ESCRS - PP11.04 - Quality Of Life In Paediatric Keratoconus: Assessment With The Portuguese Version Of The Keratoconus Outcomes Research Questionnaire (Korq)

Quality Of Life In Paediatric Keratoconus: Assessment With The Portuguese Version Of The Keratoconus Outcomes Research Questionnaire (Korq)

Published 2022 - 40th Congress of the ESCRS

Reference: PP11.04 | Type: Free paper | DOI: 10.82333/fb9k-ec92

Authors: Bruna Cunha* 1 , Pedro Gil 2 , Edgar Lopes 1 , Mariana Portela 3 , João Gil 4 , Vitor Maduro 1 , Nuno Alves 1 , Joaquim Murta 4 , João Feijão 1

1Ophthalmology Department,Centro Hospitalar e Universitário de Lisboa Central,Lisboa,Portugal, 2Ophthalmology Department,Centro Hospitalar e Universitário de Lisboa Central,Lisboa,Portugal;Faculty of Medicine, University of Coimbra (FMUC),Coimbra,Portugal, 3Ophthalmology Department,Centro Hospitalar de Lisboa Ocidental,Lisboa,Portugal, 4Ophthalmology Department,Coimbra Hospital and University Center (CHUC),Coimbra,Portugal;Ophthalmology,Clinical Academic Center of Coimbra (CACC),Coimbra,Portugal;Faculty of Medicine, University of Coimbra (FMUC),Coimbra,Portugal

Purpose

The Keratoconus Outcomes Research Questionnaire (KORQ) was designed to assess the keratoconus-specific health-related quality of life (QoL) impact in terms of “Activity Limitation” and “Symptoms”. The first part measures how much the visual impairment interferes with the ability to perform varying routine daily activities. The second expresses the degree of troublesome caused by the visual impairment in different environments. To the best of our knowledge, this is the first reported use of KORQ in a paediatric group. The purpose of this study was to use a translated and validated version of this tool to evaluate the QoL of paediatric Portuguese keratoconus patients and its associations with clinical data.

Setting

Ophthalmology Department, Centro Hospitalar e Universitário de Lisboa Central, Lisboa, Portugal; Ophthalmology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal

Methods

Multicentric cross-sectional study of paediatric patients with keratoconus. Patients were invited to fill the KORQ questionnaire, and each patient was scored using previously published spreadsheets for the 2 dimensions: functional activities and symptoms (lower scores are associated with better QoL). These KORQ scores were associated with clinical and demographic data, including age, sex, best corrected vision acuity (BCVA), maximum simulated keratometry (Kmax), flat and steep keratometry (K1 and K2), spherical equivalent, thinnest pachymetry, previous ocular surgeries and Amsler-Krumeich keratoconus stage. Univariate and multivariate linear regressions with stepwise backward modelling were used.

Results

24 patients were included (mean age 15.54±2.57 years). In univariate analysis, higher average K (p=0.012), K2>52D (p=0.011) and disease stage (p<0.001) were associated with higher functional scores. Previous ocular surgery (p=0.008) and BCVA<0.3 logMAR (p=0.030) were associated with higher symptoms score. The best multivariate model for activity limitation included spherical equivalent (p=0.041) and BCVA<0.3 logMAR (p=0.009); and for the symptoms previous ocular surgery (p=0.032) and BCVA<0.3 logMAR (p=0.011). Most common activity limitation was the ability to see small objects at distance and the most common complaint was distorted vision. The impact scores in functional activities and symptoms were positively correlated (r=0.51 p=0.011).

Conclusions

This work supports the critical need of rigorous follow-up of paediatric patients with keratoconus, as the QoL worsens as the cornea becomes steeper, vision decreases, spherical equivalent increases and there is the need for ocular surgery. There was significant overlap and correlation in the factors leading to QoL impairment both in terms of functional activity and symptoms.