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Gkioka M, Almpanidou S, Lioti N, Almaliotis D, Karampatakis V. Daily Functionality of People with Low Vision: The Impact of Visual Acuity, Depression, and Life Orientation-A Cross-Sectional Study. Behav Neurol 2024; 2024:4366572. [PMID: 38440066 PMCID: PMC10911879 DOI: 10.1155/2024/4366572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 01/31/2024] [Accepted: 02/03/2024] [Indexed: 03/06/2024] Open
Abstract
Background Low vision (LV) has a significant negative impact on the activities of daily life as well as on the psychological health of patients. Objectives The objective of this study is to investigate psychological, clinical, and demographic factors that may impact the daily functionality of patients with LV. Methods A convenience sample of 53 patients, meeting the WHO criteria for LV, was recruited. Questionnaires on daily functionality, depression, and life orientation (in terms of optimism/pessimism) were administered along with a semistructured personal interview. Key Findings. The main results revealed a significant negative correlation between daily functionality and depression (r = -0.423, p < 0.001). Conversely, there is a positive correlation between daily functionality and visual acuity (r = 0.415, p < 0.001), while years since diagnosis were negatively correlated with depression (r = -0.345, p < 0.001). Depression seems to be a moderate predictor of a person's daily functionality (β = -0.389, p < 0.002), followed by visual acuity (β = -0.344, p = 0.006), explaining the 31.1% of the total variance. Conclusions The study supports a correlation between daily functionality and both depression and visual acuity. Optimism as a personality characteristic did not factor into the prediction model for daily functionality, but it showed a strong correlation with lower levels of depressive symptoms. This highlights the potential for developing coping strategies for chronic disease management. Recommendations. The study could serve as a useful guide and may urge clinicians to pay attention to the psychological evaluation of these patients, supporting their unique emotional needs. Mental health professionals can use patients' positive resources to provide appropriate counseling and embrace the coping skills that encourage their engagement in activities of daily life.
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Affiliation(s)
- Mara Gkioka
- Laboratory of Experimental Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stavroula Almpanidou
- Laboratory of Experimental Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Niki Lioti
- Laboratory of Experimental Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Diamantis Almaliotis
- Laboratory of Experimental Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vasileios Karampatakis
- Laboratory of Experimental Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Li D, Chan VF, Virgili G, Mavi S, Pundir S, Singh MK, She X, Piyasena P, Clarke M, Whitestone N, Patnaik JL, Xiao B, Cherwek DH, Negash H, O'Connor S, Prakalapakorn SG, Huang H, Wang H, Boswell M, Congdon N. Impact of Vision Impairment and Ocular Morbidity and Their Treatment on Quality of Life in Children: A Systematic Review. Ophthalmology 2024; 131:188-207. [PMID: 37696451 DOI: 10.1016/j.ophtha.2023.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/16/2023] [Accepted: 09/05/2023] [Indexed: 09/13/2023] Open
Abstract
TOPIC This review summarizes existing evidence of the impact of vision impairment and ocular morbidity and their treatment on children's quality of life (QoL). CLINICAL RELEVANCE Myopia and strabismus are associated with reduced QoL among children. Surgical treatment of strabismus significantly improves affected children's QoL. METHODS We conducted a systematic review and meta-analysis by screening articles in any language in 9 databases published from inception through August 22, 2022, addressing the impact of vision impairment, ocular morbidity, and their treatment on QoL in children. We reported pooled standardized mean differences (SMDs) using random-effects meta-analysis models. Quality appraisal was performed using Joanna Briggs Institute and National Institutes of Health tools. This study was registered with the International Prospective Register of Systematic Reviews (identifier, CRD42021233323). RESULTS Our search identified 29 118 articles, 44 studies (0.15%) of which were included for analysis that included 32 318 participants from 14 countries between 2005 and 2022. Seventeen observational and 4 interventional studies concerned vision impairment, whereas 10 observational and 13 interventional studies described strabismus and other ocular morbidities. Twenty-one studies were included in the meta-analysis. The QoL scores did not differ between children with and without vision impairment (SMD, -1.04; 95% confidence interval [CI], -2.11 to 0.03; P = 0.06; 9 studies). Myopic children demonstrated significantly lower QoL scores than those with normal vision (SMD, -0.60; 95% CI, -1.09 to -0.11; P = 0.02; 7 studies). Children with strabismus showed a significantly lower QoL score compared with those without (SMD, -1.19; 95% CI, -1.66 to -0.73; P < 0.001; 7 studies). Strabismus surgery significantly improved QoL in children (SMD, 1.36; 95% CI, 0.48-2.23; P < 0.001; 7 studies). No randomized controlled trials (RCTs) concerning refractive error and QoL were identified. Among all included studies, 35 (79.5%) were scored as low to moderate quality; the remaining met all quality appraisal tools criteria. DISCUSSION Reduced QoL was identified in children with myopia and strabismus. Surgical correction of strabismus improves the QoL of affected children, which supports insurance coverage of strabismus surgery. Further studies, especially RCTs, investigating the impact of correction of myopia on QoL are needed. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Dongfeng Li
- Department of Ophthalmology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China; Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China; Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Ving Fai Chan
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Gianni Virgili
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom; Department Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Sonia Mavi
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Sheetal Pundir
- Department of Ophthalmology, McGill University Health Centre, Montreal, Quebec, Canada
| | | | - Xinshu She
- School of Medicine, Stanford University, Stanford, California
| | - Prabhath Piyasena
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Mike Clarke
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | | | - Jennifer L Patnaik
- Orbis International, New York, New York; Department of Ophthalmology, University of Colorado School of Medicine, Aurora, Colorado
| | - Baixiang Xiao
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom; Affiliated Eye Hospital of Nanchang University, Nanchang City, China
| | | | | | - Sara O'Connor
- Advanced Center for Eyecare Global, Bakersfield, California
| | - S Grace Prakalapakorn
- Departments of Ophthalmology and Pediatrics, Duke University Medical Center, Durham, North Carolina; Duke Global Health Institute, Duke University, Durham, North Carolina
| | - Huilan Huang
- Shandong First Medical University (Shandong Academy of Medical Science), Jinan, China
| | - Huan Wang
- Centre on China's Economy and Institutions, Stanford University, Stanford, California
| | - Matthew Boswell
- Centre on China's Economy and Institutions, Stanford University, Stanford, California
| | - Nathan Congdon
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom; Orbis International, New York, New York; Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou City, China.
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Gouveia-Moraes F, Barros S, Vide Escada A, Carreira P, Tardão G, Vaz M, Marques N, Campos N. Strabismus and Health Related Quality of Life in a pediatric Portuguese population. Strabismus 2023; 31:262-270. [PMID: 37973558 DOI: 10.1080/09273972.2023.2276138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Introduction: Strabismus is a common condition among children, and its psychosocial impact has been demonstrated in recent years. The interest in a more comprehensive approach was enhanced by the recognition of health as a four-dimensional concept, arising the term Health-related Quality of Life. Therefore, we aim to evaluate the influence of strabismus in Health-Related Quality of Life of a Portuguese pediatric population. Material and Methods: Case-control prospective transversal study enrolling children between 5 and 12 years old. All had a complete orthoptic and ophthalmological evaluation, followed by an interview with a legal representative to answer the Pediatric Quality-of-Life Inventory 4.0, proxy-version. Results: Seventy-one children were included, 35 in the control group (CG) and 36 in the strabismus group (SG). In the SG, 30 (83.3%) patients had esotropia, 20 (55.6%) had more than 10 prismatic diopters and 26 (72.2%) were already surgically treated. Overall, SG was not statistically different from the CG, showing only mild inferior performance (p > .05). Furthermore, children with exotropia, higher deviations, none or gross stereoacuity and treatment-naïve, scored worse, especially in emotional, social, educational and psychosocial scores although not statistically significant (p > .05). Conclusion: This is the first prospective study addressing HRQoL and strabismus in a pediatric Portuguese population. It would be relevant to further address this issue in order to delineate more effective and global treatment strategies, not only considering ophthalmological goals but also the well-being of both children and guardians.
