幻视综合征：眼葡萄膜黑色素瘤眼球摘除术后患者的体验。
Phantom Eye Syndrome: Patient Experiences after Enucleation for Uveal Melanoma.
机构信息
Institute of Psychology, Health & Society, University of Liverpool, Liverpool, United Kingdom; Liverpool Ocular Oncology Centre, Royal Liverpool and Broadgreen University Hospital, NHS Trust, Liverpool, United Kingdom.
Institute of Psychology, Health & Society, University of Liverpool, Liverpool, United Kingdom.
出版信息
Ophthalmology. 2015 Aug;122(8):1585-90. doi: 10.1016/j.ophtha.2015.04.005. Epub 2015 May 21.
PURPOSE
Patients undergoing enucleation for uveal melanoma need to be informed of the possibility of phantom eye syndrome (PES). The number with uveal melanoma in PES studies has been small. Aims were to: (1) determine the prevalence, symptoms, and characteristics of PES and to test associations of PES symptoms with sociodemographic and clinical characteristics; (2) examine the interrelatedness of PES symptoms; and (3) explore the emotional valence of PES and the relationship to anxiety and depression.
DESIGN
Cross-sectional questionnaire.
PARTICIPANTS
Patients (n = 179) with uveal melanoma enucleated 4 to 52 months previously.
METHODS
Questionnaire on PES. Responses to a routine audit of mood obtained from clinical records.
MAIN OUTCOME MEASURES
Patients were asked about 3 symptoms: pain, visual sensations, and a feeling of seeing through the removed eye. Mood was assessed by the Hospital Anxiety and Depression Scale.
RESULTS
Of 179 respondents, 108 (60.3%) experienced symptoms: 86 reported (48%) visual sensations, 50 reported (28%) seeing, and 42 reported (23%) pain; 14 (7.8%) reported all 3 symptoms. At the time of the questionnaire, 31 (17%) experienced 1 or more symptoms daily. Women were more likely to report pain (odds ratio [OR], 2.18; 95% confidence interval [CI], 1.08-4.40). Younger patients at enucleation were more likely to report pain (t = 4.13; degrees of freedom (df), 177; P < 0.001) and visual sensations (t = 2.11; df, 177; P < 0.05). Patients studied sooner after enucleation were more likely to report seeing (Mann-Whitney U, 2343; P < 0.05). Pain and seeing were intercorrelated (chi-square, 5.47; Φ = 0.18; df, 1; P < 0.05), pain with visual sensations (chi-square, 3.91; Φ = 0.15; df, 1; P < 0.05) and seeing with visual sensations (chi-square, 34.22; Φ = 0.45; df, 1; P < 0.001). Twenty of 108 patients (18.5%) found symptoms disturbing, and 21 of 108 (19.4%) pleasurable. Patients reporting pain were more anxious (OR, 3.53; 95% CI, 1.38-9.03) and depressed (OR, 13.26; 95% CI, 3.87-46.21).
CONCLUSIONS
Patients should be informed of PES symptoms. Pain may indicate anxiety or depression; this needs research to determine cause and effect.
目的
接受眼黑色素瘤眼摘术的患者需要被告知可能会出现幻眼综合征（PES）。在 PES 研究中，患有眼黑色素瘤的患者数量较少。目的是：（1）确定 PES 的患病率、症状和特征，并测试 PES 症状与社会人口统计学和临床特征的相关性；（2）检查 PES 症状的相关性；（3）探讨 PES 的情绪效价以及与焦虑和抑郁的关系。
设计
横断面问卷调查。
参与者
179 例眼黑色素瘤患者，在眼摘术后 4 至 52 个月。
方法
PES 问卷。从临床记录中获得有关情绪的常规审核的答复。
主要观察指标
患者被问到 3 种症状：疼痛、视觉感觉和通过切除的眼睛看到的感觉。通过医院焦虑和抑郁量表评估情绪。
结果
在 179 名应答者中，有 108 名（60.3%）经历了症状：86 名报告（48%）有视觉感觉，50 名报告（28%）有看到的感觉，42 名报告（23%）有疼痛；14 名（7.8%）报告了所有 3 种症状。在问卷调查时，有 31 名（17%）每天经历 1 种或多种症状。女性更有可能报告疼痛（优势比 [OR]，2.18；95%置信区间 [CI]，1.08-4.40）。眼摘术时年龄较小的患者更有可能报告疼痛（t = 4.13；自由度（df），177；P < 0.001）和视觉感觉（t = 2.11；df，177；P < 0.05）。在眼摘术后较短时间内接受研究的患者更有可能报告看到（Mann-Whitney U，2343；P < 0.05）。疼痛和看到的感觉相互关联（卡方，5.47；Φ = 0.18；df，1；P < 0.05），疼痛与视觉感觉（卡方，3.91；Φ = 0.15；df，1；P < 0.05）和看到与视觉感觉（卡方，34.22；Φ = 0.45；df，1；P < 0.001）。108 名患者中有 20 名（18.5%）认为症状令人困扰，21 名（19.4%）认为症状令人愉快。报告疼痛的患者更焦虑（OR，3.53；95% CI，1.38-9.03）和抑郁（OR，13.26；95% CI，3.87-46.21）。
结论
应告知患者 PES 症状。疼痛可能表明焦虑或抑郁；这需要研究来确定因果关系。
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