Abstract
Purpose To study the clinical significance of the Graves' orbitopathy-specific quality of life (GO-QOL) questionnaire in mainland Chinese patients. Methods A cross-sectional study was performed at the Ophthalmology Department of the Sun Yat-sen Memorial Hospital from April 2017 to April 2018. Eighty-eight consecutive Graves' orbitopathy (GO) patients completed the two subscales of the GO-QOL questionnaire: visual functioning and appearance. The disease severity of GO was measured by the European Group on Graves' Orbitopathy (EUGOGO) classification, and clinical activity was evaluated by the clinical activity score (CAS). Results The mean scores of GO-QOL questionnaire for the visual functioning and appearance subscales were 68.4 ± 31.2 and 62.0 ± 27.4, respectively. Lower QOL scores for the visual functioning subscale were significantly correlated with disease severity, the CAS and diplopia (all p < 0.05). Lower QOL scores for appearance were significantly correlated with the CAS (p < 0.05). Although no correlation was found between the appearance subscale scores and disease severity (p=0.407), a downward trend in the appearance subscale scores as the severity of GO increased from mild to sight-threatening GO was found. Conclusion A strong correlation between disease severity and clinical activity has been shown in the GO-QOL questionnaire, suggested by the EUGOGO. The GO-QOL questionnaire is a simple and effective appraisal instrument in the evaluation of health-related QOL in the mainland Chinese patients with GO.
Highlights
E percentages of responses to each item of the Graves’ orbitopathy-specific quality of life (GOQOL) are summarized in Table 2. e scores of Graves’ orbitopathy-specific quality of life (GO-QOL) for the visual functioning and appearance subscales were 68.4 ± 31.2 and 62.0 ± 27.4, respectively
The visual functioning subscale scores of Graves’ orbitopathy (GO)-QOL were markedly related to clinical activity (p 0.003) and disease severity (p 0.002) (Figures 1 and 2). e visual functioning scores of patients with active disease (41.9 ± 25.6) were obviously lower than those of the patients who had inactive disease (71.8 ± 30.2), and the difference was significant (p 0.003). e visual functioning subscale scores were markedly higher in patients with mild GO (84.1 ± 18.2) compared to those with moderate-severe (65.2 ± 31.1) and/or sight-threatening GO (51.6 ± 35.3)
GO restricted patients’ daily activities such as reading, watching television, and enjoying free time, as well as created a dysfunction in social roles and an impaired self-confidence because of the altered appearance. e GO-QOL survey was devised by Terwee et al [6] and has been proven to accurately measure the QOL of GO-specific conditions. [1, 7,8,9] In this study, GO-QOL scores of mainland Chinese patients were strongly correlated with disease severity and clinical activity, especially in the visual functioning subscale
Summary
Graves’ orbitopathy (GO) is an autoimmune inflammatory disease that potentially causes sight-loss, disfigures appearance, and results in an obvious loss of quality of life. [1,2,3] About 25–50% of Graves’ disease patients show clinical eye signs and/or symptoms, and those people suffer from altered appearance and/or impaired vision [4, 5]. [1,2,3] About 25–50% of Graves’ disease patients show clinical eye signs and/or symptoms, and those people suffer from altered appearance and/or impaired vision [4, 5]. [10,11,12,13,14] e objectives of this study were to evaluate the QOL of the mainland Chinese GO patients and to estimate the relationship between GO-QOL scores and the severity and activity of the disease. Data collected included patients’ age, sex, signs, symptoms, duration of GO, clinical activity, and severity classification of GO according to the European Group on Graves’ Orbitopathy (EUGOGO), history and duration of thyroid disease, history of smoking, and other systemic and eye diseases. Sight-threatening GO was defined as dysthyroid optic neuropathy (DON) and/or severe corneal exposure (large corneal epithelial and/or stromal defects) or corneal breakdown (corneal descemetocele or keratohelcosis perforation)
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