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先天性无虹膜患者健康相关生活质量的标准化评估

Standardized Assessment of Health-Related Quality of Life in Patients with Congenital Aniridia.

作者信息

Hoxha Zamira, Fries Fabian Norbert, Hecker Dietmar, Seitz Berthold, Käsmann-Kellner Barbara, Náray Annamária, Lagali Neil, Grupcheva Christina, Szentmáry Nóra, Stachon Tanja

机构信息

Dr. Rolf M. Schwiete Center for Limbal Stem Cell and Congenital Aniridia Research, Saarland University, Saarbrücken, Germany.

Department of Ophthalmology, Saarland University Medical Center and Faculty of Medicine, Homburg/Saar, Germany.

出版信息

Klin Monbl Augenheilkd. 2025 Mar;242(3):228-239. doi: 10.1055/a-2463-3879. Epub 2024 Dec 18.

Abstract

INTRODUCTION

Congenital aniridia is a rare panocular disorder that is associated with varying degrees of impairment of visual acuity. The COST Action (CA18116) developed a survey (aniridia-net.eu) to assess patient-reported experiences with congenital aniridia and its impacts on vision and daily life. Here, we correlate the survey responses of German patients with congenital aniridia with clinical ophthalmology data acquired at the Homburger Aniridia Center.

PATIENTS AND METHODS

The patients completed the German-language version of a 20-point ANIRIDIA-NET survey. The survey included demographic information, the most common symptoms caused by the disease, difficulties caused by visual impairment in various life situations, and the frequency of using visual aids in daily life. As for clinical data, best-corrected visual acuity (BCVA) as well as corneal, lens, and glaucoma status were collected.

RESULTS

A total of 71 participants, 27 (38.0%) children and 44 (61.7%) adults, completed the questionnaire, with an age range of 28.8 ± 20.2 years (6 - 78 years). Among them, 55 (77.4%) reported daily light sensitivity, 34 (47.8%) experienced dry eyes, 17 (23.9%) had fluctuating vision, 11 (15.4%) reported eye pain, and 5 (7.0%) experienced daily watering eyes. Older patients reported significantly more eye complaints than children (p < 0,001). Notably, patients with more advanced aniridia-associated keratopathy (AAK) exhibited a discernibly lower quality of life (ρ = 0.28, p = 0.027). Similarly, cataract surgery early in life was associated with a more pronounced decline in quality of life (ρ = - 0.36, p = 0.002). Thirty-five (49.2%) patients never needed assistance for their commute to school/work, 27 (38.0%) and 22 (30.9%) never needed assistance for their daily routines at home or various social activities, respectively. Regarding the use of visual aids, 39 (24.9%) reported that they always used visual aids at work or school, 24 (33.8%) during social activities, and 32 (45.1%) during free time activities.

CONCLUSIONS

Although congenital aniridia is associated with reduced visual acuity, the majority of affected individuals, especially during childhood, report that they were able to manage personal communication and various life situations independently and without significant difficulties, despite their eye-related issues. Visual aids serve as crucial support for them during their transition into adulthood and as they age. Symptoms of congenital aniridia subjects, described by the ANIRIDIA-NET survey, correlated well with clinical findings. Therefore, the questionnaire may provide important information for the treating ophthalmologist for follow-up examination of these patients and improvement in their life quality.

摘要

引言

先天性无虹膜是一种罕见的全眼球疾病,与不同程度的视力损害相关。欧洲科学与技术合作组织(COST)行动(CA18116)开展了一项调查(aniridia-net.eu),以评估患者报告的先天性无虹膜经历及其对视力和日常生活的影响。在此,我们将德国先天性无虹膜患者的调查回复与在洪堡无虹膜中心获取的临床眼科数据进行关联。

患者与方法

患者完成了一份20分的ANIRIDIA-NET调查问卷的德文版。该调查包括人口统计学信息、疾病引起的最常见症状、视力障碍在各种生活场景中造成的困难以及日常生活中使用视力辅助器具的频率。至于临床数据,收集了最佳矫正视力(BCVA)以及角膜、晶状体和青光眼状况。

结果

共有71名参与者完成了问卷,其中27名(38.0%)为儿童,44名(61.7%)为成年人,年龄范围为28.8±20.2岁(6至78岁)。其中,55名(77.4%)报告日常畏光,34名(47.8%)有干眼症状,17名(23.9%)视力波动,11名(15.4%)报告眼痛,5名(7.0%)有日常流泪症状。老年患者报告的眼部不适明显多于儿童(p<0.001)。值得注意的是,患有更严重的无虹膜相关性角膜病变(AAK)的患者生活质量明显较低(ρ=0.28,p=0.027)。同样,早年进行白内障手术与生活质量更明显的下降相关(ρ=-0.36,p=0.002)。35名(49.2%)患者上学/上班通勤时从未需要帮助,27名(38.0%)和22名(分别为30.9%)患者在家中日常活动或各种社交活动中从未需要帮助。关于视力辅助器具的使用,39名(24.9%)报告他们在工作或学校总是使用视力辅助器具,24名(33.8%)在社交活动中使用,32名(45.1%)在休闲活动中使用。

结论

尽管先天性无虹膜与视力下降相关,但大多数受影响个体,尤其是在儿童时期,报告称尽管存在眼部问题,他们仍能够独立且无重大困难地进行个人交流和应对各种生活场景。视力辅助器具在他们步入成年和随着年龄增长的过程中为他们提供了至关重要的支持。ANIRIDIA-NET调查所描述的先天性无虹膜患者的症状与临床发现密切相关。因此,该问卷可为眼科治疗医生对这些患者的随访检查及改善他们的生活质量提供重要信息。

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