Department of Ophthalmology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China; Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China; Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom.
Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom.
Ophthalmology. 2024 Feb;131(2):188-207. doi: 10.1016/j.ophtha.2023.09.005. Epub 2023 Sep 9.
This review summarizes existing evidence of the impact of vision impairment and ocular morbidity and their treatment on children's quality of life (QoL).
Myopia and strabismus are associated with reduced QoL among children. Surgical treatment of strabismus significantly improves affected children's QoL.
We conducted a systematic review and meta-analysis by screening articles in any language in 9 databases published from inception through August 22, 2022, addressing the impact of vision impairment, ocular morbidity, and their treatment on QoL in children. We reported pooled standardized mean differences (SMDs) using random-effects meta-analysis models. Quality appraisal was performed using Joanna Briggs Institute and National Institutes of Health tools. This study was registered with the International Prospective Register of Systematic Reviews (identifier, CRD42021233323).
Our search identified 29 118 articles, 44 studies (0.15%) of which were included for analysis that included 32 318 participants from 14 countries between 2005 and 2022. Seventeen observational and 4 interventional studies concerned vision impairment, whereas 10 observational and 13 interventional studies described strabismus and other ocular morbidities. Twenty-one studies were included in the meta-analysis. The QoL scores did not differ between children with and without vision impairment (SMD, -1.04; 95% confidence interval [CI], -2.11 to 0.03; P = 0.06; 9 studies). Myopic children demonstrated significantly lower QoL scores than those with normal vision (SMD, -0.60; 95% CI, -1.09 to -0.11; P = 0.02; 7 studies). Children with strabismus showed a significantly lower QoL score compared with those without (SMD, -1.19; 95% CI, -1.66 to -0.73; P < 0.001; 7 studies). Strabismus surgery significantly improved QoL in children (SMD, 1.36; 95% CI, 0.48-2.23; P < 0.001; 7 studies). No randomized controlled trials (RCTs) concerning refractive error and QoL were identified. Among all included studies, 35 (79.5%) were scored as low to moderate quality; the remaining met all quality appraisal tools criteria.
Reduced QoL was identified in children with myopia and strabismus. Surgical correction of strabismus improves the QoL of affected children, which supports insurance coverage of strabismus surgery. Further studies, especially RCTs, investigating the impact of correction of myopia on QoL are needed.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
本综述总结了视力障碍和眼部疾病及其治疗对儿童生活质量（QoL）的影响的现有证据。
近视和斜视与儿童生活质量下降有关。斜视手术可显著改善受影响儿童的生活质量。
我们通过筛选 9 个数据库中任何语言的文章，进行了系统评价和荟萃分析，这些文章的发表时间为从开始到 2022 年 8 月 22 日，旨在解决视力障碍、眼部疾病及其治疗对儿童生活质量的影响。我们使用随机效应荟萃分析模型报告了汇总的标准化均数差值（SMD）。使用 Joanna Briggs 研究所和美国国立卫生研究院的工具进行质量评估。本研究在国际前瞻性注册系统评价（标识符：CRD42021233323）中进行了注册。
我们的搜索共确定了 29118 篇文章，其中 44 项研究（0.15%）被纳入分析，这些研究包括来自 14 个国家的 32318 名参与者，研究时间为 2005 年至 2022 年。17 项观察性研究和 4 项干预性研究涉及视力障碍，而 10 项观察性研究和 13 项干预性研究描述了斜视和其他眼部疾病。21 项研究纳入荟萃分析。有视力障碍的儿童与无视力障碍的儿童的生活质量评分无差异（SMD，-1.04；95%置信区间[CI]，-2.11 至 0.03；P=0.06；9 项研究）。近视儿童的生活质量评分明显低于视力正常的儿童（SMD，-0.60；95%CI，-1.09 至-0.11；P=0.02；7 项研究）。斜视儿童的生活质量评分明显低于无斜视的儿童（SMD，-1.19；95%CI，-1.66 至-0.73；P<0.001；7 项研究）。斜视手术显著改善了儿童的生活质量（SMD，1.36；95%CI，0.48-2.23；P<0.001；7 项研究）。未发现关于屈光不正和生活质量的随机对照试验（RCT）。在所有纳入的研究中，35 项（79.5%）被评为低至中度质量；其余的研究均符合所有质量评估工具的标准。
近视和斜视儿童的生活质量下降。斜视手术矫正斜视可改善受影响儿童的生活质量，这支持斜视手术的保险覆盖。需要进一步研究，特别是 RCT，以调查近视矫正对生活质量的影响。
在本文末尾的脚注和披露中可能会发现专有的或商业的披露。
