Quality of life and its modifying factors in patients with thyroid eye disease in Western China: A cross-sectional study
TL;DR
Findings support a shift from single-modality ophthalmic care approach to a multidimensional, multidisciplinary strategy, integrating ocular symptom control, psychological support, and sleep improvement for long-term regional care of patients with thyroid eye disease.
Abstract
Background Thyroid eye disease is a common chronic autoimmune ocular disorder. Relevant quality of life studies are limited in socioeconomically and medically distinct regions of Western China. The present study aimed to address the regional gap and support targeted clinical public health strategies for long-term thyroid eye disease management. Methods This cross-sectional survey was conducted among 306 patients with thyroid eye disease from 12 provinces, municipalities, and autonomous regions in Western China. Data were collected using a general demographic questionnaire, Graves’ Ophthalmopathy Quality of Life (GO-QOL) questionnaire, Huaxi Emotional-Distress Index, and Athens Insomnia Scale. Multivariate linear regression was performed to identify independent factors. Results The mean total GO-QOL score was 41.19 ± 19.38. Multivariate analysis revealed that GO-QOL of patients with diplopia, photophobia/epiphora, restricted eye movement, and other ocular symptoms were lower by 9.024, 8.867, 9.416, and 4.159 points, respectively, than those of individuals without these symptoms (all p < 0.001, except for “other symptoms” where p = 0.006). For each 1-point increase in the Huaxi Emotional-Distress Index and Athens Insomnia Scale scores, the GO-QOL score decreased by 0.810 points (p < 0.001) and 0.543 points (p = 0.007), respectively. Compared with patients with a Clinical Activity Score <3, those with a Clinical Activity Score ≥3 had a mean GO-QOL score that was 5.626 points lower (p = 0.041). The GO-QOL of patients with junior high school education was 5.434 points higher than that of those with a bachelor's degree or higher (p = 0.028). Conclusion The quality of life of patients with thyroid eye disease in Western China remains relatively low. Low educational level, ocular symptoms (diplopia, photophobia/epiphora, and restricted motility), disease activity, emotional distress (anxiety/depression), and sleep disorders are independent risk factors for poorer quality of life. These findings support a shift from single-modality ophthalmic care approach to a multidimensional, multidisciplinary strategy, integrating ocular symptom control, psychological support, and sleep improvement for long-term regional care of patients with thyroid eye disease.