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Monye HI, Olawoye OO, Ugalahi MO, Oluleye TS. Nigerian parents' perspectives on genetic testing in their children with genetic eye diseases. J Community Genet 2023; 14:387-394. [PMID: 37498433 PMCID: PMC10444708 DOI: 10.1007/s12687-023-00658-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 07/04/2023] [Indexed: 07/28/2023] Open
Abstract
The decision for genetic testing in children is usually taken by their parents or caregivers, and may be influenced by sociocultural and ethical concerns. This study evaluateds the perspectives of Nigerian parents towards genetic testing of their children with genetic eye diseases parental willingness for genetic testing in their children, and its determinants, in a hospital setting in Nigeria. This cross-sectional, hospital-based study was conducted at the Eye clinic, University College Hospital, Ibadan. The participants were 42 parents of children with genetic eye diseases purposively recruited from April to July 2021. The main variables of interest were overall willingness to test, and willingness to test given ten different scenarios. Summary statistics were performed, and determinants of willingness to test (parental sociodemographic and children's clinical characteristics) were assessed using Fischer's exact test. All the participants expressed willingness to test when presented with six of the ten scenarios.However, slightly fewer (83-95%) proportions were willing to test for the other four scenarios (out-of-pocket payment, if test will reveal a systemic association, if test may confirm a diagnosis with no current treatment, and prenatal testing). Willingness to test was not significantly associated with the determinants tested. Thirty-nine (93%) would join a support group, 38 (91%) would inform a family member at risk, and 28 (67%) would be unwilling to have more children if there wais a risk to future offspring. This study demonstrated a high degree of parental willingness for genetic testing of their children. This is important evidence that can guide policy and planning of ophthalmic genetics services.
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Affiliation(s)
- Henrietta Ifechukwude Monye
- Department of Ophthalmology, University College Hospital, Ibadan, Nigeria
- Eleta Eye Institute, Ibadan, Nigeria
| | - Olusola Oluyinka Olawoye
- Department of Ophthalmology, University College Hospital, Ibadan, Nigeria.
- Department of Ophthalmology, College of Medicine, University of Ibadan, Ibadan, Nigeria.
| | - Mary Ogbenyi Ugalahi
- Department of Ophthalmology, University College Hospital, Ibadan, Nigeria
- Department of Ophthalmology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Tunji Sunday Oluleye
- Department of Ophthalmology, University College Hospital, Ibadan, Nigeria
- Department of Ophthalmology, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Chorfi S, Place EM, Huckfeldt RM. Disparities in Inherited Retinal Degenerations. Semin Ophthalmol 2023; 38:201-206. [PMID: 36536519 DOI: 10.1080/08820538.2022.2152715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
To review disparities in the field of inherited retinal degenerations to establish foundations for future discussions oriented toward finding possible solutions. A narrative overview of the literature. Despite collective efforts towards democratization of genetic testing and investigation, genetic databases containing primarily European populations are heavily relied upon. Access to specialized care and other resources is also still not available to all. Recognizing and addressing disparities and inequities within the field of inherited retinal degenerations will improve our care of these patients and our knowledge of their conditions.
