Association between Quality of Life and Visual Acuity in a Randomized Clinical Trial of Patients with Uveitis Taking Antimetabolites

ABSTRACT

Purpose

To evaluate how changes in visual acuity are associated with changes in quality of life (QoL) among patients with non-infectious uveitis taking antimetabolites.

Methods

This secondary analysis of the multicenter First-line Antimetabolites as Steroid-sparing Treatment (FAST) Uveitis Trial involves 216 participants randomized to methotrexate or mycophenolate mofetil. Vision-related (NEI-VFQ and IND-VFQ) and health-related (PCS and MCS SF-36v2) QoL and visual acuity were measured at baseline and 6-month primary endpoint.

Results

Visual acuity was significantly associated and correlated with all QoL measures (Spearman correlation coefficients = 0.5, 0.5, 0.3, and 0.4 for NEI-VFQ, IND-VFQ, SF-36v2 MCS and PCS, respectively). All observed changes in QoL met or exceeded the minimal clinically important difference definition on each scale. Treatment group was not significantly associated with any QoL measure.

Conclusion

By adding insight beyond visual acuity, QoL provides a more comprehensive picture of the patient experience during uveitis treatment.

Abbreviations and Acronyms: QoL = quality of life; VR-QoL = vision-related quality of life; HR-QoL = health-related quality of life; FAST = First-line Antimetabolites as Corticosteroid Sparing Treatment; NEI-VFQ = National Eye Institute Visual Functioning Questionnaire; IND-VFQ = Indian Visual Functioning Questionnaire; SF-36v2 = Medical Outcomes Study 36-Item Short Form Survey; PCS = physical component score; MCS = mental component score; 95% CI = 95% confidence interval; MCID = minimal clinically important difference

KEYWORDS:

• First-line Antimetabolites as Steroid-sparing Treatment (FAST) Uveitis Trial
• health related quality of life
• quality of life
• vision related quality of life
• visual acuity

Acknowledgments

The authors would like to acknowledge the Data and Safety Monitoring Committee members: Maureen G. Maguire, PhD (chair), William E. Barlow, PhD, Steven Yeh, MD, Albert T.Vitale, MD, Jaqueline J. Glover, PhD, and Narsing A. Rao, MD. The authors would also like to acknowledge the NEI Program Official, Donald F. Everett, MA.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study received support from NEI cooperative agreement U10 EY021125 (Acharya). The Department of Ophthalmology at University of California, San Francisco is supported by an unrestricted grant from the Research to Prevent Blindness Foundation, a core grant (EY06190) from the NEI, and That Man May See Foundation. The sponsors had no role in the design or conduct of this research.