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Affiliation(s)
| | - Sandra Barros
- Integrated Responsibility Center of Ophthalmology - Garcia de Orta Hospital, Almada
| | - Ana Vide Escada
- Integrated Responsibility Center of Ophthalmology - Garcia de Orta Hospital, Almada
- Department of Pediatric Ophthalmology and Strabismus, Integrated Responsibility Center - Garcia de Orta Hospital, Almada
| | - Pedro Carreira
- Integrated Responsibility Center of Ophthalmology - Garcia de Orta Hospital, Almada
| | - Gonçalo Tardão
- Integrated Responsibility Center of Ophthalmology - Garcia de Orta Hospital, Almada
| | - Mariana Vaz
- Integrated Responsibility Center of Ophthalmology - Garcia de Orta Hospital, Almada
| | - Nadine Marques
- Integrated Responsibility Center of Ophthalmology - Garcia de Orta Hospital, Almada
| | - Nuno Campos
- Integrated Responsibility Center of Ophthalmology - Garcia de Orta Hospital, Almada
- Head of Department of the Integrated Responsibility Ophthalmology Center - Garcia de Orta Hospital, Almada
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Almazroa A, Almatar H, Alduhayan R, Albalawi M, Alghamdi M, Alhoshan S, Alamri S, Alkanhal N, Alsiwat YJ, Alrabiah S, Aldrgham M, AlSaleh AA, Alsanad HA, Alsomaie B. The Patients' Perspective for the Impact of Late Detection of Ocular Diseases on Quality of Life: A Cross-Sectional Study. CLINICAL OPTOMETRY 2023; 15:191-204. [PMID: 37719025 PMCID: PMC10503557 DOI: 10.2147/opto.s422451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 09/01/2023] [Indexed: 09/19/2023]
Abstract
Background Late detection of ocular diseases negatively affects patients' quality of life (QoL), encompassing health status, psychological, financial, and social aspects. However, the early detection of eye conditions leads to rapid intervention and avoiding complications, thus preserving the QoL. This study assessed the impact of ocular diseases late detection on patients' QoL at multi-eye clinics based on questionnaire responses. Methods We developed an original Arabic-English questionnaire to assess the QoL of patients with ocular diseases referred from primary and secondary healthcare centers to tertiary hospitals. It covered preliminary data, patient perspectives on having lately detected ocular disease and treatment costs, and the impact of late detection on finances, social life, psychology, health status, and awareness of current initiatives. Logistic regression analysis was used to explore the associations between patient perspectives on having ocular diseases detected at a late stage and its impact on different domains. Multivariate logistic regression was applied with impact types of health status, psychological, financial, and social (dependent variables) and age, income levels, and hospital type (independent variables). Results Three hundred and eighty-eight responded, with 50% experiencing psychological effects, 27% health issues, 23% social impacts, and 23% financial burdens. Two hundred seventeen patients (56%) reported having ocular condition detected in late stage. Logistic regression analysis showed positive association with health status, social well-being, and financial effects (p < 0.05). Multivariate analysis revealed pronounced effects in patients ≤ 50 years, with income \< 5000 SAR, and those visiting private clinics (p < 0.05). The social impact was greater in patients visiting private hospitals. Ninety percent of all patients emphasized the importance of increasing awareness for better QoL. Conclusion Significant associations were found between the late detection of eye diseases and their impact on QoL. Therefore, early detection and increasing patients' awareness of ocular diseases and treatment are essential.
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Affiliation(s)
- Ahmed Almazroa
- Department of Imaging Research, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Hessa Almatar
- Department of Imaging Research, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Reema Alduhayan
- Department of Imaging Research, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Maram Albalawi
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Department of Biostatistics and Bioinformatics, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Mansour Alghamdi
- Department of Optometry and Vision Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Saja Alhoshan
- Department of Ophthalmology, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Suhailah Alamri
- Department of Imaging Research, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Norah Alkanhal
- Department of Imaging Research, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Yara J Alsiwat
- Department of Imaging Research, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Saad Alrabiah
- Department of Ophthalmology, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Mohammed Aldrgham
- Department of Ophthalmology, King Abdullah bin Abdulaziz University Hospital, Princess Nourah Bint AbdulRahman University, Riyadh, Saudi Arabia
| | | | - Hessa Abdulrahman Alsanad
- Department of Social Planning, College of Social Work, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Barrak Alsomaie
- Department of Imaging Research, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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Gong L, Yu X, Wei L, Zhang R, Cao S, Xiong Y, He Z, Xu M, Yu H, Yu X, Lu F, Qu J, Zhou J. Translating and evaluating the Chinese version of Pediatric Eye Questionnaire (PedEyeQ-CN) for children. Eye (Lond) 2023; 37:1397-1404. [PMID: 35760903 PMCID: PMC10169794 DOI: 10.1038/s41433-022-02157-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 06/08/2022] [Accepted: 06/16/2022] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES To investigate the reliability and validity of Chinese version of the Pediatric Eye Questionnaire (PedEyeQ-CN) by testing ophthalmic patients in China. METHODS The PedEyeQ (standard English version) was translated by local researchers. Children were asked to complete the Child section, and their parents the Proxy and Parent sections. 160 children (32 normal controls, 77 with refractive error, 48 with strabismus/amblyopia, 3 with other eye conditions) aged 5-11 years old, and one parent of each child were recruited. Cronbach's α and intraclass correlation coefficient were calculated to examine the reliability and test-retest reliability; the score differences between controls and patients were compared to examine the validity. RESULTS The internal consistency (Cronbach's α ≥ 0.76) and test-retest reliability (r > 0.80) of PedEyeQ-CN were robust. Children with eye conditions had lower scores compared with children with normal vision (refractive error: 10 out of 13 domains, P ≤ 0.021; strabismus/amblyopia: all domains, P ≤ 0.015). Children with strabismus/amblyopia had lower scores compared with children with refractive error (two domains, P = 0.048, P = 0.001). Visual acuity was significantly correlated with functional vision (P = 0.005), but not significantly correlated with the eye-related quality of life (ER-QOL). CONCLUSIONS The PedEyeQ-CN is a valuable tool for assessing the functional vision and ER-QOL of Chinese children and help us increase our understanding about the impact of eye conditions on children and their families.
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Affiliation(s)
- Ling Gong
- School of Ophthalmology and Optometry, Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xi Yu
- School of Ophthalmology and Optometry, Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Lili Wei
- School of Ophthalmology and Optometry, Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ran Zhang
- School of Ophthalmology and Optometry, Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Suqi Cao
- School of Ophthalmology and Optometry, Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yue Xiong
- School of Ophthalmology and Optometry, Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zhifen He
- School of Ophthalmology and Optometry, Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Meiping Xu
- School of Ophthalmology and Optometry, Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Huanyun Yu
- School of Ophthalmology and Optometry, Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xinping Yu
- Zhongshan Ophthalmic Center, Sun Yat-Sun University, Guangzhou, Guangdong, China.
| | - Fan Lu
- School of Ophthalmology and Optometry, Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jia Qu
- School of Ophthalmology and Optometry, Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jiawei Zhou
- School of Ophthalmology and Optometry, Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, Zhejiang, China.
