Quality-of-Life Outcomes From a Randomized Clinical Trial Comparing Antimetabolites for Intermediate, Posterior, and Panuveitis

Niemeyer, Katherine M.; Gonzales, John A.; Rathinam, Sivakumar R.; Babu, Manohar; Thundikandy, Radhika; Kanakath, Anuradha; Porco, Travis C.; Browne, Erica N.; Rao, Maya M.; Acharya, Nisha R.

doi:10.1016/j.ajo.2017.04.003

Cited by 24 publications

(9 citation statements)

References 46 publications

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“…49,50 Prior analyses suggest that visual acuity is associated with poorer quality of life, but consistent with our study, it is a weak to moderate predictor. [49][50][51][52] The low number of predictors associated with PSS-10 scores illustrates the complexity of the concept being evaluated. Psychological stress is a subjective and heterogeneous experience that can be affected by many factors, not all of which can be captured by standardized survey data.…”

Section: Discussionmentioning

confidence: 99%

Association Between Noninfectious Uveitis and Psychological Stress

et al. 2019

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IMPORTANCE Uveitis involves dysregulation of the ocular immune system. Stress has been shown to affect immune function, but it is unclear whether there is an association between stress and uveitis.OBJECTIVE To determine whether having uveitis is associated with psychological stress. DESIGN, SETTING, AND PARTICIPANTSA cross-sectional, case-control study including a self-administered survey, medical records review, and diurnal salivary cortisol test was conducted at a university-based uveitis clinic and comprehensive eye clinic. Participants included 146 consecutive adults with noninfectious uveitis and age-matched controls with no eye disease. The study was conducted from December 1, 2017, to March 14, 2018. MAIN OUTCOMES AND MEASURESParticipants completed the self-administered, Cohen 10-item Perceived Stress Scale (PSS-10), a demographics questionnaire. Responses to each question were categorized on a 5-point Likert scale, with total scores ranging from 0 (no stress) to 40 (high stress). In addition, participants submitted 3 salivary cortisol samples. Those with uveitis were classified as having recently active or controlled disease through medical records review. The prespecified primary analysis was a linear regression of PSS-10 score and uveitis correcting for age, sex, educational level, employment, and median income. Secondary analyses included comparing PSS-10 scores in patients with recently active and controlled uveitis, determining predictors of stress, and comparing diurnal salivary cortisol between uveitis and control groups. RESULTSOf 146 eligible patients, 17 declined participation and 9 consented but were excluded because they did not complete both questionnaires, resulting in 120 patients (80 uveitis; 40 controls) in the final analysis. Eighty participants (66.7%) were women, and 70 (58.3%) were white. Median age was 40 years (interquartile range, 29-59 years). Having uveitis was associated with a 4.3-point increase in PSS-10 score (95% CI, 1.8 to 6.9; P = .002). There was no significant difference in PSS-10 scores between patients with recently active and controlled uveitis (1.0 point greater for patients with active uveitis; 95% CI, −2.0 to 3.9; P = .52). Factors associated with increased PSS-10 score in patients with uveitis included female sex (coefficient, 4.0; 95% CI, 1.6 to 6.5; P = .002), current immunomodulatory therapy (coefficient, 2.5; 95% CI, −0.3 to 5.2; P = .08), history of depression (coefficient, 3.8; 95% CI, 0.8 to 6.8; P = .02), and having posterior or panuveitis (coefficient, 2.6; 95% CI, 0.8 to 4.4; P = .006). Of the 70 participants (58.3%) who had testable samples for cortisol analysis, diurnal salivary cortisol levels did not significantly differ between uveitis and nonuveitis groups.CONCLUSIONS AND RELEVANCE These findings suggest that patients with uveitis have higher levels of psychological stress compared with controls, yet no significant difference was identified in the stress of patients with active vs controlled uveitis. Consequently, comprehensive treatment for noninf...

