Related quality of life questionnaire specific to dysthyroid ophthalmopathy evaluated in a population of patients with Graves' disease.

Laura Carolina Delfino,María del Carmen Silva Croome,Verónica Sapia,Anabela Zunino,Alicia Teresa Gauna,Verónica Ilera

doi:10.1590/2359-3997000000252

Laura Carolina Delfino, María del Carmen Silva Croome + Show 4 more

Open Access

https://doi.org/10.1590/2359-3997000000252

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Abstract

The aim of this study was to measure quality of life (QOL) impairment in individuals currently suffering from Graves' ophthalmopathy (GO) and to determine the correlation of GO-specific QOL scores with disease severity and activity. Seventy three GO-specific QOL surveys were prospectively analysed and compared with GO status. The GO-specific QOL survey was translated into Spanish and applied to Argentine patients with Graves' disease (GD). Results were compared with presence or absence of GO, Clinical Activity Score (CAS), severity score, age, gender and thyroid function. Fifty-six patients answered the survey and underwent complete ophthalmic evaluation, 15 did not have GO and were considered to be a control group. Appearance QOL score for patients with GO (53 ± 31.4) was lower than the control group (88.3 ± 17) (p < 0,000), no difference was observed in functional QOL score. There was a negative correlation between GO severity and both functional (r = -0.575; p < 0.000) and appearance QOL (r = -0.577; p < 0.000). Functional QOL differed between patients with active GO vs control group (p = 0.043). Patients with active and inactive GO had lower appearance QOL scores than control group (p < 0.000, p < 0.001 respectively). GO has significant impact on the life of these Argentine patients. QOL was worse in GO patients than in control group, functional QOL was mostly affected by the activity and appearance QOL was mainly altered by the effects of the disease. Patients with more severe GO had lower scores on both QOL scales.

Highlights

Graves’ ophthalmopathy (GO) is a chronic, debilitating infiltrative eye disease that is clinically present in about 50% of patients with Graves’ disease
There were no significant differences in disease severity and activity in relation to gender, thyroid functional status or age
There was no significant correlation between Clinical Activity Score (CAS) and the quality of life (QOL) subscales, there was a tendency for a negative correlation between CAS and functional QOL (p = 0.056) (Figure 3A)

Summary

Introduction

Graves’ ophthalmopathy (GO) is a chronic, debilitating infiltrative eye disease that is clinically present in about 50% of patients with Graves’ disease. It is characterized by disfiguring proptosis, pain, redness and swelling of the eyelids, grittiness of the eyes and diplopia. 3% to 5% of patients suffer severe forms of the disease that could lead to permanent blindness [1,2]. GO may be a severely disabling condition because of its effect on appearance and visual comfort. The patient is usually the best person to monitor and judge outcomes in medical care, data concerning patients’ experiences about the disease and response to treatment are not routinely collected [3]. Scoring standardized responses to standardized questions is an efficient way to measure health status and related QOL [4]

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