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6
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Li D, Chan VF, Virgili G, Piyasena P, Negash H, Whitestone N, O'Connor S, Xiao B, Clarke M, Cherwek DH, Singh MK, She X, Wang H, Boswell M, Prakalapakorn SG, Patnaik JL, Congdon N. Impact of Vision Impairment and Ocular Morbidity and Their Treatment on Depression and Anxiety in Children: A Systematic Review. Ophthalmology 2022; 129:1152-1170. [PMID: 35660416 DOI: 10.1016/j.ophtha.2022.05.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 05/25/2022] [Accepted: 05/25/2022] [Indexed: 12/17/2022] Open
Abstract
TOPIC This systematic review and meta-analysis summarizes existing evidence to establish whether vision impairment, ocular morbidity, and their treatment are associated with depression and anxiety in children. CLINICAL RELEVANCE Understanding and quantifying these associations support early detection and management of mental health symptoms in children with vision impairment and ocular morbidity. Additionally, this review provides evidence in favor of insurance coverage for timely strabismus surgery. METHODS We searched 9 electronic databases from inception through February 18, 2021, including observational and interventional studies assessing whether vision impairment, ocular morbidity, or both and their treatment are associated with depression, anxiety, or both in children. We used narrative synthesis and meta-analysis with the residual maximum likelihood method. A protocol was registered and published on The International Prospective Register of Systematic Reviews (identifier: CRD42021233323). RESULTS Among 28 992 studies, 28 956 studies (99.9%) were excluded as duplicates or unrelated content. Among 36 remaining studies, 21 studies (58.3%) were observational studies concerning vision impairment, 8 studies (22.2%) were observational studies concerning strabismus, and 7 studies (19.4%) were interventional studies. Vision impaired children demonstrated significantly higher scores of depression (standard mean difference [SMD], 0.57; 95% confidence interval [CI], 0.26-0.89; 11 studies) and anxiety (SMD, 0.62; 95% CI, 0.40-0.83; 14 studies) than normally sighted children. In particular, children with myopia demonstrated higher scores of depression (SMD, 0.58; 95% CI, 0.36-0.81; 6 studies) than normally sighted children. Strabismus surgery significantly improved symptoms of depression (SMD, 0.59; 95% CI, 0.12-1.06; 3 studies) and anxiety (SMD, 0.69; 95% CI, 0.25-1.14; 4 studies) in children. CONCLUSION Among children, vision impairment is associated with greater symptoms of depression and anxiety. Surgical treatment of strabismus improved these symptoms. Further randomized controlled trials exploring the impact of public health measures for myopia correction on mental health in children are needed. Scaling up access to strabismus surgery could improve the mental health of affected children.
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Affiliation(s)
- Dongfeng Li
- Department of Ophthalmology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China; Department of Ophthalmology, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China; Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Ving Fai Chan
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Gianni Virgili
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom; Department NEUROFARBA, University of Florence, Florence, Italy
| | - Prabhath Piyasena
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | | | | | - Sara O'Connor
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Baixiang Xiao
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom; Affiliated Eye Hospital of Nanchang University, Nanchang City, China
| | - Mike Clarke
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | | | | | - Xinshu She
- School of Medicine, Stanford University, Stanford, California
| | - Huan Wang
- Centre on China's Economy and Institutions, Stanford University, Stanford, California
| | - Matthew Boswell
- Centre on China's Economy and Institutions, Stanford University, Stanford, California
| | - S Grace Prakalapakorn
- Departments of Ophthalmology and Pediatrics and Duke Global Health Institute, Duke University, Durham, North Carolina
| | - Jennifer L Patnaik
- Orbis International, New York, New York; Department of Ophthalmology, University of Colorado School of Medicine, Aurora, Colorado
| | - Nathan Congdon
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom; Orbis International, New York, New York; Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou City, China.
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7
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Temeltürk RD, Koçer AM, Yaşar HH. Psychosocial Improvements in Children and Their Parents Following Strabismus Surgery. J Pediatr Ophthalmol Strabismus 2022; 59:261-268. [PMID: 35076312 DOI: 10.3928/01913913-20211130-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the psychosocial effects of strabismus surgery, the authors investigated the psychiatric symptoms and quality of life of children with strabismus and their parents. METHODS Children with strabismus between 6 and 18 years old (n = 39) and their parents (n = 39) were included. Psychiatric problems and the health-related quality of life were assessed with the Child Behavior Checklist and Pediatric Quality of Life Inventory, respectively. The State-Trait Anxiety Inventory for Children and Beck Anxiety Inventory were administered to children and parents, respectively. All assessments were conducted before and 3 months after strabismus surgery. RESULTS Compared with preoperative assessments, children with strabismus had significantly fewer psychiatric problems and a better quality of life after the surgery (P < .001). Following surgery, decreased symptom levels of anxiety scores were also obtained from children and their parents (P < .001). The amount of ocular realignment was directly correlated with improvement in social and attention problems among children (r = 0.354 and r = 0.324, respectively; P < .05). CONCLUSIONS Successful strabismus surgery has positive effects on psychosocial functioning and quality of life in children and their families. Surgical interventions seem beneficial for the management of strabismus in improving both physical and mental health. [J Pediatr Ophthalmol Strabismus. 2022;59(4):261-268.].
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8
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Lee YH, Repka MX, Borlik MF, Velez FG, Perez C, Yu F, Coleman AL, Pineles SL. Association of Strabismus With Mood Disorders, Schizophrenia, and Anxiety Disorders Among Children. JAMA Ophthalmol 2022; 140:373-381. [PMID: 35266979 PMCID: PMC8914883 DOI: 10.1001/jamaophthalmol.2022.0137] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Importance Children with strabismus have poorer functional vision and decreased quality of life than those without strabismus. Objective To evaluate the association between strabismus and mental illness among children. Design, Setting, and Participants This cross-sectional study analyzed claims data from the OptumLabs Data Warehouse, a longitudinal deidentified commercial insurance claims database, from 12 005 189 patients enrolled in the health plan between January 1, 2007, and December 31, 2017. Eligibility criteria included age younger than 19 years at the time of strabismus diagnosis, enrollment in the health plan between 2007 and 2018, and having at least 1 strabismus claim based on International Classification of Diseases, Ninth Revision, Clinical Modification and International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Clinical Modification codes. Controls were children in the same database with no eye disease codes other than refractive error reported. Demographic characteristics and mental illness claims were compared. Statistical analysis was conducted from December 1, 2018, to July 31, 2021. Main Outcomes and Measures Presence of mental illness claims. Results Among the 12 005 189 patients (6 095 523 boys [50.8%]; mean [SD] age, 8.0 [5.9] years) in the study, adjusted odds ratios for the association of mental illnesses with strabismus were 2.01 (95% CI, 1.99-2.04) for anxiety disorder, 1.83 (95% CI, 1.76-1.90) for schizophrenia, 1.64 (95% CI, 1.59-1.70) for bipolar disorder, 1.61 (95% CI, 1.59-1.63) for depressive disorder, and 0.99 (95% CI, 0.97-1.02) for substance use disorder. There was a moderate association between each strabismus type (esotropia, exotropia, and hypertropia) and anxiety disorder, schizophrenia, bipolar disorder, and depressive disorder; odds ratios ranged from 1.23 (95% CI, 1.17-1.29) for the association between esotropia and bipolar disorder to 2.70 (95% CI, 2.66-2.74) for the association between exotropia and anxiety disorder. Conclusions and Relevance This cross-sectional study suggests that there was a moderate association between strabismus and anxiety disorder, schizophrenia, bipolar disorder, and depressive disorder but not substance use disorder. Recognizing that these associations exist should encourage mental illness screening and treatment for patients with strabismus.
