.004).

Conclusions: Patients with ocular GVHD experience measurable impairment of vision-related QOL. This study highlights the impact of ocular GVHD on the vision-related QOL, and thus the importance of comprehensive diagnosis and treatment of this condition.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Chronic Disease
  • Corneal Diseases / physiopathology
  • Corneal Diseases / psychology*
  • Dry Eye Syndromes / psychology
  • Female
  • Fluorophotometry
  • Graft vs Host Disease / physiopathology
  • Graft vs Host Disease / psychology*
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / therapy
  • Prospective Studies
  • Quality of Life / psychology*
  • Sickness Impact Profile
  • Surveys and Questionnaires
  • Tears / chemistry
  • Vision, Ocular / physiology*
  • Visual Acuity / physiology
  • Young Adult