Wickwar S, McBain H B, Ezra D G, Hirani S P, Rose G E, Newman S P
1] Centre for Health Services Research, School of Community & Health Sciences, City University London, London, UK [2] Adnexal Department, Moorfields Eye Hospital, London, UK.
1] Centre for Health Services Research, School of Community & Health Sciences, City University London, London, UK [2] Community Health Newham, East London Foundation Trust, London, UK.
Eye (Lond). 2015 Jul;29(7):951-7. doi: 10.1038/eye.2015.76. Epub 2015 May 22.
Graves' orbitopathy (GO) is associated with changes in the appearance of the eyes and visual dysfunction. Patients report feeling socially isolated and unable to continue with day-to-day activities. This study aimed at investigating the demographic, clinical, and psychosocial factors associated with quality of life in patients presenting for orbital decompression surgery.
One-hundred and twenty-three adults with GO due for orbital decompression at Moorfields Eye Hospital London were recruited prospectively. Clinical measures including treatment history, exophthalmos, optic neuropathy, and diplopia were taken by an ophthalmologist. Participants completed psychosocial questionnaires, including the Graves' Ophthalmopathy Quality of Life Scale (GO-QOL), the Hospital Anxiety and Depression Scale, and the Derriford Appearance Scale. Hierarchical multiple regression analyses were used to identify predictors of quality of life.
Higher levels of potential cases of clinical anxiety (37%) and depression (26%) were found in this study sample than in patients with other chronic diseases or facial disfigurements. A total of 55% of the variance in GO-QOL visual function scores was explained by the regression model; age, asymmetrical GO and depressed mood were significant unique contributors. In all, 75% of the variance in GO-QOL appearance scores was explained by the regression model; gender, appearance-related cognitions and depressed mood were significant unique contributors.
Appearance-related quality of life and mood were particularly affected in this sample. Predominantly psychosocial characteristics were associated with quality of life. It is important when planning surgery for patients that clinicians be aware of factors that could potentially influence outcomes.
格雷夫斯眼眶病（GO）与眼部外观变化及视觉功能障碍相关。患者表示感到社交孤立，无法继续日常活动。本研究旨在调查与接受眼眶减压手术患者生活质量相关的人口统计学、临床和心理社会因素。
前瞻性招募了123名因眼眶减压而就诊于伦敦摩尔菲尔德眼科医院的成年GO患者。眼科医生进行了包括治疗史、眼球突出、视神经病变和复视等临床测量。参与者完成了心理社会调查问卷，包括格雷夫斯眼病生活质量量表（GO-QOL）、医院焦虑抑郁量表和德里福德外貌量表。采用分层多元回归分析来确定生活质量的预测因素。
本研究样本中临床焦虑（37%）和抑郁（26%）的潜在病例水平高于其他慢性病或面部畸形患者。回归模型解释了GO-QOL视觉功能评分中55%的方差；年龄、不对称性GO和情绪低落是显著的独立影响因素。回归模型解释了GO-QOL外貌评分中75%的方差；性别、与外貌相关的认知和情绪低落是显著的独立影响因素。
本样本中与外貌相关的生活质量和情绪受到特别影响。主要的心理社会特征与生活质量相关。在为患者规划手术时，临床医生了解可能潜在影响手术结果的因素很重要。