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Affiliation(s)
- Yoon H Lee
- Department of Ophthalmology, Stein Eye Institute, University of California, Los Angeles, Los Angeles
| | - Michael X Repka
- Department of Ophthalmology, Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Marcy F Borlik
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles
| | - Federico G Velez
- Department of Ophthalmology, Stein Eye Institute, University of California, Los Angeles, Los Angeles.,Department of Ophthalmology, Doheny Eye Institute, University of California, Los Angeles, Los Angeles.,Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
| | - Claudia Perez
- Department of Medicine Statistics Core, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles
| | - Fei Yu
- Department of Ophthalmology, Stein Eye Institute, University of California, Los Angeles, Los Angeles.,Department of Biostatistics, University of California, Los Angeles Fielding School of Public Health, Los Angeles
| | - Anne L Coleman
- Department of Ophthalmology, Stein Eye Institute, University of California, Los Angeles, Los Angeles.,Department of Epidemiology, University of California, Los Angeles Fielding School of Public Health, Los Angeles
| | - Stacy L Pineles
- Department of Ophthalmology, Stein Eye Institute, University of California, Los Angeles, Los Angeles.,OptumLabs, Eden Prairie, Minnesota
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9
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Gu S, Hu Y, Zhao Y, Chen L, Sun W, Chang P, Wang D, Zhao Y. A Retrospective Study on the Eye-Related Quality of Life, Functional Vision, and Their Determinants Among Children Following Congenital and Developmental Cataracts Surgery and Its Impact on Their Families Using the PedEyeQ. Front Public Health 2022; 10:788384. [PMID: 35372237 PMCID: PMC8968105 DOI: 10.3389/fpubh.2022.788384] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 02/21/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectivesTo evaluate the eye-related quality of life (ER-QOL), functional vision, and their determinants in children following congenital and developmental cataract surgery, as the impact on their families, using the Pediatric Eye Questionnaire (PedEyeQ).Materials and MethodsThis was a retrospective cross-sectional study involving 107 children (aged 0–11 years) with congenital and developmental cataracts who had undergone surgery, as well as 59 visually healthy controls (aged 0–11 years). One parent for each child completed either the Proxy 0–4 PedEyeQ, the Proxy 5–11 PedEyeQ, or the Parent PedEyeQ, depending on their child's age. Mann-Whitney U and Kruskal-Wallis tests were then conducted to compare the differences between groups and to analyze their determinants.ResultsPedEyeQ scores were found to be lower in postoperative children with congenital and developmental cataracts compared with the control group across all study domains. The PedEyeQ Proxy 0 to 4 years' greatest mean difference was 27 points worse in the Functional Vision domain (95% CI −34 to −19; p < 0.001). We also found that the occurrence of nystagmus (p < 0.005) and strabismus (p < 0.005) were the major factors affecting participants' functional vision. The PedEyeQ Proxy 5 to 11 years' greatest mean difference was 23 points worse in this same domain (95% CI −30 to −15; p < 0.001), with nystagmus (p < 0.05) being the main determinant herein. Parent PedEyeQ 0 to 4 years' greatest difference was 46 points worse on the Worry about their Child's Eye Condition domain (95% CI −57 to −36; p < 0.001). Similarly, parents of children with ophthalmologic abnormalities, including nystagmus (p < 0.001) and strabismus (p < 0.05), were significantly more worried about their children's eye condition. Parent PedEyeQ 5 to 11 years' greatest difference was also found to be 30 points worse on the Worry about their Child's Eye Condition domain (95% CI −43 to −17; p < 0.005).ConclusionsChildren who have undergone congenital and developmental cataract surgery experience a lower quality of life and reduced functional vision. Their families are also significantly and adversely affected herein. Thus, more attention is needed on these groups, with more focused measures being administered to both children and their families.
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Affiliation(s)
- Siyi Gu
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, China
- Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China
| | - Yiwen Hu
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, China
- Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China
| | - Yinying Zhao
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, China
- Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China
| | - Lulu Chen
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, China
- Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China
| | - Weijie Sun
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, China
- Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China
| | - Pingjun Chang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, China
- Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China
| | - Dandan Wang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, China
- Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China
| | - Yune Zhao
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, China
- Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China
- *Correspondence: Yune Zhao
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Tadiotto TF, Hungria CCAD, Ventorin BS, Morais AFL, Mariuzzo LCA, Issaho DC. Quality of life in children with strabismus. REVISTA BRASILEIRA DE OFTALMOLOGIA 2022. [DOI: 10.37039/1982.8551.20220018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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11
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Silva N, Castro C, Caiado F, Maia S, Miranda V, Parreira R, Menéres P. Evaluation of Functional Vision and Eye-Related Quality of Life in Children with Strabismus. Clin Ophthalmol 2022; 16:803-813. [PMID: 35321043 PMCID: PMC8934867 DOI: 10.2147/opth.s354835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 02/14/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Nisa Silva
- Department of Ophthalmology, Centro Hospitalar Universitário do Porto, Porto, Portugal
- Correspondence: Nisa Silva, Department of Ophthalmology, Centro Hospitalar Universitário do Porto, Largo do Prof. Abel Salazar, Porto, 4099-001, Portugal, Tel +35 1918367661, Fax +35 1222077500, Email
| | - Catarina Castro
- Department of Ophthalmology, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Filipa Caiado
- Department of Ophthalmology, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Sofia Maia
- Department of Ophthalmology, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Vasco Miranda
- Department of Ophthalmology, Centro Hospitalar Universitário do Porto, Porto, Portugal
- Department of Ophthalmology, Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal
| | - Ricardo Parreira
- Department of Ophthalmology, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Pedro Menéres
- Department of Ophthalmology, Centro Hospitalar Universitário do Porto, Porto, Portugal
- Department of Ophthalmology, Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal
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12
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Mao D, Lin J, Chen L, Luo J, Yan J. Health-related quality of life and anxiety associated with childhood intermittent exotropia before and after surgical correction. BMC Ophthalmol 2021; 21:270. [PMID: 34193079 PMCID: PMC8247233 DOI: 10.1186/s12886-021-02027-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 06/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Intermittent exotropia (IXT) is the most common form of exotropia in children. In addition to cosmetic effects and loss of stereoscopic function, IXT may negatively impact the psychological well-being of children and their parents. The purpose of this study was to assess the patient-reported outcomes of Chinese children with IXT before and after strabismus surgery. METHODS The records of children with IXT who underwent strabismus surgery at the Zhongshan Ophthalmic Center of Sun Yat-sen University, China over the period from January 1, 2016 to December 31, 2018 were prospectively recruited. All children underwent ophthalmic and orthoptic examinations, including the prism and alternate cover test, fusion function by synoptophore, stereoacuity and Newcastle control score. Two patient-reported outcome measures were used: the intermittent Exotropia Questionnaire (IXTQ) to measure disease-specific health-related quality of life (HRQOL) and the Hospital Anxiety and Depression Scale (HADS) to measure anxiety and depression. Patient-reported outcome measurements were made before and after surgery with responses from children and their parents. RESULTS A total of 389 children were eligible for inclusion (47.8% male, 52.2% female, mean + SD age = 8.17 ± 2.81). Preoperative IXTQ scores in both children (48.21 ± 26.2) and their parents (44.6 ± 25.68) were significantly correlated with near stereoacuity (P = 0.029 and P = 0.015, respectively). The angle of deviation at near vision showed a negative linear relationship with visual function (P = 0.026) and psychological (P = 0.019) scores as well as opinions regarding surgery (P = 0.024). HADS scores (anxiety scale score: 11 ± 2.92, depression scale score: 10.44 ± 2.9) were also related to near stereoacuity (P < 0.05). After surgery, both children's (74.83 ± 16.59) and parents' (68.57 ± 17.06) IXTQ scores significantly improved (p<0.01). Children's IXTQ scores were related to the angle of deviation at distance, and their psychological and visual function scores showed a negative relationship with the angle of deviation at near vision (P < 0.05). CONCLUSION Children and parents' HRQOL and HADS were associated with near stereoacuity. Parents usually attend more readily to the angle of deviation at near in their IXT children. HRQOL improved significantly after surgery and can be used as one of the indices for preoperative evaluation but is not recommended as a criterion for surgical intervention.