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Affiliation(s)
- Sarah Chorfi
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Ocular Genomics Institute, Boston, MS, USA
| | - Emily M Place
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Ocular Genomics Institute, Boston, MS, USA
| | - Rachel M Huckfeldt
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Ocular Genomics Institute, Boston, MS, USA
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Knight LS, Ridge B, Staffieri SE, Craig JE, Senthil MP, Souzeau E. The caregiver experience in childhood glaucoma: An interview study. Ophthalmol Glaucoma 2022; 5:531-543. [PMID: 35151897 DOI: 10.1016/j.ogla.2022.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 02/03/2022] [Accepted: 02/04/2022] [Indexed: 10/19/2022]
Abstract
PURPOSE To investigate and report on the quality of life (QoL) issues experienced by caregivers of individuals with childhood glaucoma. DESIGN Exploratory qualitative study PARTICIPANTS: Thirty-five caregivers of individuals with childhood glaucoma (defined as disease onset <18 years) recruited from the Australian and New Zealand Registry of Advanced Glaucoma. METHODS A qualitative research methodology (interpretive phenomenology) was applied. Data were collected through semi-structured in-depth interviews. NVivo-12 software (QSR International Pty Ltd) was used to inductively analyze, code, and organize data into QoL themes. MAIN OUTCOME MEASURES Quality of life themes and their sub-themes. RESULTS The mean caregiver age was 50.2 ± 13.6 years and 27/35 (77%) were mothers of an individual with childhood glaucoma. A total of six QoL themes were identified. Coping strategies and emotional well-being were the most prominent themes. Caregivers frequently adopted problem-focused adaptive coping strategies including partner and/or peer support and normalization. A caregivers' psychosocial well-being was often impacted by feelings of guilt and regret regarding their child's delayed diagnosis, fear and anxiety related to medical and social support, and loss of control as their child developed medical autonomy. The effect of family planning from the perspective of the caregiver formed a novel QoL theme and was associated with normalization and parental confidence in management of the condition. CONCLUSION Childhood glaucoma poses a substantial threat to a caregivers' psychosocial well-being. Strategies which promote normalization, peer support, psychotherapeutic intervention and genetic counseling may be indicated and indeed critical to the caregiver as they adapt to supporting their child with glaucoma.
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Affiliation(s)
- Lachlan Sw Knight
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia; Department of Ophthalmology, Women's and Children's Hospital, North Adelaide, Australia.
| | - Bronwyn Ridge
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Sandra E Staffieri
- Department of Ophthalmology, Royal Children's Hospital, Parkville, Australia; Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia; Ophthalmology, University of Melbourne, Department of Surgery, Parkville, Australia
| | - Jamie E Craig
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Mallika Prem Senthil
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, Australia
| | - Emmanuelle Souzeau
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
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Inaba A, Yoshida A, Maeda A, Kawai K, Kosugi S, Takahashi M. Perception of genetic testing among patients with inherited retinal disease: Benefits and challenges in a Japanese population. J Genet Couns 2022; 31:860-867. [PMID: 35106875 DOI: 10.1002/jgc4.1556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/10/2022] [Accepted: 01/15/2022] [Indexed: 11/10/2022]
Abstract
Inherited retinal disease (IRD) is clinically and genetically heterogeneous. Awareness of the importance of genetic testing for IRD in the clinical setting is increasing with the recent development of new therapeutic strategies, such as gene therapy. Here, the perception of genetic testing, including its benefits and potential challenges, among patients with IRD was investigated to establish strategies for IRD genetic testing and counseling practices that can meet the requirements of the patients in Japan. An anonymous self-administered questionnaire was distributed to 275 patients with IRD who underwent genetic testing after clinical consultation and genetic counseling to investigate the motivations for genetic testing, benefits, challenges, status of communication of results to family, and attitude to timing of genetic testing. In total, 228 (82.9%) responses were analyzed. Several major motivations for genetic testing were identified, including gaining information on future treatment options and clarification of the inheritance pattern, among others. No association was found between the sharing of results with family members and the results of genetic testing. Moreover, according to patients who received positive results, the benefits of genetic testing included information on the inheritance pattern, additional information on the diagnosis, and mental preparation for the future. Even patients who received negative or inconclusive (variant of uncertain significance) results reported certain informative and psychological benefits. Altogether, these findings suggest that provisions for genetic testing and genetic counseling are necessary within a certain period after clinical diagnosis and it is necessary to facilitate appropriate family communication about genetic testing results while paying attention to the background of family relationships. Moreover, the benefits of genetic testing can be influenced by the careful interpretation and information provided on the test results during genetic counseling and consultation.
