School of Public Health, Medical College of Soochow University, 199 Ren Ai Road, Suzhou, 215123, China.
Department of Ophthalmology, Dushu Lake Hospital Affiliated to Soochow University, Suzhou, China.
Graefes Arch Clin Exp Ophthalmol. 2023 Sep;261(9):2455-2463. doi: 10.1007/s00417-023-06034-z. Epub 2023 Mar 14.
This study is to quantitatively estimate the health-related quality of life (HRQOL) impact of major age-related eye diseases (AREDs) including cataract, glaucoma, age-related macular degeneration (AMD), and diabetic retinopathy (DR) assessed by the EuroQoL Five-Dimensional Questionnaire (EQ-5D).
PubMed, Embase, Cochrane Library, and CINAHL were searched until October 20, 2022. Studies were included if they reported the EQ-5D health utility score (HUS) or visual analogue scale (VAS) score of both AREDs patients and healthy controls. The mean difference (MD) in HUS or VAS score between cases and controls and its 95% confidence interval (95%CI) were pooled using the random-effects model. We also performed sensitivity analysis using the leaving-one-out method and subgroup analyses by sample size and race. The prevalence in reporting any problems in the five EQ-5D dimensions was summarized and compared between cases and controls using the Chi-square test.
Fifteen articles involving 30,491 participants were included in this review. Pooled estimates indicated reduced HUS in AMD patients (MD = - 0.04, 95%CI - 0.07, - 0.01; P = 0.009), DR patients (MD = - 0.03, 95%CI - 0.05, - 0.01; P = 0.01), and glaucoma patients (MD = - 0.06, 95%CI - 0.10, - 0.01; P = 0.01), compared with the controls. Significantly lower EQ-5D VAS score was also observed in cataract patients (MD = - 11.33, 95%CI - 13.47, - 9.18; P < 0.001) and DR patients (MD = - 6.41, 95%CI - 10.64, - 2.18; P = 0.003). AREDs patients reported usual activities and anxiety/depression problems more frequently than the control group.
Our findings confirmed the HRQOL impairment caused by major AREDs including AMD, cataract, DR, and glaucoma. High-quality studies with large sample sizes are warranted to further verify our results.
本研究旨在通过欧洲五维健康量表（EQ-5D）评估白内障、青光眼、年龄相关性黄斑变性（AMD）和糖尿病视网膜病变（DR）等主要年龄相关性眼病（ARED）对健康相关生活质量（HRQOL）的影响。
检索了 PubMed、Embase、Cochrane Library 和 CINAHL，截至 2022 年 10 月 20 日。如果研究报告了 ARED 患者和健康对照组的 EQ-5D 健康效用评分（HUS）或视觉模拟量表（VAS）评分，则纳入研究。使用随机效应模型对病例组和对照组之间 HUS 或 VAS 评分的均值差异（MD）及其 95%置信区间（95%CI）进行汇总。我们还使用剔除一个样本的方法进行敏感性分析，并按样本量和种族进行亚组分析。使用卡方检验比较病例组和对照组在五个 EQ-5D 维度中任何问题的报告率。
本综述纳入了 15 篇文章，共涉及 30491 名参与者。汇总估计表明，AMD 患者（MD=-0.04，95%CI-0.07，-0.01；P=0.009）、DR 患者（MD=-0.03，95%CI-0.05，-0.01；P=0.01）和青光眼患者（MD=-0.06，95%CI-0.10，-0.01；P=0.01）的 HUS 降低，与对照组相比。白内障患者（MD=-11.33，95%CI-13.47，-9.18；P<0.001）和 DR 患者（MD=-6.41，95%CI-10.64，-2.18；P=0.003）的 EQ-5D VAS 评分也显著降低。ARED 患者比对照组更常报告日常活动和焦虑/抑郁问题。
我们的研究结果证实了包括 AMD、白内障、DR 和青光眼在内的主要 ARED 引起的 HRQOL 损害。需要高质量、大样本量的研究来进一步验证我们的结果。
