From the Department of Ophthalmology & Visual Sciences (A.Z., L.T., A.A.B., M.R.), Washington University School of Medicine, St. Louis, Missouri, USA.
Department of Psychiatry (J.N.C.), Washington University School of Medicine, St. Louis, Missouri, USA.
Am J Ophthalmol. 2023 Mar;247:9-17. doi: 10.1016/j.ajo.2022.10.022. Epub 2022 Nov 4.
This study aims to characterize the eye-related quality of life of children with neurodevelopmental and ocular disorders at baseline and after refractive surgery.
Prospective interventional case series.
We enrolled children and adolescents 5 to 18 of age with neurodevelopmental disorders undergoing refractive surgery (6 for pre-/postsurgical assessment and 14 for baseline analysis). Eye-related quality of life was measured using the Pediatric Eye Questionnaire (PedEyeQ). Baseline levels of adaptive functioning and social behaviors were measured using the Adaptive Behavioral Assessment System (ABAS-3) and Social Responsiveness Scale (SRS-2). We assessed the correlation between baseline PedEyeQ scores, number of ocular comorbidities, magnitude of refractive error, and ABAS-3 and SRS-2 scores.
At baseline, 14 patients demonstrated decreased median eye-related quality of life (<60/100) in 5 of 9 PedEyeQ domains, moderate deficiencies in social behaviors (SRS-2 median 71, range 49-90), and low adaptive functioning (ABAS-3 median percentile for age of 0.100). Baseline PedEyeQ scores did not correlate with magnitude of refractive error or adaptive functioning scores but did correlate with number of ocular comorbidities and social behavior scores. Six patients have undergone refractive surgery without complication. Postoperatively, 11 of 11 eyes were within ±1.5 diopters spherical equivalent. Four of 6 patients exhibited clinically significant improvements in PedEyeQ scores after surgery.
Even in the presence of significant social and adaptive impairments, quality of life in children with neurodevelopmental disorders is decreased by ocular disorders. Refractive surgery is associated with clinically significant improvements in eye-related quality of life.
本研究旨在描述神经发育和眼部疾病患儿在屈光手术前后与眼部相关的生活质量。
前瞻性干预性病例系列研究。
我们招募了 5 至 18 岁的神经发育障碍且正在接受屈光手术的儿童和青少年（6 例用于手术前后评估，14 例用于基线分析）。使用小儿眼病问卷（PedEyeQ）测量与眼部相关的生活质量。使用适应行为评估系统（ABAS-3）和社会反应量表（SRS-2）测量基线适应性功能和社会行为水平。我们评估了基线 PedEyeQ 评分、眼部合并症数量、屈光不正程度与 ABAS-3 和 SRS-2 评分之间的相关性。
基线时，14 例患者在 9 个 PedEyeQ 领域中的 5 个领域中表现出中度至重度的眼部相关生活质量下降（<60/100），中度社会行为缺陷（SRS-2 中位数 71，范围 49-90），以及低适应性功能（ABAS-3 年龄中位数百分位为 0.100）。基线 PedEyeQ 评分与屈光不正程度或适应性功能评分无关，但与眼部合并症数量和社会行为评分相关。6 例患者已行屈光手术，无并发症。术后，11 只眼的球镜等效值均在±1.5 屈光度以内。4/6 例患者术后 PedEyeQ 评分有显著改善。
即使存在显著的社会和适应功能障碍，神经发育障碍患儿的生活质量仍因眼部疾病而降低。屈光手术与与眼部相关的生活质量的显著改善相关。
