Vision-Related Quality of Life and Emotional Impact in Children with Strabismus: A Prospective Study

Chai, Yong; Shao, Yi; Shen, Lin; Ky, Xiong; Chen, Ws; Li, Yuanyuan; Jl, Yi; Zhang, L; Tan, Guangming; Tang, Jun

doi:10.1177/147323000903700415

Cited by 35 publications

(28 citation statements)

References 15 publications

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“…By carefully defining criteria for post-surgical success, partial success, and failure, we aimed to reduce the influence of a possible placebo effect on our findings. In a recent study by Chai et al,17 the VFQ-25 and HADS questionnaires (Chinese versions) were administered as proxy measures to parents of children undergoing strabismus surgery. Improvements in HRQOL were reported using both questionnaires, but the VFQ-25 was designed for adults and not intended for use as a proxy questionnaire.…”

Section: Discussionmentioning

confidence: 99%

Responsiveness of Health-Related Quality-of-life Questionnaires in Adults Undergoing Strabismus Surgery

Hatt¹,

Leske²,

Holmes³

2010

Ophthalmology

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Objective To evaluate the responsiveness of 2 health related quality of life (HRQOL) questionnaires, the Adult Strabismus-20 (AS-20) and National Eye Institute Visual Function Questionnaire-25 (VFQ-25), to changes in HRQOL following strabismus surgery. Design Cohort study Participants 106 adults (aged 18 to 84, median 48.5 years) undergoing strabismus surgery, 80 (75%) with diplopia and 26 (25%) without diplopia. Methods All participants completed AS-20 and VFQ-25 questionnaires pre-operatively and a median of 7 (range 4 to 13) weeks post-operatively. Using pre-defined clinical criteria, post-operative outcomes were graded as either ‘success’ (n=65), ‘partial success’ (n=32) or ‘failure’ (n=9). Main outcome measures For each questionnaire, mean composite and subscale scores (ranging from 0 to 100; worst to best HRQOL) were calculated for each patient. Median change in scores pre- to post-operatively was compared for successes, partial successes, and failures, and the proportion of patients whose scores exceeded 95% limits of agreement was calculated. Results Successfully aligned diplopic patients (n=46) showed greater improvement than failures (n=7) using both the AS-20 questionnaire (21.3 [quartiles 12.5 to 35.0] vs. 8.8 [3.8 to 12.5]; P=0.002) and the VFQ-25 questionnaire (18.3 [8.6 to 26.1] vs. 8.3 [0.8 to 13.5]; P=0.02). Successfully aligned non-diplopic patients (n=19) also showed greater improvement than failures (n=2): (AS-20 23.8 [10.0 to 32.5] vs. −3.1 [−10.0 to 3.8]; P=0.05). In non-diplopic patients, changes on VFQ-25 were small but significantly greater for successes than failures (5.0 [0.0 to 10.1] vs. −15.4 [−19.4 to −11.4]; P=0.03). More successfully aligned patients showed improvement exceeding the 95% limits of agreement for AS-20 scores than VFQ-25 scores (67% vs. 65% [P=0.8] for diplopic patients and 63% vs. 21% [P=0.005] for non-diplopic patients). Conclusions AS-20 and VFQ-25 questionnaires are responsive to improved HRQOL in adults undergoing successful strabismus surgery. Changes on VFQ-25 were smaller, particularly for non-diplopic strabismus. The AS-20 is more responsive than the VFQ-25 across the range of adult strabismus.

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Section: Discussionmentioning

confidence: 99%

Responsiveness of Health-Related Quality-of-life Questionnaires in Adults Undergoing Strabismus Surgery

Hatt¹,

Leske²,

Holmes³

2010

Ophthalmology

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“…National Eye Institute Visual Function Questionnaire (NEI VFQ‐25) (Original [n = 7], Chinese [n = 4], German [n = 1])…”

Section: Resultsmentioning

confidence: 99%

Patient‐reported outcome measures in amblyopia and strabismus: a systematic review

