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[遗传性视网膜营养不良的诊断。从患者角度看分子遗传学检测的相关性]

[Diagnosis of inherited retinal dystrophies. Relevance of molecular genetic testing from the patient's perspective].

作者信息

Kellner Ulrich, Jansen Sandra, Bucher Franziska, Stingl Katarina

机构信息

Zentrum für seltene Netzhauterkrankungen, AugenZentrum Siegburg, MVZ Augenärztliches Diagnostik- und Therapiecentrum Siegburg GmbH, Siegburg, Deutschland.

RetinaScience, Bonn, Deutschland.

出版信息

Ophthalmologie. 2022 Aug;119(8):820-826. doi: 10.1007/s00347-022-01602-w. Epub 2022 Mar 21.

Abstract

BACKGROUND

The diagnostic process of inherited retinal dystrophies (IRD) is impeded by their low prevalence and the variability of the clinical presentations; however, for patients a valid diagnosis is vital for future planning and evaluating the potential of an appropriate early treatment to delay disease progression.

OBJECTIVE

Aim of the current study was to outline the patients' journeys until they receive the final diagnosis. This should help uncover diagnostic shortcomings and highlight potential for improvement with respect to the use of genetic diagnostic testing.

MATERIAL AND METHODS

Data were collected by questionnaires and an online survey conducted by the self-help association PRO RETINA Deutschland e. V. among patients with IRD. Data were analyzed by descriptive statistics.

RESULTS

From 15 March to 22 April 2021, 183 questionnaires were completed and 42 online interviews conducted. The surveyed population consisted of 48% female patients, mean age was 55 years and first symptoms occurred at a mean age of 22 years. On average about 14 years passed from first symptoms until final diagnosis. Only 66% of the patients reported that they had received at least 1 diagnostic genetic testing; less than half of the patients (47%) received genetic counseling. The huge majority of patients (85%) would be interested in gene therapy.

CONCLUSION

From the perspective of affected patients, a shortening of the time to diagnosis, the use of molecular genetic testing and the offer of genetic counseling are important to improve patient care for patients with IRD.

摘要

背景

遗传性视网膜营养不良(IRD)的诊断过程因发病率低和临床表现的变异性而受阻;然而,对于患者来说,准确的诊断对于未来规划以及评估适当的早期治疗延缓疾病进展的潜力至关重要。

目的

本研究的目的是概述患者在获得最终诊断之前的就医历程。这有助于发现诊断中的不足,并突出在基因诊断检测应用方面的改进潜力。

材料与方法

通过德国视网膜自助协会PRO RETINA e.V.对IRD患者进行问卷调查和在线调查收集数据。采用描述性统计方法对数据进行分析。

结果

2021年3月15日至4月22日,共完成183份问卷,进行了42次在线访谈。调查人群中女性患者占48%,平均年龄55岁,首次出现症状的平均年龄为22岁。从首次出现症状到最终确诊平均约需14年。只有66%的患者报告他们至少接受过1次诊断性基因检测;不到一半的患者(47%)接受过遗传咨询。绝大多数患者(85%)对基因治疗感兴趣。

结论

从受影响患者的角度来看,缩短诊断时间、使用分子基因检测以及提供遗传咨询对于改善IRD患者的医疗护理非常重要。

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