{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T17:52:38Z","timestamp":1789235558321,"version":"build-2803163510"},"reference-count":17,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,9,10]],"date-time":"2020-09-10T00:00:00Z","timestamp":1599696000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Ophthalmologica"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To analyse the vision\u2010related quality of life (vr\u2010QoL) in stable and progressive keratoconus (KC) patients with a still good visual acuity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Combined prospective\/cross\u2010sectional study design. The Refractive Status and Vision Profile (RSVP) and the National Eye Institute Visual Functioning \u2013 25 (NEI\u201025) questionnaire were used in 16 emmetropic, 32 myopic and 56 KC patients, whereby KC patients with a stable (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a026) and patients with a progressive stage (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a030) and some of them\u00a0before and after corneal cross\u2010linking (CXL;\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a010) were included. All patients had a DCVA in at least one eye of \u22650.7 (decimal chart).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The analyses revealed a minor decline of the vr\u2010QoL from emmetropes to myopes to early KC patients with a stable disease. Nonetheless, sociological subscales (i.e. \u2018social functioning\u2019, \u2018role difficulties\u2019 and \u2018dependency\u2019) did not display statistically significant differences comparing these groups. In progressive KC, we could demonstrate a statistically significant decline also of these sociological subscales, which did not improve after CXL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Due to a still high and almost unaffected vr\u2010QoL in early KC patients and the distinct decline after progression without rehabilitation after CXL, a reconsideration of current strategies to perform CXL only after a progression is diagnosed should be re\u2010evaluated.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aos.14564","type":"journal-article","created":{"date-parts":[[2020,9,28]],"date-time":"2020-09-28T17:12:36Z","timestamp":1601313156000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Quality of life in stable and progressive \u2018early\u2010stage\u2019 keratoconus patients"],"prefix":"10.1111","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3091-9347","authenticated-orcid":false,"given":"Johannes","family":"Steinberg","sequence":"first","affiliation":[{"name":"Department of Ophthalmology UKE \u2010 University Medical Center Hamburg\u2010Eppendorf Martinistrasse 52 Hamburg 20246 Germany"},{"name":"Martinistrasse 64 20251 Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nils","family":"Bu\u00dfmann","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology UKE \u2010 University Medical Center Hamburg\u2010Eppendorf Martinistrasse 52 Hamburg 20246 Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8977-4261","authenticated-orcid":false,"given":"Andreas","family":"Frings","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology University Hospital Duesseldorf Moorenstra\u00dfe 5 Duesseldorf 40225 Germany"},{"name":"UCL Institute of Ophthalmology 11\u201043 Bath St London EC1V 9EL UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toam","family":"Katz","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology UKE \u2010 University Medical Center Hamburg\u2010Eppendorf Martinistrasse 52 Hamburg 20246 Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasyl","family":"Druchkiv","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology UKE \u2010 University Medical Center Hamburg\u2010Eppendorf Martinistrasse 52 Hamburg 20246 Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan J.","family":"Linke","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology UKE \u2010 University Medical Center Hamburg\u2010Eppendorf Martinistrasse 52 Hamburg 20246 Germany"},{"name":"Martinistrasse 64 20251 Hamburg 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