Responsiveness of vision-specific and general quality of life metrics to ocular and systemic events in patients with uveitis

Abstract Objective To evaluate the responsiveness of quality of life (QoL) metrics to ocular and systemic events in patients with non-infectious uveitis. Design Cohort study using randomized controlled trial data. Participants Patients with active or recently active intermediate, posterior, or panuveitis enrolled in the Multicenter Steroid Treatment (MUST) Trial and Follow-up Study. Methods Data on the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25), EuroQol Questionnaire (EQ-5D), and the Short Form Survey Instrument (SF-36) were evaluated semi-annually during the first 3 years after randomization. The impact of ocular (e.g. changes in visual acuity, activity status, cataract surgery) and systemic events (e.g infections requiring treatment) on the 6-month changes in QoL was assessed for each metric using generalized estimating equations. Main Outcome Measures The primary outcomes were the 6-month changes in vision-related (NEI-VFQ-25) and general health-related (EQ-5D index, SF-36 physical component score) QoL. Results Changes in visual acuity (adjusted change [aΔ]: 2.70 units per 5 letter change, p Conclusion The NEI-VFQ-25 was more sensitive to ocular changes than the general QoL metrics but less sensitive to acute systemic events. When performing QoL or cost-effectiveness analyses, it is important to consider the expected outcomes (e.g., ocular versus systemic) to ensure that the selected measurement is sensitive enough to detect clinically important changes in disease status or effects of treatment.