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Affiliation(s)
- Danyi Mao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China
| | - Jing Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China
| | - Lina Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China
| | - Jiying Luo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China
| | - Jianhua Yan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China.
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13
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Kumaran SE, Khadka J, Baker R, Pesudovs K. Patient‐reported outcome measures in amblyopia and strabismus: a systematic review. Clin Exp Optom 2021. [DOI: 10.1111/cxo.12553] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Sheela E Kumaran
- Discipline of Optometry and Vision Science, Flinders University, Adelaide, South Australia, Australia,
| | - Jyoti Khadka
- Discipline of Optometry and Vision Science, Flinders University, Adelaide, South Australia, Australia,
| | - Rod Baker
- Discipline of Optometry and Vision Science, Flinders University, Adelaide, South Australia, Australia,
| | - Konrad Pesudovs
- Discipline of Optometry and Vision Science, Flinders University, Adelaide, South Australia, Australia,
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14
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The impact of strabismus on psychosocial heath and quality of life: a systematic review. Surv Ophthalmol 2021; 66:1051-1064. [PMID: 33773997 DOI: 10.1016/j.survophthal.2021.03.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 03/09/2021] [Accepted: 03/15/2021] [Indexed: 02/07/2023]
Abstract
Strabismus can hinder an individual's ability to perform daily functions and negatively affect their well-being. I examine the impact strabismus has on psychosocial health and quality of life in children and adults and evaluate the challenges confronted by parents of children with strabismus. Numerous misconceptions exist regarding the impact strabismus has on overall health. Negative attitudes persist toward those affected, resulting in difficulties with self-image. Individuals with strabismus are at increased risk for both visual system and psychiatric disorders. Misinformation regarding available treatment options for children and adults with strabismus continues to exist, resulting in decreased access to care. Improved education of health care providers can increase appropriate referrals and initiation of treatment. Treatment of strabismus is not merely cosmetic and has the potential to improve psychosocial health and quality of life for children and adults with and without diplopia.
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15
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Hatt SR, Leske DA, Castañeda YS, Wernimont SM, Liebermann L, Cheng-Patel CS, Birch EE, Holmes JM. Association of Strabismus With Functional Vision and Eye-Related Quality of Life in Children. JAMA Ophthalmol 2021; 138:528-535. [PMID: 32215586 DOI: 10.1001/jamaophthalmol.2020.0539] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Strabismus is common, affecting 2% to 4% of children, but how children and their families are affected in everyday life is poorly understood. Objective To evaluate the association of strabismus with functional vision and eye-related quality of life in children and their families using the Pediatric Eye Questionnaire (PedEyeQ). Design, Setting, and Participants This cross-sectional study was conducted between December 2017 and October 2019 and included 91 children with strabismus and 166 visually normal controls across 3 age groups (0-4, 5-11, and 12-17 years) who were enrolled at Mayo Clinic, Rochester, Minnesota, and Retina Foundation of the Southwest, Dallas, Texas. Exposures Children completed the child PedEyeQ (5 to 11- and 12 to 17-year versions: functional vision, bothered by eyes/vision, social, and frustration/worry domains); parents completed the proxy (0 to 4-, 5 to 11-, and 12 to 17-year versions: functional vision, bothered by eyes/vision, social, frustration/worry, and eye care domains) and the parent PedEyeQ (impact on parent and family, worry about child's eye condition, worry about child's self-perception and interactions, and worry about child's functional vision domains). Rasch-calibrated PedEyeQ scores were calculated for each domain and converted to 0 (worst) to 100. Main Outcomes and Measures PedEyeQ domain scores. Results Of 91 participants with strabismus, 41 (45.1%) were girls, 74 (81.3%) were white, 4 (4.4%) were Asian, 5 (5.5%) were more than 1 race, 5 (5.5%) were African American, and 2 (2.2%) were American Indian/Alaska Native. Child PedEyeQ domain scores were lower with strabismus vs visually normal controls among children ages 5 to 11 years and the greatest mean (SD) difference was in functional vision (12 [14] points; 95% CI, 6-18; P = .001), and among children ages 12 to 17 years, the greatest mean (SD) difference was in frustration/worry (27 [13] points; 95% CI, 18-36; P < .001). Proxy PedEyeQ domain scores were also lower with strabismus. The greatest difference among children ages 0 to 4 years was in functional vision (13 [9] points; 95% CI, 9-16; P < .001), among children ages 5 to 11 years was in functional vision (26 [10] points; 95% CI, 22-30; P < .001); and among children ages 12 to 17 years was in functional vision (21 [12] points; 95% CI, 12-30; P < .001), social (21 [13] points; 95% CI, 12-30; P < .001), and frustration/worry (21 [13] points; 95% CI, 12-30; P < .001). Parent PedEyeQ domain scores were lower with strabismus; the greatest difference was in worry about child's eye condition (38 [14] points; 95% CI, 34-42; P < .001). Conclusions and Relevance Strabismus is associated with reduced functional vision and eye-related quality of life in children. Parents of children with strabismus also experience a reduced quality of life. These findings advance our understanding of how strabismus affects children and their families and should be considered when defining patient management goals.
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Affiliation(s)
- Sarah R Hatt
- Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota
| | - David A Leske
- Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota
| | | | | | | | | | - Eileen E Birch
- Retina Foundation of the Southwest, Dallas, Texas.,Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas
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16
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A dichoptic feedback-based oculomotor training method to manipulate interocular alignment. Sci Rep 2020; 10:15634. [PMID: 32973252 PMCID: PMC7515870 DOI: 10.1038/s41598-020-72561-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 08/24/2020] [Indexed: 11/15/2022] Open
Abstract
Strabismus is a prevalent impairment of binocular alignment that is associated with a spectrum of perceptual deficits and social disadvantages. Current treatments for strabismus involve ocular alignment through surgical or optical methods and may include vision therapy exercises. In the present study, we explore the potential of real-time dichoptic visual feedback that may be used to quantify and manipulate interocular alignment. A gaze-contingent ring was presented independently to each eye of 11 normally-sighted observers as they fixated a target dot presented only to their dominant eye. Their task was to center the rings within 2° of the target for at least 1 s, with feedback provided by the sizes of the rings. By offsetting the ring in the non-dominant eye temporally or nasally, this task required convergence or divergence, respectively, of the non-dominant eye. Eight of 11 observers attained 5° asymmetric convergence and 3 of 11 attained 3° asymmetric divergence. The results suggest that real-time gaze-contingent feedback may be used to quantify and transiently simulate strabismus and holds promise as a method to augment existing therapies for oculomotor alignment disorders.
