Low Vision Services Are Underutilized by Patients with Vision Loss from Corneal Disease.

IF 1.9 3区医学 Q2 OPHTHALMOLOGY

Cornea Pub Date : 2025-03-11 DOI:10.1097/ICO.0000000000003847

Güldeniz Usta, David J Ramsey

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引用次数: 0

Abstract

Purpose: This study evaluated the rate at which patients with visual impairment primarily from corneal disease were referred for low vision (LV) services and assessed the visual outcomes from completed evaluations.

Methods: This 1-year retrospective, cross-sectional study included patients with corneal disease limiting best-corrected visual acuity (BCVA) to ≤ 20/40. Outcome measures included the change in BCVA achieved after distance refraction by a LV specialist. Incremental costs per quality-adjusted life years (QALY) gained were calculated upon the better-seeing eye, by using a willingness-to-pay threshold of USD 50,000/QALY.

Results: Of 3230 patients, 143 (4.4%) had visual impairment from corneal disease. The median age of those patients was 80 years (IQR: 66-88 years) and 64.3% were male. Just over half were referred for LV evaluations (53.2%), and most completed appointments (96.1%). Patients more likely to be referred had better vision in their worse-seeing eye (0.961 logMAR vs. 1.451 logMAR, P = 0.002) and were more frequently diagnosed with corneal dystrophies, degenerations, or ectatic disease (51.3% vs. 26.9%, P = 0.003) compared with other corneal conditions, but they were less likely to have immunologic conditions (2.6% vs. 13.4%, P = 0.016). In total, two-thirds of patients achieved improved BCVA for their better-seeing eye, with 32% gaining ≥ 2 lines. This translated into an average gain of 0.04 QALYs/patient at a cost of USD 3128/QALY. The estimated net monetary benefit was USD 1923/LV evaluation completed.

Conclusions: Referring patients with corneal disease to LV services resulted in significant improvements in visual function at a reasonable cost.

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角膜疾病导致视力丧失的患者未充分利用低视力服务。

目的：本研究评估了主要由角膜疾病引起的视力损害患者转介到低视力（LV）服务的比率，并评估了完成评估的视力结果。方法：这项为期1年的回顾性横断面研究纳入了最佳矫正视力(BCVA)≤20/40的角膜疾病患者。结果测量包括由LV专家进行距离折射后BCVA的变化。每个质量调整生命年（QALY）的增量成本是根据视力更好的眼睛计算的，使用支付意愿阈值为50,000美元/QALY。结果：在3230例患者中，143例（4.4%）有角膜疾病引起的视力损害。这些患者的中位年龄为80岁（IQR: 66-88岁），64.3%为男性。超过一半的人被转诊进行LV评估（53.2%），大多数人完成了预约（96.1%）。与其他角膜疾病相比，更有可能转诊的患者视力较差（0.961 logMAR vs. 1.451 logMAR, P = 0.002），并且更常被诊断为角膜营养不良、变性或扩张性疾病（51.3% vs. 26.9%, P = 0.003），但他们较少可能患有免疫疾病（2.6% vs. 13.4%, P = 0.016）。总的来说，三分之二的患者视力较好，BCVA得到改善，32%的患者获得≥2条线。这意味着每名患者平均获得0.04个QALY，成本为3128美元/QALY。估计净货币收益为1923美元/LV评估完成。结论：将角膜疾病患者转介到LV服务，以合理的成本显著改善了视力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cornea 医学-眼科学

CiteScore

5.20

自引率

10.70%

发文量

354

审稿时长

3-6 weeks

期刊介绍： For corneal specialists and for all general ophthalmologists with an interest in this exciting subspecialty, Cornea brings together the latest clinical and basic research on the cornea and the anterior segment of the eye. Each volume is peer-reviewed by Cornea''s board of world-renowned experts and fully indexed in archival format. Your subscription brings you the latest developments in your field and a growing library of valuable professional references. Sponsored by The Cornea Society which was founded as the Castroviejo Cornea Society in 1975.