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Section: Discussionmentioning

confidence: 99%

Association Between Noninfectious Uveitis and Psychological Stress

et al. 2019

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“…Niemeyer et al concluded using IND-VFQ scores, on average, over its 6 months study period (p = 0.0001) [12]. They observed a decreased mental component summary score (p = 0.04) and decreased vitality subscale (p = 0.001), while the SF-36 physical component summary score did not significantly differ throughout the trial.…”

Section: Discussionmentioning

confidence: 96%

Vision-related quality of life and psychosocial well-being of patients with episcleritis and scleritis: a neglected essence?

Tamrakar

Sitaula

Joshi

et al. 2021

J Ophthal Inflamm Infect

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Background To assess the change in vision-related quality of life and psychosocial well-being of the patients with episcleritis and scleritis patients before and after treatment. Results This one-and-a-half-year prospective study was conducted among 76 eyes of 71 new patients of episcleritis and scleritis. A structured questionnaire was used to assess the visual and to analyze the change in effect size. The male-to-female ratio was 1:1.536. Episcleritis was seen in 41 cases (57.7%) while scleritis was seen in 30 cases (42.3%). Patients with episcleritis had statistically significant improvement in general function score (GF) (p < 0.05) using paired t-test. The effect size showed medium improvement (approximately 0.5). Whereas there was no statistically significant change in psychosocial impact (PI), visual symptoms (VS) scoring, and a total score (p < 0.05) using paired t-test. The effect size showed no improvement for PI and total score and small improvement for VS score. Patients with scleritis had statistically significant improvement in general function score (GF), visual symptoms (VS) scoring and total score (p < 0.05) using paired-t-test. The effect size showed medium improvement (approximately 0.5) for general function score (GF) and total score. However, the effect size showed only a small improvement (approximately 0.2) for psychosocial impact (PI) score. Conclusions VisionRelated Quality of Life of patients with scleritis showed significant improvement following treatment unlike episcleritis indicating scleritis more adversely affecting psychosocial well-being.

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“…Niemeyer et al concluded using IND-VFQ scores, on average, over its 6 months study period (p = 0.0001) [13]. They up Study [14].…”

Section: Discussionmentioning

confidence: 98%

Vision-Related Quality of Life and Psychosocial Well-Being of Patients with Episcleritis and Scleritis: A Neglected Essence ?

Tamrakar

Sitaula

Joshi

et al. 2021

Preprint

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Background: To assess the change in vision-related quality of life and psychosocial well-being of the patients with episcleritis and scleritis patients before and after treatment.Results: This one-and-a-half-year prospective study was conducted among 76 eyes of 71 new patients of episcleritis and scleritis. A structured questionnaire was used to assess the visual and to analyze the change in effect size. The male-to-female ratio was 1:1.536. Episcleritis was seen in 41 cases (57.7%) while scleritis was seen in 30 cases (42.3%). Patients with episcleritis had statistically significant improvement in general function score (GF) (p<0.05) using paired t-test. The effect size showed medium improvement (approximately 0.5). Whereas there was no statistically significant change in psychosocial impact (PI), visual symptoms (VS) scoring, and a total score (p<0.05) using paired t-test. The effect size showed no improvement for PI and total score and small improvement for VS score. Patients with scleritis had statistically significant improvement in general function score (GF), visual symptoms (VS) scoring and total score (p<0.05) using paired-t-test. The effect size showed medium improvement (approximately 0.5) for general function score (GF) and total score. However, the effect size showed only a small improvement (approximately 0.2) for psychosocial impact (PI) score.Conclusions: Vision Related Quality of Life of patients with scleritis showed significant improvement following treatment unlike episcleritis indicating scleritis more adversely affecting psychosocial well-being.

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Quality-of-Life Outcomes From a Randomized Clinical Trial Comparing Antimetabolites for Intermediate, Posterior, and Panuveitis

Cited by 24 publications

References 46 publications

Association Between Noninfectious Uveitis and Psychological Stress

Association Between Noninfectious Uveitis and Psychological Stress

Vision-related quality of life and psychosocial well-being of patients with episcleritis and scleritis: a neglected essence?

Vision-Related Quality of Life and Psychosocial Well-Being of Patients with Episcleritis and Scleritis: A Neglected Essence ?

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