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17
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Schuster AK, Elflein HM, Pokora R, Schlaud M, Baumgarten F, Urschitz MS. Health-related quality of life and mental health in children and adolescents with strabismus - results of the representative population-based survey KiGGS. Health Qual Life Outcomes 2019; 17:81. [PMID: 31064363 PMCID: PMC6505127 DOI: 10.1186/s12955-019-1144-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 04/15/2019] [Indexed: 11/12/2022] Open
Abstract
Background To estimate the effect of strabismus (squinting) on mental health and health-related quality of life aspects in children and adolescents. Methods Data from the German Health Interview and Examination Survey for Children and Adolescents KiGGS (2003–2006 baseline survey; N = 14,835, aged 3 to 17 years, 49% girls) were examined. The presence of strabismus was derived by parental questionnaire, and health-related quality of life and mental health were investigated with the KINDL-R and Strengths and Difficulties Questionnaire. Associations between strabismus and outcomes were analyzed using multivariable linear and logistic regression models. Results Of 12,989 children without missing data, 579 children (4.5% of the sample) were reported to have strabismus. Children with strabismus had lower scores in the parent-reported KINDL-R total scale (adjusted beta = − 1.02; 95%CI: -1.86 to − 0.18; p = 0.018) and sub-scale ‘friends’ (adjusted beta = − 2.18; 95%CI: -3.56 to -0.80; p = 0.002) compared to children without strabismus. The presence of strabismus was also associated with more mental health problems like ‘hyperactivity/inattention’ (adjusted OR = 1.50; 95%CI: 1.14 to 1.98; p = 0.005), and ‘peer problems’ (adjusted OR = 1.35; 95%-CI: 1.05 to 1.74; p = 0.018) as reported by parents. Conclusions Strabismus in children and adolescents is associated with lower health-related quality of life. Electronic supplementary material The online version of this article (10.1186/s12955-019-1144-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alexander K Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.
| | - Heike M Elflein
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Roman Pokora
- Division of Pediatric Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Martin Schlaud
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Franz Baumgarten
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Michael S Urschitz
- Division of Pediatric Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
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18
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Ozates S, Ezerbolat Ozates M, Can CU, Polat S, Yasar HH, Taskale B, Gogus AK. Improvement in psychiatric symptoms after strabismus surgery in adolescent patients in long-term follow-up. Br J Ophthalmol 2018; 103:966-970. [DOI: 10.1136/bjophthalmol-2018-312510] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 07/02/2018] [Accepted: 07/21/2018] [Indexed: 11/04/2022]
Abstract
AimsTo assess the psychological effects of preoperative primary eye position and surgical correction of strabismus in adolescent patients.MethodsEighty-three adolescent patients with exotropia were included in this observational and prospective study. Patients with preoperative manifest exotropia formed the manifest exotropia group. Patients with intermittent exotropia that had orthophoria with overcorrecting minus lenses and recently increased frequency of manifest phase were indicated for surgery and formed the latent deviation group. All patients were scored with the Turkish version of the Social Appearance Anxiety Scale (SAAS), depression subscale of Hospital Anxiety and Depression Scale (HAD-D) Brief Fear of Negative Evaluation Scale (BFNE), state anxiety subscale of State-Trait Anxiety Inventory (STAI-S) and trait anxiety subscale of State-Trait Anxiety Inventory (STAI-T) before and 1 year after strabismus surgery.ResultsThe mean preoperative scores of the HAD-D, SAAS, BFNE, STAI-S and STAI-T before strabismus surgery were significantly higher in the manifest exotropia group than in the latent deviation group (p≤0.001 for all). Surgical correction significantly improved the outcomes of all scales in the manifest exotropia group (p≤0.001 for all). Outcomes of the STAI-S and STAI-T significantly improved in the latent deviation group after the surgery (p=0.008, p=0.006, respectively), whereas outcomes of the HAD-D, SAAS and BFNE did not improve (p=0.079, p=0.071, p=0.127, respectively). The mean postoperative scores of all scales did not differ between the two groups (p>0.05 for all).ConclusionsStrabismus has psychological consequences in adolescent patients, and the visible eye deviation caused by strabismus is a strong indicator of psychological distress.
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Hull S, Tailor V, Balduzzi S, Rahi J, Schmucker C, Virgili G, Dahlmann‐Noor A. Tests for detecting strabismus in children aged 1 to 6 years in the community. Cochrane Database Syst Rev 2017; 11:CD011221. [PMID: 29105728 PMCID: PMC6486041 DOI: 10.1002/14651858.cd011221.pub2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Strabismus (misalignment of the eyes) is a risk factor for impaired visual development both of visual acuity and of stereopsis. Detection of strabismus in the community by non-expert examiners may be performed using a number of different index tests that include direct measures of misalignment (corneal or fundus reflex tests), or indirect measures such as stereopsis and visual acuity. The reference test to detect strabismus by trained professionals is the cover‒uncover test. OBJECTIVES To assess and compare the accuracy of tests, alone or in combination, for detection of strabismus in children aged 1 to 6 years, in a community setting by non-expert screeners or primary care professionals to inform healthcare commissioners setting up childhood screening programmes.Secondary objectives were to investigate sources of heterogeneity of diagnostic accuracy. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 12) (which contains the Cochrane Eyes and Vision Trials Register) in the Cochrane Library, the Health Technology Assessment Database (HTAD) in the Cochrane Library (2016, Issue 4), MEDLINE Ovid (1946 to 5 January 2017), Embase Ovid (1947 to 5 January 2017), CINAHL (January 1937 to 5 January 2017), Web of Science Conference Proceedings Citation Index-Science (CPCI-S) (January 1990 to 5 January 2017), BIOSIS Previews (January 1969 to 5 January 2017), MEDION (to 18 August 2014), the Aggressive Research Intelligence Facility database (ARIF) (to 5 January 2017), the ISRCTN registry (www.isrctn.com/editAdvancedSearch); searched 5 January 2017, ClinicalTrials.gov (www.clinicaltrials.gov); searched 5 January 2017 and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en); searched 5 January 2017. We did not use any date or language restrictions in the electronic searches for trials. In addition, orthoptic journals and conference proceedings without electronic listings were searched. SELECTION CRITERIA All prospective or retrospective population-based test accuracy studies of consecutive participants were included. Studies compared a single or combination of index tests with the reference test. Only those studies with sufficient data for analysis were included specifically to calculate sensitivity and specificity and determine diagnostic accuracy.Participants were aged 1 to 6 years. Studies reporting participants outside this range were included if subgroup data were available.Permitted settings included population-based vision screening programmes or opportunistic screening programmes, such as those performed in schools. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. In brief, two review authors independently assessed titles and abstracts for eligibility and extracted the data, with a third senior author resolving any disagreement. We analysed data primarily for specificity and sensitivity. MAIN RESULTS One study from a total of 1236 papers, abstracts and trials was eligible for inclusion with a total number of participants of 335 of which 271 completed both the screening test and the gold standard test. The screening test using an automated photoscreener had a sensitivity of 0.46 (95% confidence interval (CI) 0.19 to 0.75) and specificity of 0.97 (CI 0.94 to 0.99). The overall number affected by strabismus was low at 13 (4.8%). AUTHORS' CONCLUSIONS There is very limited data in the literature to ascertain the accuracy of tests for detecting strabismus in the community as performed by non-expert screeners. A large prospective study to compare methods would be required to determine which tests have the greatest accuracy.
