Brady Parker D, Hernandez Roberto Sergio, Salter Amber, Truong-Le Melanie
Department of Ophthalmology (Brady) and Department of Neurology, Section on Statistical Planning and Analysis (Hernandez, Salter), University of Texas Southwestern Medical Center, Dallas; independent researcher, Dallas (Truong-Le).
J Neuropsychiatry Clin Neurosci. 2025 Spring;37(2):115-124. doi: 10.1176/appi.neuropsych.20240027. Epub 2024 Dec 4.
The purpose of this study was to compare functional vision loss (FVL) among adults and children, including its presentation and the biopsychosocial factors that may contribute to FVL development.
PubMed, Scopus, and PsycInfo databases were searched in April 2023 for studies reporting data on visual acuity loss (VAL), visual field defects (VFDs), psychiatric disorders, or biopsychosocial stressors of patients with FVL. Studies were excluded if they did not report information on the specific outcomes for all patients or reported on only a subset of FVL patients.
Overall, 27 studies were included, comprising 1,476 patients. Twenty-six articles reported on visual symptoms, 14 on psychiatric disorders, and 11 on biopsychosocial stressors. The prevalence of VAL was similar among adults (80%) compared with children (83%), but VFDs were significantly more common among adults (86% in adults vs. 50% in children). The prevalence of a history of psychiatric disorders was similar among both adults (42%) and children (23%). Adults most commonly reported accidents or physical trauma (31%) as predisposing or precipitating factors for VAL, whereas children most frequently reported family or home stress (19%).
VFDs were found to be more common among adults than among children with FVL. Among adults and children with FVL, different psychiatric and biopsychosocial stressors were reported. This review was limited by the heterogeneous data among studies and unstandardized methods of data collection and reporting. Future research may seek to better understand the differences between adults and children with FVL and explore possible treatment options.
本研究旨在比较成人和儿童的功能性视力丧失（FVL）情况，包括其表现以及可能导致FVL发生的生物心理社会因素。
于2023年4月在PubMed、Scopus和PsycInfo数据库中检索报告FVL患者视力丧失（VAL）、视野缺损（VFD）、精神障碍或生物心理社会应激源数据的研究。如果研究未报告所有患者的特定结局信息或仅报告了部分FVL患者的信息，则将其排除。
总共纳入了27项研究，涵盖1476名患者。26篇文章报告了视觉症状，14篇报告了精神障碍，11篇报告了生物心理社会应激源。成人VAL的患病率（80%）与儿童（83%）相似，但VFD在成人中明显更为常见（成人中为86%，儿童中为50%）。成人（42%）和儿童（23%）精神障碍病史的患病率相似。成人最常报告意外事故或身体创伤（31%）是VAL的诱发或促发因素，而儿童最常报告家庭或家庭压力（19%）。
发现FVL成人中VFD比儿童更常见。在患有FVL的成人和儿童中，报告了不同的精神和生物心理社会应激源。本综述受到研究间数据异质性以及数据收集和报告方法未标准化的限制。未来的研究可能试图更好地理解患有FVL的成人和儿童之间的差异，并探索可能的治疗选择。
