Garcia Giancarlo A, Khoshnevis Matin, Gale Jesse, Frousiakis Starleen E, Hwang Tiffany J, Poincenot Lissa, Karanjia Rustum, Baron David, Sadun Alfredo A
Doheny Eye Institute, Los Angeles, CA, USA; University of California, Irvine School of Medicine, Irvine, CA, USA.
Doheny Eye Institute, Los Angeles, CA, USA; Department of Ophthalmology, Temple University, Philadelphia, PA, USA.
Clin Ophthalmol. 2017 Feb 22;11:417-427. doi: 10.2147/OPTH.S113414. eCollection 2017.
The aim of this study was to evaluate the effects of profound vision loss on psychological well-being in adolescents, young adults, and middle-aged adults with regard to mood, interpersonal interactions, and career-related goals. In addition, we assessed the significance of the resources that may be used to enhance psychological well-being in cases of profound vision loss, and in particular, examined the utility of low vision aids and the role of the ophthalmologist as a provider of emotional support.
A questionnaire was issued to individuals aged 13-65 years with profound vision loss resulting from Leber's hereditary optic neuropathy (LHON). Depression prevalence was evaluated with questions regarding major depressive disorder symptomatology. Participants appraised the effects of vision loss on their interpersonal interactions and career goals by providing an impact rating (IR) on a 21-point psychometric scale from -10 to +10. Social well-being index was defined as the average of interpersonal IR and career IR. Subjects were additionally asked about the use of low vision aids and sources of emotional support.
A total of 103 participants (mean age =26.4±11.2 years at LHON diagnosis; mean ± standard deviation) completed the questionnaire. Nearly half (49.5%) met the depression criteria after vision loss. Negative impacts on interpersonal interactions (median IR = -5) and career goals (median IR = -6) were observed; both ratings were worse (<0.001) for depressed versus nondepressed subjects. Older age at diagnosis corresponded to higher depression prevalence and increased incidence of negative interpersonal IR and career IR. Sixty-eight percent of subjects used electronic vision aids; controlling for age, social well-being index was higher among these individuals than for those who did not use electronic aids (=0.03). Over half of the participants (52.4%) asserted that they derived emotional support from their ophthalmologist.
Profound vision loss in adolescents, young adults, and middle-aged adults is associated with significant negative psychological and psychosocial effects, which are influenced by age and use of electronic vision aids. Ophthalmologists, in addition to managing vision loss, may serve an important role in the emotional adaptation of these patients.
本研究旨在评估严重视力丧失对青少年、青年和中年成年人心理健康的影响，涉及情绪、人际互动和职业相关目标。此外，我们评估了在严重视力丧失情况下可用于增强心理健康的资源的重要性，特别是检查了低视力辅助器具的效用以及眼科医生作为情感支持提供者的作用。
向年龄在13 - 65岁、因Leber遗传性视神经病变（LHON）导致严重视力丧失的个体发放问卷。通过关于重度抑郁症症状学的问题评估抑郁症患病率。参与者通过在从 - 10到 + 10的21点心理量表上提供影响评分（IR）来评估视力丧失对其人际互动和职业目标的影响。社会幸福感指数定义为人际IR和职业IR的平均值。此外，还询问了受试者低视力辅助器具的使用情况和情感支持来源。
共有103名参与者（LHON诊断时的平均年龄 = 26.4±11.2岁；均值±标准差）完成了问卷。近一半（49.5%）在视力丧失后符合抑郁症标准。观察到对人际互动（中位数IR = - 5）和职业目标（中位数IR = - 6）有负面影响；抑郁受试者的这两个评分均比非抑郁受试者更差（<0.001）。诊断时年龄较大对应较高的抑郁症患病率以及人际IR和职业IR负面发生率增加。68%的受试者使用电子视力辅助器具；在控制年龄后，使用电子辅助器具的个体的社会幸福感指数高于未使用电子辅助器具的个体（=0.03）。超过一半的参与者（52.4%）声称他们从眼科医生那里获得了情感支持。
青少年、青年和中年成年人的严重视力丧失与显著的负面心理和社会心理影响相关，这些影响受年龄和电子视力辅助器具使用情况的影响。眼科医生除了管理视力丧失外，在这些患者的情感适应方面可能发挥重要作用。