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Affiliation(s)
- Sarah Hull
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology162 City RoadLondonUKEC1V 2PD
| | - Vijay Tailor
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology162 City RoadLondonUKEC1V 2PD
| | - Sara Balduzzi
- University of Modena and Reggio EmiliaCochrane Italy, Department of Diagnostic, Clinical and Public Health MedicineVia del Pozzo 71ModenaItaly41124
| | - Jugnoo Rahi
- UCL Institute of Child Health and UCL Institute of OphthalmologyDepartment of EpidemiologyLondonUK
| | - Christine Schmucker
- Medical Center – Univ. of Freiburg, Faculty of Medicine, Univ. of FreiburgCochrane GermanyBreisacher Straße 153FreiburgGermany79110
| | - Gianni Virgili
- University of FlorenceDepartment of Translational Surgery and Medicine, Eye ClinicLargo Brambilla, 3FlorenceItaly50134
| | - Annegret Dahlmann‐Noor
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology162 City RoadLondonUKEC1V 2PD
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Liebermann L, Leske DA, Castañeda YS, Hatt SR, Wernimont SM, Cheng CS, Birch EE, Holmes JM. Childhood esotropia: child and parent concerns. J AAPOS 2016; 20:295-300.e1. [PMID: 27381528 PMCID: PMC5116237 DOI: 10.1016/j.jaapos.2016.04.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 04/19/2016] [Accepted: 04/21/2016] [Indexed: 12/01/2022]
Abstract
PURPOSE To identify specific health-related quality of life (HRQOL) concerns affecting children with esotropia as expressed by children or one of their parents (proxy) and concerns affecting the parents themselves. METHODS Sixty children with esotropia (0-17 years of age) and 1 parent for each child were prospectively enrolled. Individual semistructured interviews were conducted with children aged 5-17 years (n = 40) and 1 parent each for child ages 0-17 years. Transcripts of recorded interviews were evaluated using NVivo software. Specific concerns were identified from both child and parent interviews and coded. From these specific codes, broad themes were identified. Frequency of each theme was calculated, along with the frequency of specific codes within each theme. RESULTS Regarding the child's experience 6 broad themes were identified: visual function (mentioned by 32 of 40 children (80%) and by 50 of 60 parents (proxy assessment of child, 83%), treatment (78% and 85%), emotions (65% and 67%), social (58% and 68%), physical (58% and 32%), and worry (45% and 7%). Regarding the parents' own experience, 5 broad themes were identified: treatment (59 of 60 parents, 98%), worry (97%), emotions (82%), compensation for condition (80%), and affects family (23%). CONCLUSIONS A wide range of concerns were identified from interviews of children with esotropia and their parents. Concerns reflect the impact of esotropia in physical, emotional, and social domains, and specific concerns will be used for the development of questionnaires to quantify the effects of esotropia on children's and parents' quality of life.
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Affiliation(s)
| | - David A Leske
- Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota
| | | | - Sarah R Hatt
- Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota
| | | | | | - Eileen E Birch
- Retina Foundation of the Southwest, Dallas, Texas; Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, Texas
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Affiliation(s)
- Saeid Shahraz
- Predictive Analytics and Comparative Effectiveness Center, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts, USA
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Griffith JF, Wilson R, Cimino HC, Patthoff M, Martin DF, Traboulsi EI. The Use of a Mobile Van for School Vision Screening: Results of 63 841 Evaluations. Am J Ophthalmol 2016; 163:108-114.e1. [PMID: 26621684 DOI: 10.1016/j.ajo.2015.11.026] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Revised: 11/14/2015] [Accepted: 11/17/2015] [Indexed: 12/01/2022]
Abstract
PURPOSE To present data from an established mobile screening program for children in the amblyogenic age group using gold-standard examination techniques by eye care professionals. DESIGN Retrospective 12-year, cross-sectional study. METHODS setting: Single center. STUDY POPULATION All children enrolled in pre-kindergarten, kindergarten, and first grades in public schools in Cleveland, Ohio were eligible for evaluations. intervention procedure: An ophthalmic technician and/or optometrist examined children in a customized van that visits all elementary schools. The initial screening included testing of monocular near and distance visual acuity, stereoacuity, ocular alignment, motility, pupils, and external abnormalities. Children meeting the 2003 American Academy of Pediatrics vision screening referral criteria underwent cycloplegic retinoscopy and ophthalmoscopy by the on-site optometrist and received glasses. In addition, these children were referred to pediatric ophthalmology for ongoing care. MAIN OUTCOME MEASURE Determination of the proportion of children with refractive errors, amblyopia, and/or strabismus. RESULTS Between 2002 and 2014, 63 841 evaluations were performed, representing approximately 55% of eligible children. Overall, 6386 (10.0%) of children met 1 or more referral criteria: 5355 (8.39%) received glasses, 873 (1.37%) had amblyopia, and 1125 (1.76%) had strabismus. Over the 12-year period, there was no statistically significant change in the prevalence of strabismus (1.73%-2.24%, P = .91) or amblyopia (0.9%-2.08%, P = .13) among first grade students. CONCLUSIONS Amblyopia, strabismus, and refractive errors are common in young children. During the study period, the rates of amblyopia and strabismus remained stable, indicating the need for continued vision screening and treatment services. A van-based model, traveling directly to schools, appears to be effective in reaching young children in underserved communities.
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Affiliation(s)
| | - Rhonda Wilson
- Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio
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Tan G, Huang X, Zhang Y, Wu AH, Zhong YL, Wu K, Zhou FQ, Shao Y. A functional MRI study of altered spontaneous brain activity pattern in patients with congenital comitant strabismus using amplitude of low-frequency fluctuation. Neuropsychiatr Dis Treat 2016; 12:1243-50. [PMID: 27284244 PMCID: PMC4882152 DOI: 10.2147/ndt.s104756] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE The aim of this study was to use amplitude of low-frequency fluctuation (ALFF) to investigate local features of spontaneous brain activity in patients with congenital comitant strabismus and clarify their relationship with emotional and psychosocial problems. METHODS A total of 20 patients with congenital comitant strabismus (ten males and ten females), and 20 healthy controls (ten males and ten females) closely matched in age, sex, and education underwent resting-state functional magnetic resonance imaging scans. The ALFF method was used to assess local features of spontaneous brain activity. Congenital comitant strabismus patients were distinguished from healthy controls by receiver operating characteristic curve. Correlation analysis was performed to explore the relationships between the observed mean ALFF signal values of the different areas and the Chinese version of the Hospital Anxiety and Depression Scale. RESULTS Compared with healthy controls, patients with congenital comitant strabismus had significantly lower ALFF in the bilateral medialfrontal gyrus and higher values in the bilateral cerebellum posterior lobe and left angular gyrus. In the congenital comitant strabismus group, the Hospital Anxiety and Depression Scale-depression score showed a negative correlation with the ALFF signal values of the bilateral medial frontal gyrus (r=-0.550, P=0.012) and a negative correlation was noted between the mean ALFF signal values of the left angular gyrus and strabismus duration (r=-0.515, P=0.020). CONCLUSION Congenital comitant strabismus mainly involves dysfunction in the bilateral medial frontal gyrus, bilateral cerebellum posterior lobe, and left angular gyrus, which may reflect the underlying pathologic mechanism of congenital strabismus.
