Ophthalmological Oncology Unit, Department of Neuroscience, Sensory Organs and Chest, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of Low Vision Patients, IAPB Italia Onlus, Rome, Italy.
Optom Vis Sci. 2024 Apr 1;101(4):211-223. doi: 10.1097/OPX.0000000000002131.
This multicenter study assessed clinical and psychological aspects of infantile nystagmus syndrome (INS) focusing on its management and nonsurgical treatment.
This study aimed to assess clinical features, management, relationship life, and psychological impact in a group of patients with nystagmus onset in pediatric age.
This observational study included patients diagnosed with INS referred to two Italian centers from January 1, 2017, to December 31, 2020. Ophthalmologic and orthoptic features and impact of visual function on quality of life, according to nystagmus-specific nystagmus quality of life questionnaire, were analyzed within the overall sample and in any of INS subgroups.
Forty-three patients were included; 65.1% of them had idiopathic INS (IINS), and 34.9% had INS associated with ocular diseases (INSOD). The median age was 15.4 years (interquartile range [IQR], 10.4 to 17.3 years), significantly different between groups (median, 15.8 years among those with IINS vs. 12.3 years among those with INSOD; p<0.001). In the INSOD subgroup, strabismus was significantly more prevalent (93.3 vs. 57.1%; p=0.017). Binocular distance best-corrected visual acuity in primary position was significantly higher in the IINS subsample (p<0.001). Such behavior was further confirmed at anomalous head position evaluation (p<0.001). At near best-corrected visual acuity assessment, differences between groups were more remarkable in primary position (p<0.001) than in anomalous head position. Contrast sensitivity showed significantly higher values in the IINS subgroup (p<0.001). The nystagmus quality of life questionnaire disclosed a significantly lower score in IINS as compared with INSOD (median total score, 90.5 [IQR, 84 to 97] vs. 94 [IQR, 83.0 to 96.5]; p<0.001).
The IINS group showed significantly better ophthalmologic and orthoptic outcomes than the INSOD group. The psychological and quality-of-life impact was instead significantly greater in the IINS group. To the best of our knowledge, this is the first multicenter study investigating the clinical features of IIN and comparing the two main subgroups, IINS and INSOD.
本多中心研究评估了婴儿性眼球震颤综合征(INS)的临床和心理方面,重点是其管理和非手术治疗。
本研究旨在评估儿科年龄组出现眼球震颤的一组患者的临床特征、管理、生活关系和心理影响。
本观察性研究纳入了 2017 年 1 月 1 日至 2020 年 12 月 31 日期间因 INS 就诊于意大利两家中心的患者。分析了所有患者的眼科和视轴矫正特征,以及视觉功能对生活质量的影响,根据眼球震颤特异性眼球震颤生活质量问卷进行评估。
共纳入 43 例患者,其中 65.1%为特发性 INS(IINS),34.9%为与眼部疾病相关的 INS(INSOD)。其中位年龄为 15.4 岁(四分位间距[IQR]:10.4 至 17.3 岁),两组间差异有统计学意义(中值:IINS 组为 15.8 岁,INSOD 组为 12.3 岁;p<0.001)。在 INSOD 亚组中,斜视更为常见(93.3%比 57.1%;p=0.017)。IINS 亚组的第一眼位双眼最佳矫正视力明显较高(p<0.001)。在异常头位评估中,这种表现更为明显(p<0.001)。在近视力最佳矫正视力评估中,两组间的差异在第一眼位时更为明显(p<0.001),而在异常头位时则不明显。对比敏感度在 IINS 亚组中显示出显著更高的值(p<0.001)。眼球震颤生活质量问卷显示 IINS 组的总分明显低于 INSOD 组(总分中位数,90.5[IQR:84 至 97]比 94[IQR:83.0 至 96.5];p<0.001)。
IINS 组的眼科和视轴矫正结果明显优于 INSOD 组。而 IINS 组的心理和生活质量影响则明显更大。据我们所知,这是第一项研究特发性 INS 临床特征并比较其两个主要亚组(IINS 和 INSOD)的多中心研究。