Severe impairment of health-related quality of life in patients suffering from ocular surface diseases.

AIMS: To evaluate health-related quality of life (HRQoL) in French patients suffering from ocular surface diseases (OSDs). BACKGROUND: Specific instruments exist in the OSD area, but they do not comprehensively cover all domains of HRQoL. Recently, the OSD-specific questionnaire (OSD-QoL) was developed to address this need. METHODS: The OSD-QoL includes 28 items divided into seven dimensions: "Daily activities," "Difficulties with work and handicap," "Giving up make-up," "Acknowledgement of the disease," "Acceptance of the disease," "Fear for the future" and "Emotional well-being." The OSD-QoL was administered and completed by 214 French patients with OSDs. RESULTS: The mean scores of all OSD-QoL dimensions showed impairment, particularly "Acknowledgement of the disease," "Giving up make-up" and "Fear for the future"; 88.4% of patients thought that their eye problems were not acknowledged by people, 55.7% gave up make-up, and 53.9% feared they were incurable. Dimension scores differed according to patient characteristics; particularly, the more severe the ocular disease, the lower the scores of most of the OSD-QoL dimensions. Physical and psychological disability levels also had an impact on the dimension scores. CONCLUSION: OSDs have a detrimental impact on patients' HRQoL, that the specific OSD-QoL questionnaire was able to characterize. The level of impairment varies according to the severity of the disease and physical and psychological disability. The clinician's perception of their disease does not completely reflect the patient's perception of their disease.

[Glaucoma and quality of life]. / Glaucome et qualité de vie.

Glaucoma is a serious ocular disorder potentially leading to blindness. Measuring the quality of life of patients with glaucoma is important because it makes it possible to evaluate the impact of the disease and its treatment on the patient's everyday life. Hitherto, this was done using generic scales, or those developed for other diseases; but no scale suitable for glaucoma was available. The recently developed GlauQOL scale is now available. We present the short version of this questionnaire adapted to individual use within an ophthalmology consultation setting.

[Creating a specific diagnostic and quality-of-life questionnaire for patients with ocular surface disease]. / Création d'un questionnaire spécifique d'aide au diagnostic et d'évaluation de la qualité de vie chez les patients souffrant de pathologie de la surface oculaire.

INTRODUCTION: Ocular surface diseases (OSD) affect about 15% of the population over 65 years of age. Nevertheless, OSD knowledge in the scientific community remains poor, and the healthcare system does not adequately recognize this disorder. However, many patients with OSD suffering from chronic pain experience substantial alteration in their quality of life (QoL). PURPOSE: Our work aimed at developing a patient self-evaluation questionnaire specific to OSD. This questionnaire could thus become a useful diagnostic tool that ophthalmologists could employ in daily practice in order to better understand patients'complaints and thereby correctly treat their disease. It also may serve as an evaluation tool in medical research. This article describes the phases of item generation, validation by experts, and identification of dimensions in the QoL section. METHODS: The questionnaire was developed in French by a group of experts including clinicians and methodologists. It comprised two parts: one on diagnostic aid, and the other on subjective perception of the disease (symptoms, perception of treatment, quality of life). The questionnaire was tested on five patients. It was then modified according to the patients' suggestions and tested again on 20 patients. After a second review by the scientific committee, a pilot questionnaire suitable for systematic use in quantitative studies was prepared. A cross-sectional observational study then identified the statistical dimensions of the QoL section, which led to a reduction in the total number of items. RESULTS: The resulting operational version of the questionnaire included four sections CONCLUSION: The next study will test the reproducibility of the operational version of the OSD questionnaire obtained after the item reduction phase.

[Creating a specific quality-of-life questionnaire in patients with glaucoma: item generation]. / Création d'un questionnaire spécifique évaluant la qualité de vie chez les patients glaucomateux: la génération des items.

The methods for developing Health-Related Quality-of-Life (HRQoL) measures and their application in medical research have demonstrated their utility in various chronic, progressive, or life-threatening diseases. The efforts made to allow the patient's perspective to be included in the methodological framework of evidence-based medicine have been successful. The assumption of a strong relationship between clinical status and daily life is certainly valid in ophthalmology. However, there is a lack of specific HRQoL measures dedicated to ophthalmic diseases. Our work aimed at creating the first Glaucoma-specific Quality of Life scale - the Glau-QoL questionnaire - to provide researchers and physicians with a comprehensive, practical, and validated tool. This article describes the first stage of the process, which consisted in generating items and formatting them in order to create a questionnaire that exhaustively covers the relevant concepts. The whole process was conducted by an expert committee including clinicians and methodologists. The standard recommendations in the development of a HRQoL questionnaire were followed: we first identified existing tools and performed a preliminary collection of concepts from the published literature; we then designed an interview guide with the help of clinicians; a trained psychologist interviewed 22 patients at various disease severity stages (from isolated hypertonic to severely impaired); the interviews were tape-recorded and scripted; general domains and related detailed concepts were identified from the script; they were then analyzed and organized; the format of the questionnaire was set up; and questions were derived from the patient's verbatim to capture the identified detailed concepts. The test questionnaire was applied to seven patients for cognitive debriefing. We finally amended the test questionnaire and designed the pilot questionnaire according to the patients' tests and the clinician's review. The test questionnaire was well accepted by the patients, despite a completion duration ranging from 14 to 35 minutes. The pilot questionnaire contained 151 items, grouped into 5 sections: (1) vision problems, physicians, and daily treatment (49 items); (2) activities of daily living (37 items); (3) self-expression (37 items); (4) vision problems and mood (14 items); and (5) other questions (14 items). The next step of our work will be the item reduction process and the psychometric validation of the Glau-QoL questionnaire.

[Relevance of quality of life and treatment compliance measurement in patients with chronic open-angle glaucoma]. / Intérêt de la mesurede la qualité de vie (QDV) et de l'observance thérapeutiquechez les patients atteints de glaucome chronique à angleouvert. Groupe d'étude Glaucome et Qualité de Vie.

Chronic glaucoma is a severe disease that can induce blindness.Early diagnosis and symptomatic treatment reduce the risk of blindness. Treatment that will be started before the onset of clinical signs and will remain lifelong thereafter is troublesome, and therapeutic compliance is usually poor. Thus, quality of life (QOL) measurement in patients with chronic glaucoma has a particular purpose: to measure patients' perception of the disease and treatment in order to maintain good treatment compliance to ensure therapeutic management efficacy and to preserve visual function. No glaucoma-specific instrument is available in the medical and QOL literature. Various generic(SF-36, SF-20 and SIP) and specific(VAQ, VF-14, NEI-VFQ) QOL questionnaires,one glaucoma-specific symptomatic scale (GSS),and one treatment preference scale (COMTol) have been used to measure QOL in glaucoma patients. These instruments do not sufficiently measure the psychosocial dimension of the disease and the QOL impact of treatment. An instrument able to measure all dimensions needs to be developed in order to help ophthalmologists in the therapeutic management of their patients and to measure QOLin patients in the successive stages of the disease.

Antioxidant activity of plasma from subjects with and without senile cataract.

The relationship between overall plasma antioxidant activity and senile cataract was examined in 148 subjects aged 37-90 years. Antioxidant activity of plasma from 52 control and 96 patients with senile cataract was determined by a method which measures the capacity of plasma to inhibit auto-oxidation of bovine brain homogenate. In contrast to previous studies which demonstrated a relationship between decreased levels of antioxidant components in blood and the occurrence of lens opacities, the present study does not show any significant difference between subjects with and without senile cataract.