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Affiliation(s)
- Gang Tan
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute and Oculopathy Research Centre, Nanchang, Jiangxi, People's Republic of China; Department of Ophthalmology, The First Affiliated Hospital of University of South China, Hengyang, Hunan, People's Republic of China
| | - Xin Huang
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute and Oculopathy Research Centre, Nanchang, Jiangxi, People's Republic of China; Department of Ophthalmology, The First People's Hospital of Jiujiang City, Jiujiang, People's Republic of China
| | - Ying Zhang
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute and Oculopathy Research Centre, Nanchang, Jiangxi, People's Republic of China
| | - An-Hua Wu
- Department of Ophthalmology, The First Affiliated Hospital of University of South China, Hengyang, Hunan, People's Republic of China
| | - Yu-Lin Zhong
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute and Oculopathy Research Centre, Nanchang, Jiangxi, People's Republic of China
| | - Kai Wu
- Department of Ophthalmology, The First Affiliated Hospital of University of South China, Hengyang, Hunan, People's Republic of China
| | - Fu-Qing Zhou
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Medical Imaging Research Institute, Nanchang, Jiangxi, People's Republic of China
| | - Yi Shao
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute and Oculopathy Research Centre, Nanchang, Jiangxi, People's Republic of China
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Yu H, Yang X, Ye T, Chen J, Zhang F, Yu X. Development and Evaluation of a Chinese Version of the Adult Strabismus Questionnaire (AS-20). Ophthalmic Epidemiol 2013; 20:239-47. [DOI: 10.3109/09286586.2013.809771] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Tadic V, Hogan A, Sobti N, Knowles RL, Rahi JS. Patient-reported outcome measures (PROMs) in paediatric ophthalmology: a systematic review. Br J Ophthalmol 2013; 97:1369-81. [PMID: 23743433 DOI: 10.1136/bjophthalmol-2013-303350] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIM To identify patient-reported outcome measures (PROMs) specifically developed and used to assess the impact of ophthalmic disorders in children and to systematically assess their quality as a basis for recommendations about their use in clinical and research settings. METHODS A systematic review of the literature was performed in MEDLINE, EMBASE, PsychINFO, CINAHL and AMED, supplemented by a grey literature search. Papers reporting development and validation of questionnaire instruments for assessing patient-reported outcomes of an ophthalmic disorder in patients aged 2-18 years were included. Quality was assessed by examining the purpose and psychometric properties of the instruments. Strengths and limitations were summarised with recommendations regarding use. RESULTS Search identified 17 instruments. Of these, 11 were condition-specific and six were intended for a broader population of children and young people with visual impairment regardless of the ophthalmic condition. Three were developed for use in a specific trial and two are still in development. CONCLUSIONS Paediatric ophthalmology PROM development and application is a developing field and new instruments are needed. There is scope for improvement in this area through (a) clarity of definitions of the underlying constructs intended to be measured at the onset of development of new instruments, (b) application of child-centred approaches and (c) adherence to extant guidance and best practice in questionnaire instrument development.
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Affiliation(s)
- Valerija Tadic
- Medical Research Council (MRC) Centre of Epidemiology for Child Health at the Centre for Paediatric Epidemiology and Biostatistics, University College London (UCL) Institute of Child Health, , London, UK
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Yu Y, Feng L, Shao Y, Tu P, Wu HP, Ding X, Xiao WH. Quality of life and emotional change for middle-aged and elderly patients with diabetic retinopathy. Int J Ophthalmol 2013; 6:71-4. [PMID: 23549357 DOI: 10.3980/j.issn.2222-3959.2013.01.15] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2012] [Accepted: 01/20/2013] [Indexed: 12/27/2022] Open
Abstract
AIM To evaluate the SF-36, Diabetes Specificity Quality of Life Scale (DSQL) and anxiety and depression symptoms and investigate its changes in proliferative diabetic retinopathy (PDR) by vitrectomy interventions. METHODS The present study included 108 diabetic retinopathy (DR) patients: 54 with PDR and 54 with non-proliferative diabetic retinopathy (NPDR). Each healthy control group (n=54) sociodemographically matched to DR groups was established respectively. The quality of life, anxiety and depression symptoms were evaluated and analyzed on preoperative and postoperative month 1 using SF-36, DSQL and Hospital Anxiety and Depression Scale (HADS). RESULTS DR patients described impaired HRQL (Health Related Quality of life, SF-36) in 6 out of 8 subscales, including 'Body Health', 'Body Role Function', 'General Health', 'Society Function', 'Emotion Role Function' and 'Mental Health'. Compared with controls, DR patients (NPDR and PDR) suffered from statistically significantly impaired HRQL (SF-36 Summary score) (P<0.05). By surgical intervention, the anxiety and depression score were significantly reduced, while the health and quality of life (SF-36 Summary scores and DSQL scores) was improved in patients with PDR (P<0.05). CONCLUSION DR patients were affected in mentation and quality of life. Surgery interventions can improve SF-36, DSQL, anxiety and depression in PDR patients.
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Affiliation(s)
- Yao Yu
- Department of Endocrinology, the First Affiliated Hospital, Medical College of Jinan University, Guangzhou 510632, Guangdong Province, China ; Department of Endocrinology, the Third Hospital of Nanchang, the Affiliated Nanchang Hospital of Southern Medical University, Nanchang 330009, Jiangxi Province, China
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Hatt SR, Leske DA, Holmes JM. Responsiveness of health-related quality-of-life questionnaires in adults undergoing Strabismus surgery. Ophthalmology 2010; 117:2322-2328.e1. [PMID: 20832120 DOI: 10.1016/j.ophtha.2010.03.042] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2009] [Revised: 03/12/2010] [Accepted: 03/16/2010] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE To evaluate the responsiveness of 2 health-related quality-of-life (HRQOL) questionnaires, the Adult Strabismus-20 (AS-20) and National Eye Institute Visual Function Questionnaire-25 (VFQ-25), to changes in HRQOL after strabismus surgery. DESIGN Cohort study. PARTICIPANTS We included 106 adults (aged 18-84 years; median, 48.5) undergoing strabismus surgery, 80 (75%) with diplopia and 26 (25%) without diplopia. METHODS All participants completed AS-20 and VFQ-25 questionnaires preoperatively and a median of 7 weeks (range, 4-13) postoperatively. Using predefined clinical criteria, postoperative outcomes were graded as either "success" (n = 65), "partial success" (n = 32), or "failure" (n = 9). MAIN OUTCOME MEASURES For each questionnaire, mean composite and subscale scores (range, 0-100; worst to best HRQOL) were calculated for each patient. Median change in scores pre- to postoperatively was compared for successes, partial successes, and failures, and the proportion of patients whose scores exceeded 95% limits of agreement was calculated. RESULTS Successfully aligned diplopic patients (n = 46) showed greater improvement than failures (n = 7) using both the AS-20 questionnaire (21.3 [quartiles 12.5-35.0] vs. 8.8 [3.8-12.5]; P = 0.002) and the VFQ-25 questionnaire (18.3 [8.6-26.1] vs 8.3 [0.8-13.5]; P = 0.02). Successfully aligned nondiplopic patients (n = 19) also showed greater improvement than failures (n = 2; AS-20, 23.8 [10.0-32.5] vs -3.1 [-10.0 to 3.8]; P = 0.05). In nondiplopic patients, changes on VFQ-25 were small but significantly greater for successes than failures (5.0 [0.0-10.1] vs -15.4 [-19.4 to -11.4]; P = 0.03). More successfully aligned patients showed improvement exceeding the 95% limits of agreement for AS-20 scores than VFQ-25 scores (67% vs 65% [P = 0.8] for diplopic patients and 63% vs 21% [P = 0.005] for nondiplopic patients). CONCLUSIONS The AS-20 and VFQ-25 questionnaires are responsive to improved HRQOL in adults undergoing successful strabismus surgery. Changes on VFQ-25 were smaller, particularly for nondiplopic strabismus. The AS-20 is more responsive than the VFQ-25 across the range of adult strabismus.
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Affiliation(s)
- Sarah R Hatt
- Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, USA
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