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Affiliation(s)
- Akira Inaba
- Department of Ophthalmology, Kobe City Eye Hospital, Kobe, Japan.,Laboratory for Retinal Regeneration, RIKEN, Center for Biosystems Dynamics Research, Kobe, Japan.,Department of Medical Ethics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Akiko Yoshida
- Department of Ophthalmology, Kobe City Eye Hospital, Kobe, Japan.,Laboratory for Retinal Regeneration, RIKEN, Center for Biosystems Dynamics Research, Kobe, Japan
| | - Akiko Maeda
- Department of Ophthalmology, Kobe City Eye Hospital, Kobe, Japan.,Laboratory for Retinal Regeneration, RIKEN, Center for Biosystems Dynamics Research, Kobe, Japan
| | - Kanako Kawai
- Department of Ophthalmology, Kobe City Eye Hospital, Kobe, Japan.,Laboratory for Retinal Regeneration, RIKEN, Center for Biosystems Dynamics Research, Kobe, Japan
| | - Shinji Kosugi
- Department of Medical Ethics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masayo Takahashi
- Department of Ophthalmology, Kobe City Eye Hospital, Kobe, Japan.,Laboratory for Retinal Regeneration, RIKEN, Center for Biosystems Dynamics Research, Kobe, Japan
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Wang Q, Pang C, Meng L, Wang G. Public perceived knowledge of, attitude toward, and use of genetic testing in urban China. J Genet Couns 2021; 30:1629-1639. [PMID: 33942946 DOI: 10.1002/jgc4.1428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 03/22/2021] [Accepted: 03/22/2021] [Indexed: 11/07/2022]
Abstract
Because most research about laypeople and genetic testing (GT) has been conducted in other nations than China, we conducted a study in urban China (a) to determine the perceived knowledge of, attitude toward, and use of GT there; (b) to identify influencing factors associated with the public's perceived knowledge, attitudes, and use of GT; and (c) to explore the relationship among public knowledge of, attitude toward, and use of GT. Our data came from a community-based survey in urban Dalian of 868 individuals. We used generalized ordered logit and logit models to examine factors associated with perceived knowledge of, attitude toward, and use of GT. We found that 67% of community members knew about GT, that 45% had a positive opinion of GT, and that only 4% accessed GT. Older people were more likely to have less perceived knowledge of GT and less likely to have a negative attitude toward it; these relationships were especially stronger among those aged ≥60 years. We also found that socially disadvantaged people were more likely to have less perceived knowledge of GT and more likely to have a negative opinion of it. Having a greater level of perceived knowledge was significantly correlated with increased odds of having a more positive or neutral attitude toward GT and of being more likely to access GT. Our findings may help policy makers design effective action plans and regulations regarding GT and genetic counseling services for laypersons in China.
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Affiliation(s)
- Qun Wang
- Faculty of Humanities and Social Sciences, Dalian University of Technology, Dalian, China
| | - Cong Pang
- School of Philosophy, Center for Biomedical Ethics, Fudan University, Shanghai, China
| | - Lingyu Meng
- School of Philosophy, Center for Biomedical Ethics, Fudan University, Shanghai, China
| | - Guoyu Wang
- School of Philosophy, Center for Biomedical Ethics, Fudan University, Shanghai, China
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Wang Y, Lian Z, Zhou Y, Li X, Wu J, Zhang X, Jin G, Zheng D. Differential diagnosis of Marfan syndrome based on ocular biologic parameters. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:1354. [PMID: 33313099 PMCID: PMC7723569 DOI: 10.21037/atm-20-1069] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background The present study aimed to investigate the ocular characteristics of Chinese patients with Marfan syndrome (MFS) and to evaluate the sensitivity and specificity of ocular parameters in distinguishing MFS from ectopia lentis. Methods A total of 103 patients (103 eyes) with ectopia lentis from 13 provinces and 47 cities were recruited from Zhongshan Ophthalmic Center, Sun Yat-sen University, from June 2017 to June 2019. Ghent-2 criteria were used, as they are the gold standard diagnostic criteria for MFS. Ocular parameters, such as flat keratometry (Kf), steep keratometry (Ks), mean keratometry (Km), corneal astigmatism (AST), axial length (AL), white-to-white corneal diameter (WTW), central corneal thickness (CCT), and axial length/curvature radius (AL/CR), were recorded. Diagnostic analyses based on various combinations of parameters to differentiate MFS from ectopia lentis were made using receiver-operating characteristic (ROC) curves. Results The mean age of the 103 included patients was 10.25±9.67 (range: 3–48) years, and 66.02% were male. Km combined with CCT was found to have good sensitivity and specificity in the differential diagnosis of MFS from ectopia lentis; Km of 41.36 D and CCT of 537.32 mm were found to be the optimal cut-off points, representing a sensitivity of 89.8% and specificity of 68.7%. Conclusions Special characteristics of ocular parameters were detected in MFS. Our findings indicate that ocular biologic parameters are valuable for the differential diagnosis of MFS from ectopia lentis. Km, combined with CCT, could be used as a screening tool for MFS.
