Original articleChanges in the Quality-of-Life of People with Keratoconus
Section snippets
Methods
The CLEK study is a multicenter, observational study designed to assess the natural history of keratoconus. Details of the CLEK study and its enrollment criteria have been presented elsewhere.2 We enrolled 1,209 patients and completed eight years of follow-up. The institutional review board of each participating clinic approved the CLEK protocol, and all subjects signed informed consent documents before enrollment.
All CLEK patients completed an annual examination to assess visual acuity and
Results
Of the 1,209 CLEK patients, 925 (76%) met the criteria for inclusion in these analyses. The demographic characteristics of these patients are provided in Table 1, and the clinical characteristics are detailed in Table 2.
The unadjusted mean slopes (Table 2) show that, on average, patients with keratoconus perceive a decline in V-QoL on all scales except ocular pain and mental health. Extrapolating the annual slope to the seven-year follow-up period of CLEK indicates that the average decline on
Discussion
Over seven years, CLEK participants, on average, reported a decline in their V-QoL as measured by most NEI-VFQ scales. On scales for which a decline was seen, the decline was modest (see Table 2), ranging from less than one point over seven years (general vision) to almost two points (near activities). The exceptions to this were dependency, which declined considerably, and mental health and ocular pain, which improved. In both cases, we suspect that these were examples of changes in extreme
Dr Steven Kymes is a Research Assistant Professor in the Department of Ophthalmology and Visual Sciences at Washington University School of Medicine, where he is an Assistant Director of the Vision Research Coordinating Center and a Senior Fellow in the Center for Health Policy. Prior to entering academic life, Dr Kymes held various management and marketing positions with health care and managed care organizations. Dr Kymes’ research interests concern cost-effectiveness of medical treatment and
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Dr Steven Kymes is a Research Assistant Professor in the Department of Ophthalmology and Visual Sciences at Washington University School of Medicine, where he is an Assistant Director of the Vision Research Coordinating Center and a Senior Fellow in the Center for Health Policy. Prior to entering academic life, Dr Kymes held various management and marketing positions with health care and managed care organizations. Dr Kymes’ research interests concern cost-effectiveness of medical treatment and testing, assessment of health-related quality-of-life, and the relationship between insurance plan design and health outcomes.