Quality of life in keratoconus: evaluation with Keratoconus Outcomes Research Questionnaire (KORQ)

Roberto Damian Pacheco Pinto,Alexandre Fattah Martini,Flávia Cid Gomes,Paulo Rodolfo Tagliari Barbisan,Arthur Gustavo Fernandes,Carlos Eduardo Leite Arieta,Ricardo Yuji Abe,Monica Alves,Daniel De Almeida Borges

doi:10.1038/s41598-021-92346-1

Roberto Damian Pacheco Pinto, Alexandre Fattah Martini + Show 7 more

Open Access

https://doi.org/10.1038/s41598-021-92346-1

Copy DOI

Abstract

To assess the quality of life of keratoconus patients using the Keratoconus Outcomes Research Questionnaire (KORQ), translated and validated in Portuguese language. The KORQ is the only validated keratoconus specific questionnaire and has a high rating for its psychometric properties. This cross-sectional study enrolled 100 keratoconus patients from a tertiary referral eye hospital between April 2018 and June 2019. Associations between age, sex, allergic conjunctivitis, keratoconus stage, best-corrected visual acuity (BCVA), maximum simulated keratometry (Kmax), steep keratometry (K2), pachymetry, treatments performed, hydrops, and KORQ scores were evaluated using univariate (Wilcoxon test and the Kruskal Wallis test) and multivariate linear regression with stepwise backward modeling. Lower KORQ scores are associated with better quality of life, whereas, higher scores are associated with greater impairment of functional activities and symptoms. Among the 100 patients, mild, moderate, and severe keratoconus were observed in 15%, 46% and 39% of participants, respectively. Univariate analysis showed lower function scores values, with male sex (p < 0.05) and both functional and symptom scores were significantly associated with BCVA < 0.3 (LogMAR) (p < 0.05). Multivariate analysis indicated significantly lower functional scores in individuals with BCVA < 0.3 (LogMAR) (p < 0.001) and those with a history of crosslinking treatment (p = 0.022), while symptom scores were only significantly associated with only BCVA < 0.3 (LogMAR) (p < 0.001). In patients with keratoconus, BCVA in the better eye and history of crosslinkig were factors associated with better quality of life scores using the KORQ.

Highlights

To assess the quality of life of keratoconus patients using the Keratoconus Outcomes Research Questionnaire (KORQ), translated and validated in Portuguese language
To test the hypothesis that the KORQ measures a single underlying construct, we initially evaluated the fit statistics, recording them as mean square standardized residuals (MNSQ); The fit of the Rasch model was evaluated with the infit and outfit statistics
In this study we evaluated the psychometric properties of KORQ using an Andrich rating scale model, corroborating previous studies showing that KORQ is a psychometrically robust patient-reported outcome (PRO) measure to evaluate QoL parameters in individuals with k eratoconus[15,16]

Summary

Introduction

To assess the quality of life of keratoconus patients using the Keratoconus Outcomes Research Questionnaire (KORQ), translated and validated in Portuguese language. BCVA in the better eye and history of crosslinkig were factors associated with better quality of life scores using the KORQ. Keratoconus it is a progressive corneal disease with a typical onset in adolescence or early adulthood, some cases of severe keratoconus have been reported in children as young as 4 years of age[1]. Increasing attention has been given to the assessment of health-related quality-of-life (QoL) outcome measures in clinical trials during the past three decades. Among these measures, vision-related quality-of-life (VQRL) is a person’s satisfaction with visual function and how visual ability affects life[6]. How much do on coming lights interfere with your ability to see, to do your tasks?

Objectives

Methods

Results

Conclusion