Reading performance, using a novel app, and quality of life in patients with inflammatory eye disease

Purpose : To assess the relationship of reading performance and quality of life measures in two groups of patients with inflammatory eye disease, using an innovative mobile app reading test.

Methods : A mobile app on an iPad was used to measure and calculate the reading acuity, critical print size and reading speed in patients with ocular surface disease (OSD, n=48 (female n=30; age 56.2±19.9 (mean ±SD) years; diagnosis, cicatrizing conjunctivitis (n=18 38%), Sjögren’s Syndrome (n=5 10%), peripheral ulcerative keratitis (n=4, 8%); and uveitis (n=45 (female, n=25; age 45.6 ±14.9 years; diagnosis, panuveitis (n=19, 42%), anterior uveitis (n=10, 24%). The app presents sentences from the Radner reading speed test at decreasing size, objectively measuring reading speed using voice recognition. Reading acuity was calculated automatically by the app. Patients also completed a Visual Function Questionnaire 25 (VFQ-25) and EQ-5D questionnaire.

Results : There was no difference between the mean composite score for VFQ-25 between the OSD and uveitis groups (VFQ-25: OSD 67 (SD 21), uveitis 72 (SD 22), p=0.26. The mean EQ-5D visual analogue scale (VAS) score (indicating patient perception of general health as a percentage on that day) was 73 in the OSD group compared to 77 in the uveitis group. Comparing reading acuity and VFQ-25 score in all patients, there was a correlation between a higher VFQ-25 score and better reading acuity (all patients, r= -0.642 (p=<0.05)) and this effect was greater in the OSD [r= -0.717 (p=<0.05)] than the uveitis [r= -0.541 (p=<0.05)] patients. The results of the EQ-5D [SR1] VAS demonstrated a correlation between better reading acuity and better patient perceived health in both groups: OSD r= -0.295 (p=<0.05); uveitis r= -0.415 (p=<0.05). There was no statistically significant difference in mean reading speed between the OSD and uveitis groups.

Conclusions : Poorer reading vision correlates with lower scores in the VFQ-25 and EF-5D questionnaires in patients with both OSD and uveitis. This emphasizes the need to assess reading vision as well as distance vision at each clinical visit. The mobile app allows efficient objective assessment of a key clinical parameter that can be utilized to monitor disease severity and gauge impact on quality of life, something that has previously been difficult to achieve.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016