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Affiliation(s)
- Yiyao Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Zhangkai Lian
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yijing Zhou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xuepei Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Jieyi Wu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xinyu Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Guangming Jin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Danying Zheng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
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Zhang Y, Huang S, Xiao H, Ding X. Parental genetic knowledge and attitudes toward childhood genetic testing for inherited eye diseases. Mol Genet Genomic Med 2020; 8:e1402. [PMID: 32662217 PMCID: PMC7507097 DOI: 10.1002/mgg3.1402] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 05/13/2020] [Accepted: 06/24/2020] [Indexed: 11/16/2022] Open
Abstract
Background This study aimed to explore the parental genetic knowledge and attitudes toward childhood genetic testing of the inherited eye diseases (IEDs) in China. Methods This is a cross‐sectional survey. All parents were assessed via self‐administered questionnaires. Data were collected through the Internet at the pediatric eye clinics in a tertiary referral eye hospital. Results In total, 359 parents were included into this survey. The proportion of correctly answered the factual genetic knowledge questionnaire ranged from 35.7% to 81.3%, which is positively correlated to the educational levels and household per capita income. The attitudes toward childhood IEDs genetic testing appeared to be consistent. More factual genetic knowledge was predictive for a favorable attitude toward genetic testing. Han Chinese might be slightly more likely to have a favorable attitude. Interestingly, the higher educational levels and lower monthly incomes were predictive factors for a reserved attitude toward genetic testing. The families without history of IEDs were more inclined to remain a reserved attitude than those with family history of IEDs. Conclusion This study illustrated that more factual genetic knowledge was considered as an indicator for the favorable attitudes. Therefore, the effective strategies should be taken to provide the correct knowledge of genetics and genetic testing to parents, especially those who need to make an informed decision thereon to undertake childhood genetic testing.
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Affiliation(s)
- Yu Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Sijian Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Huiming Xiao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xiaoyan Ding
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
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Galvin O, Chi G, Brady L, Hippert C, Del Valle Rubido M, Daly A, Michaelides M. The Impact of Inherited Retinal Diseases in the Republic of Ireland (ROI) and the United Kingdom (UK) from a Cost-of-Illness Perspective. Clin Ophthalmol 2020; 14:707-719. [PMID: 32184557 PMCID: PMC7062501 DOI: 10.2147/opth.s241928] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 01/31/2020] [Indexed: 12/17/2022] Open
Abstract
To date, there has been a global lack of data regarding the prevalence of conditions falling under the Inherited Retinal Diseases (IRD) classification, the impact on the individuals and families affected, and the cost burden to economies. The absence of an international patient registry, and equitable access to genetic testing, compounds this matter. The resulting incomplete knowledge of the impact of IRDs hinders the development and commissioning of clinical services, provision of treatments, and planning and implementation of clinical trials. Thus, there is a need for stronger evidence to support value for money to regulatory bodies for treatments approved, and progressing through clinical trials. To ensure a strategic approach to future research and service provision, it is necessary to learn more about the IRD landscape. This review highlights two recent cost-of-illness reports on the socio-economic impact of 10 IRDs in the Republic of Ireland (ROI) and the United Kingdom (UK), which demonstrate the comprehensive impact of IRDs on individuals affected, their families, friends and society. Total costs attributable to IRDs in the ROI were estimated to be £42.6 million in 2019, comprising economic (£28.8 million) and wellbeing