New Patient Reported Outcome Measures For Adult Strabismus

1. Jonathan M. Holmes
2. David A. Leske
3. Sarah R. Hatt
4. Laura Liebermann

Mayo Clinic, Rochester, MN, USA

Purpose: We have recently developed 1) a new health-related quality of life (HRQOL) questionnaire specifically for adults with strabismus – the Adult Strabismus-20 (AS-20), with function and psychosocial subscales, and 2) a revised diplopia questionnaire (RDQ) symptom survey, rating diplopia on a 5-point scale (never, rarely, sometimes, often, always) in specific positions of gaze (reading, straight ahead distance, down, right, left, up, and other). As part of validating these questionnaires, we compared their performance, hypothesizing that the AS-20 function subscale, but not the psychosocial subscale, would be inversely correlated with RDQ score.

Methods: 132 strabismus patients (aged 18y to 86y) completed the AS-20 and RDQ at their office visit. For the AS-20, and subscales, possible scores ranged from 0 (worst HRQOL) to 100 (best HRQOL). For the RDQ, possible scores ranged from 0 (no diplopia) to 100 (diplopia always in all positions of gaze), weighted to straight ahead distance and reading. We evaluated correlations by Spearman rank methods.

Results: AS-20 HRQOL scores ranged from 15 to 100 and RDQ scores ranged from 0 to 100. Overall, AS-20 scores were inversely correlated to diplopia (RDQ) scores (r= -0.33, p<0.0001). AS-20 function subscale scores were more strongly inversely correlated to diplopia scores (r= -0.50, p<0.0001), but, as hypothesized, AS-20 psychosocial subscale scores were not correlated to diplopia (r= -0.08, p=0.3).

Conclusions: The Adult Strabismus-20 and Revised Diplopia
Questionnaires are useful patient reported outcome measures, providing means of quantifying HRQOL and diplopia in a strabismus practice and in future clinical trials.