Penn State College of Medicine, Hershey, Pennsylvania.
Department of Public Health Science, Penn State College of Medicine, Hershey, Pennsylvania.
J AAPOS. 2024 Jun;28(3):103929. doi: 10.1016/j.jaapos.2024.103929. Epub 2024 May 3.
To investigate the incidence of psychiatric diagnoses in relation to strabismus surgery timing among children with an early strabismus diagnosis who underwent surgery in childhood.
We conducted a retrospective cohort study using TriNetX network data from 2003-2023 on patients diagnosed with strabismus at ≤5 years of age and having strabismus surgery before 18 years of age. Cohort 1 comprised patients who underwent initial strabismus surgery at ≤6 years of age; cohort 2, patients with initial surgical intervention at ≥7 years of age. Incidence of mental health diagnoses from 7 until 18 years of age were compared between cohorts.
In cohort 1, 59 of 688 patients (8.6%) of patients were diagnosed with at least 1 mental health disorder versus 123 of 693 patients (17.7%) in cohort 2 (risk ratio [RR] = 2.07; 95% CI, 1.546 to 2.77; P < 0.0001). Gender analysis showed that only males had a statistically significant increased rate of mental health diagnoses in cohort 2 versus cohort 1 (RR = 1.82; 95% CI, 1.284 to 2.577; P = 0.006). An increased risk for specific psychiatric diagnoses was found in cohort 2 versus cohort 1; anxiety disorders (RR = 2.19; 95% CI, 1.225-3.922; P = 0.0065), attention-deficit / hyperactivity disorder (RR = 2.18; 95% CI, 1.499-3.175; P < 0.0001), conduct disorders (RR = 2.81; 95% CI, 1.425-5.556; P = 0.0018), and adjustment disorders (RR = 2.07; 955% CI, 1.103-3.876; P = 0.0204). Depressive disorders showed no statistically significant difference between cohorts (RR = 1.00; 95% CI, 0.419-2.392; P = 0.9974).
Compared with children having early strabismus surgery, those having surgery at a later age after an early strabismus diagnosis at ≤5 years of age may be more likely to experience a mental health disorder during childhood, although it is unclear whether such disorders are a result of delayed surgery or a driver of the decision to opt for surgery rather than continued conservative management.
调查斜视诊断早期接受斜视手术的儿童中，斜视手术时机与精神科诊断发生率的关系。
我们使用 2003 年至 2023 年 TriNetX 网络数据进行了一项回顾性队列研究，纳入了≤5 岁确诊斜视且在 18 岁前接受斜视手术的患者。队列 1 包括≤6 岁接受初次斜视手术的患者；队列 2 包括初次手术干预≥7 岁的患者。比较两组患者 7 至 18 岁期间的精神健康诊断发生率。
队列 1 中，59/688 名患者（8.6%）至少诊断出 1 种精神健康障碍，而队列 2 中，123/693 名患者（17.7%）患有精神健康障碍（风险比[RR] = 2.07；95%CI，1.546 至 2.77；P < 0.0001）。性别分析显示，仅男性在队列 2 中患精神健康诊断的风险较队列 1 显著增加（RR = 1.82；95%CI，1.284 至 2.577；P = 0.006）。队列 2 与队列 1 相比，特定精神科诊断的风险增加，包括焦虑障碍（RR = 2.19；95%CI，1.225 至 3.922；P = 0.0065）、注意缺陷多动障碍（RR = 2.18；95%CI，1.499 至 3.175；P < 0.0001）、品行障碍（RR = 2.81；95%CI，1.425 至 5.556；P = 0.0018）和适应障碍（RR = 2.07；95%CI，1.103 至 3.876；P = 0.0204）。两组抑郁障碍的发生率无统计学差异（RR = 1.00；95%CI，0.419 至 2.392；P = 0.9974）。
与早期接受斜视手术的儿童相比，5 岁前确诊斜视且在≤5 岁时接受手术的儿童在儿童期更有可能出现精神健康障碍，尽管尚不清楚这些障碍是手术延迟的结果，还是选择手术而不是继续保守治疗的决定因素。
