Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


Development of a Vision Related Quality of Life Instrument for Children with Juvenile Idiopathic Arthritis-Associated Uveitis.

Angeles-Han4,  Sheila, Griffin7,  Kenneth, Harrison5,  Melanie J., Fields2,  Kerrie, Ponder2,  Lori, Reeves-Robb3,  Rachel, Shainberg3,  Marla

Emory Children's Center, Atlanta, GA
Emory Children's Center
Emory Eye Center
Emory University, Atlanta, GA
Pfizer, Blue Bell, PA
Rollins School of Public Health
Weill Cornell Medical College

Purpose:

Studies on quality of life (QOL) in JIA-associated uveitis (JIA-U) focus on visual acuity (VA) and the presence of flare and cells during the ophthalmologic exam as a measure of visual function. However, these measures do not adequately assess the impact of disease activity on daily life from a child's perspective. Assessment of QOL in JIA-U could improve by including both objective measures of visual function and subjective assessments of the impact of disease activity on daily functioning. However, there are no validated instruments that measure vision related QOL in children 8–18 years old. Hence, we developed a new instrument to evaluate the performance of activities that rely on vision in home and school – Effects of Youngsters' Eyesight on QOL (EYE-Q).

Methods:

We interviewed experts in the field and children regarding how vision affects a child's daily activities. In addition to developing new items, we selected relevant items from existing instruments and adapted them to increase their relevance to a U.S.-based sample of children. We administered preliminary versions of the EYE-Q to normal sighted children and those with JIA-U. We then recruited 82 children, 8–18 years old, with various (or no) ocular conditions that affect vision. We measured VA and contrast sensitivity (CS). Patient-based questionnaires were administered -the EYE-Q to measure vision related QOL, and the Pediatric Quality of Life Inventory (Peds QL) to measure overall QOL. The EYE-Q was again completed 10 days after the visit. VA was converted to logmar VA values which are a linear scale for statistical analysis. Test-test reliability over a 10 day period was calculated, and validity was determined by examining associations between the EYE-Q and VA, CS, and QOL using Pearson's correlation.

Results:

Of 82 patients, 42.4% were female, 65.9% were Caucasian, 22.4% were African American, and 76.5% had eye disease. Mean age was 11.1 years (range 8–18). Mean scores of the instruments, VA, and CS are shown in Table 1.

Table 1. Mean Scores of Visual Function Measures

 Mean (SD)
EYE-Q1 score3.51 (0.52)
2nd EYE-Q1 score3.54 (0.52)
PedsQL2 Physical score85.91 (15.04)
PedsQL2 Psychosocial score75.56 (17.66)
PedsQL2 Total score79.18 (15.49)
Logmar VA3, left eye0.245 (0.357)
Logmar VA3, right eye0.220 (0.510)
Contrast Sensitivity1.74 (0.18)
1 Effects of Youngsters' Eyesight on QOL;2Pediatric Quality of Life Inventory;3 Visual Acuity

Correlations between EYE-Q and measures of validity and reliability are shown in Table 2.

Table 2. Correlation Between the EYE-Q and PedsQL With Measures of Validity and Reliability

MeasuresRP value
EYE-Q1 repeat0.9430.00**
PedsQL2 Physical0.4890.00**
PedsQL2 Psychosocial0.4270.00**
PedsQL2 Total0.4890.00**
Logmar Far VA3, left eye-0.5460.000**
Logmar Far VA3, right eye-0.6090.00**
Contrast Sensitivity0.3660.019**
PedsQL2 and Logmar VA3, left eye-0.2990.018**
PedsQL2 and Logmar VA3, right eye-0.1970.122
1 Effects of Youngsters' Eyesight on QOL;2Pediatric Quality of Life Inventory;3Visual Acuity;**p < 0.05

There were significant associations between the EYE-Q and standardized measures.

Conclusions:

Our study confirms the validity and reliability of our EYE-Q and the contribution of visual function to overall QOL. Studies on QOL in JIA-U should incorporate all components of disability in their analysis and not rely only on objective measurements of vision or measures of overall QOL. Our EYE-Q may be an important instrument in the assessment of vision related QOL in children with JIA-U and a better measure than VA or measures of overall QOL alone.

To cite this abstract, please use the following information:
Angeles-Han, Sheila, Griffin, Kenneth, Harrison, Melanie J., Fields, Kerrie, Ponder, Lori, Reeves-Robb, Rachel, et al; Development of a Vision Related Quality of Life Instrument for Children with Juvenile Idiopathic Arthritis-Associated Uveitis. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1405
DOI: 10.1002/art.29171

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