costs (£13.8 million). Wellbeing costs were estimated using the World Health Organization (WHO) burden of disease methodology, a non-financial approach, where pain, suffering and premature mortality are measured in terms of disability-adjusted-life-years (DALYs). In the UK, wellbeing costs attributable to IRDs were £196.1 million, and economic costs were £327.2 million amounting to £523.3 million total costs in 2019. Accounting for over one-third of total costs, the wellbeing burden of persons affected by IRDs should be emphasized and factored into reimbursement processes for therapies and care pathways. This targeted review presents the most current and relevant data on IRD prevalence in the ROI and the UK, and the impacts (financial and non-financial) of IRDs in terms of diagnosis, wellbeing, employment, formal and informal care, health system costs, deadweight losses and issues surrounding payers and reimbursement. This review demonstrates IRD patients and their families have common issues including, the need for timely equitable access to genetic testing and counselling, equality in accessing employment, and a revision of the assessment process for reimbursement of therapies currently focused on the cost-of-illness to the healthcare system. This review reveals that IRD patients do not frequently engage the healthcare system and as such suggests a cost-of-illness model from a societal perspective may be a better format.
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Affiliation(s)
- Orla Galvin
- Retina International, Dublin 8, D08 R9CN, Ireland
| | - Gloria Chi
- Genentech, Roche Group, South San Francisco, CA 94080-4990, USA
| | - Laura Brady
- Fighting Blindness, Dublin 2, D02 TW98, Ireland
| | | | | | - Avril Daly
- Retina International, Dublin 8, D08 R9CN, Ireland
| | - Michel Michaelides
- UCL Institute of Ophthalmology, University College London, London, UK.,Moorfields Eye Hospital NHS Foundation Trust, London, UK
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Zhang Y, Wang Z, Huang S, Sun L, Zhao S, Zhong Y, Xiao H, Ding X. Parents' perceptions of diagnostic genetic testing for children with inherited retinal disease in China. Mol Genet Genomic Med 2019; 7:e916. [PMID: 31373165 PMCID: PMC6732314 DOI: 10.1002/mgg3.916] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 07/18/2019] [Accepted: 07/19/2019] [Indexed: 01/20/2023] Open
Abstract
Background In this study, we aim to investigate the awareness of, attitudes toward, and experiences with diagnostic genetic testing among parents of children suspected of having inherited retinal disease (IRDs) in China. Methods Semistructured, face‐to‐face, and in‐depth interviews were carried out with parents of children with suspected IRDs in this qualitative study. Inductive content analysis was used for data processing. Results Forty‐six parents participated in our interviews, and 47.8% of them supported genetic testing for following four main reasons: to help in making informed reproductive health decisions, to prepare for novel potential treatment, to identify the underlying causes of IRDs, and to satisfy curiosity about the heredity of IRDs. Among them, 19.6% were opposed to the testing for four main reasons, namely lack of therapeutic benefit, difficulty in affording the testing cost, doubt in the accuracy of clinical diagnosis, and the presence of concerns about the limitations of genetic testing. 47.8% of the parents expressed concerns that the genetic findings might lead to potential psychological stress. Conclusion In this study, we showed that nearly half of the parents supported genetic testing mainly for family planning, and a fifth of the parents were opposed to the testing mainly for lack of therapeutic benefit. Moreover, half of the parents expressed concern that a positive genetic result may create potential psychological burden to the parents and children.
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Affiliation(s)
- Yu Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Zhirong Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Sijian Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Limei Sun
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Shiying Zhao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yimin Zhong
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Huiming Xiao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xiaoyan Ding
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
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