Kumaran

Khadka

Baker

et al. 2018

Clinical and Experimental Optometry

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Background: Many patient-reported outcome measures (PROMs) have been developed and/or used to measure the impact of amblyopia and strabismus on quality of life (QoL). Identifying the one with superior quality is important for evaluating the effectiveness of novel therapy for amblyopia and for directing improved clinical decision-making in adults considering strabismic surgery. Therefore, the aim of this review is to identify all PROMs previously developed/used to study the impact of amblyopia and/or strabismus on QoL and to appraise the quality and comprehensiveness of content of the disease-specific instruments. Methods: A systematic search was carried out in the electronic databases of PubMed, Cochrane, Web of Science and PsycINFO. The quality of content and measurement properties of all the disease-specific instruments were assessed using established quality standards. Further, the content of the instruments were examined for comprehensiveness by categorising each item across the eight ophthalmic QoL domains (activity limitation, concerns, emotional well-being, social well-being, economic, convenience, symptoms and mobility). Results: Seventy-one PROMs were identified, out of which 32 were amblyopia-and/or strabismus-specific. Out of all the disease-specific instruments, just four have been subjected to modern psychometric tests and only the adult strabismus questionnaire demonstrated good measurement properties. Most of the amblyopia-specific instruments measured the impact of the treatment of amblyopia on children, while most of the strabismus-specific instruments measured concerns related to appearance and treatment outcome in adults. All instruments have gaps in their content and failed to address QoL comprehensively. Conclusion: All the existing amblyopia-and/or strabismus-specific instruments fall short of desired quality and/or comprehensiveness of content. The review identifies the need for developing an instrument with superior quality and discusses potential directions of future research.Key words: amblyopia, patient reported outcome, quality assessment, quality of life, questionnaire, strabismus Amblyopia and strabismus are common developmental conditions of childhood and are known to cause functional deficits like impaired stereoscopic depth perception and defective sensory, motor, visual cognition and prehension skills.1-3 These functional deficits manifest in the individual as imprecise or inefficient performance of real-life activities like reading, grasping and driving and affect quality of life (QoL). 4,5 Apart from the implications of these functional deficits, socially noticeable strabismus also affects the psychosocial and emotional well-being of individuals. [6][7][8][9][10] Analysis of the cost-effectiveness of screening for amblyopia and its utility are limited by the lack of evidence about the long-term impact, the degree of disability and the impact of amblyopia on QoL. 11-13Incorporating patient-reported outcome measures (PROMs) as one of the treatment outcomes is considered importa...

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“…With the decline in binocular function in the later stages of IXT, the resultant abnormal activities in these children may cause anxiety or depression within the parents. Results from a prospective study by Chai et al [33] reveal that the children, adolescents or adults with strabismus may experience symptoms of anxiety and depression, and that children are more affected and less likely to recover their emotional and mental state. Mcbain [16] and Snaith [34] have emphasized that it was society's and patient's awareness of the disease that affected the quality of life, not the severity of disease itself.…”

Section: Discussionmentioning

confidence: 99%

The health-related quality of life and anxiety for childhood intermittent exotropia before and after surgical correction

Mao

Lin

Chen

et al. 2020

Preprint

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Purposes:To assess the health-related quality of life (HRQOL) and hospital anxiety and depression scale (HADS) in Chinese children with intermittent exotropia (IXT) before and after strabismus surgery.Patients and Methods: The records of children with IXT who underwent strabismus surgery at the Zhongshan Ophthalmic Center, of Sun Yat-sen University, China over the period from January 1, 2016 to December 31, 2018 were retrospectively reviewed. All children underwent ophthalmic and orthoptic examinations including the prism and alternate cover test, fusion function by synoptophore, stereoacuity and Newcastle control score. With use of the Intermittent Exotropia Questionnaire (IXTQ), the pre- and post-operative HRQOL and pre-operative HADS were assessed within these children and their parents.Results: A total of 389 children were eligible for inclusion (47.8% male, 52.2% female, mean + SD age = 8.17 ± 2.81). Pre-operative IXTQ scores in both children and their parents were significantly correlated with near stereoacuity (P = 0.029 and P = 0.015, respectively). The angle of deviation at near vision showed a negative linear relationship with visual function (P = 0.026) and psychological (P = 0.019) scores and opinions regarding surgery(P = 0.024). HADS scores were also related with near stereoacuity (P < 0.05). After surgery, both children’s and parents’ IXTQs significantly improved (p༜0.01). Children’ IXTQ scores were related to the angle of deviation at distance and their psychological and visual function scores showed a negative relationship with the angle of deviation at near vision (P < 0.05).Conclusion: Children and parents HRQOL and HADS were associated with near stereoacuity. Parents usually attend more readily to the angle of deviation at near in their IXT children. HRQOL improved significantly after surgery and can be used as one of the indices for pre-operative evaluation, but is not recommended as a criteria for surgical intervention.These first two authors contributed equally to this work

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Vision-Related Quality of Life and Emotional Impact in Children with Strabismus: A Prospective Study

Cited by 35 publications

References 15 publications

Responsiveness of Health-Related Quality-of-life Questionnaires in Adults Undergoing Strabismus Surgery

Responsiveness of Health-Related Quality-of-life Questionnaires in Adults Undergoing Strabismus Surgery

Patient‐reported outcome measures in amblyopia and strabismus: a systematic review

The health-related quality of life and anxiety for childhood intermittent exotropia before and after surgical correction

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