Humanistic Burden of Noninfectious Uveitis: A Systematic Review and Meta-Analysis

IF 4.1 1区医学 Q1 OPHTHALMOLOGY

American Journal of Ophthalmology Pub Date : 2024-11-09 DOI:10.1016/j.ajo.2024.10.027

Aswen Sriranganathan , Justin Grad , Rafael N. Miranda , Jobanpreet Dhillon , Solin Saleh , Tina Felfeli

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引用次数: 0

Abstract

Purpose

This study aimed to evaluate the humanistic burden of noninfectious uveitis (NIU).

Design

Systematic review and meta-analysis.

Methods

A comprehensive search was conducted across Medline, Embase, and Scopus databases from inception to March 2023. Studies pertaining to the health-related quality of life (HRQoL) of patients with NIU in both adult and pediatric populations were included. Identified studies were critically appraised and assessed for bias using the Joanna Briggs Institute Critical Appraisal tools.

Results

A total of 68 studies involving 8403 participants met the inclusion criteria, and 10 studies were included in the meta-analysis. Across 14 HRQoL instruments used across the studies, Visual Function Questionnaire 25 was the most frequently used (n = 35), followed by the 36-Item Short-Form Survey and 8-Item Short Form Survey (n = 30), EuroQol 5-Dimensions (n = 8) and Pediatric QoL (n = 8). Thirteen studies assessed pediatric populations (19%), 12 studies compared NIU and systemic disease (18%), 14 studies assessed QoL outcomes with different treatment modalities (21%), and 4 studies explored QoL outcomes through qualitative exploratory methods (6%). Patients with juvenile idiopathic arthritis-associated uveitis had poorer HRQoL scores than nonuveitic juvenile idiopathic arthritis by 5.26 (95% confidence interval [CI] –7.24, –3.28; P < .05) on the Effects of Youngsters’ Eyesight on QoL questionnaire and the Childhood Health Assessment Questionnaire. Adults with NIU with systemic disease scored notably lower on both Mental Component Summary (mean difference: –5.63; 95% CI –9.37, –1.88; P < .01) and Physical Component Summary (mean difference: –4.99; 95% CI –11.71, 1.73; P < .01) segments of the 36-Item Short-Form Survey compared to healthy controls. Overall, the studies were of moderate to high quality.

Conclusions

NIU poses a significant QoL impact from a physical health, mental health, daily functioning, and caregiving perspective. Patients with NIU experience significant declines in QoL, particularly those with comorbid conditions and systemic diseases, highlighting the need for validation of uveitis-specific patient-reported outcome measures. Future studies should develop interventions and explore QoL impacts on diverse geographic regions.

查看原文本刊更多论文

非传染性葡萄膜炎的人文负担：系统回顾与元分析》：简短标题: 非传染性葡萄膜炎的人文负担。

目的：本研究旨在评估非传染性葡萄膜炎（NIU）的人文负担：方法：系统回顾和荟萃分析：方法：对 Medline、Embase 和 Scopus 数据库中从开始到 2023 年 3 月的内容进行全面检索。纳入了与成人和儿童 NIU 患者的健康相关生活质量 (HRQoL) 相关的研究。采用乔安娜-布里格斯研究所（Joanna Briggs Institute）的批判性评估工具对所确定的研究进行批判性评估，并评估其偏倚性：共有 68 项研究（涉及 8,403 名参与者）符合纳入标准，其中 10 项研究被纳入荟萃分析。在各项研究中使用的 14 种 HRQoL 工具中，最常用的是视觉功能问卷 25 (VFQ-25)（35 人），其次是 36 项简表调查 (SF-36) 和 8 项简表调查 (SF-8)（30 人）、EuroQol 5-Dimensions (EQ-5D) （8 人）和儿科生活质量 (PedsQL) （8 人）。13项研究评估了儿科人群（19%），12项研究比较了NIU和全身性疾病（18%），14项研究评估了不同治疗方式的QoL结果（21%），4项研究通过定性探索方法探讨了QoL结果（6%）。在 "青少年视力对生活质量的影响"（EYE-Q）问卷和 "儿童健康评估问卷"（CHAQ）中，U型JIA患者的HRQoL评分比非葡萄胎型JIA患者低5.26分（95% CI -7.24, -3.28；P < .05）。与健康对照组相比，患有全身性疾病的 NIU 成年人在 36 项短表调查 (SF-36) 的精神部分摘要 (MCS) （平均差 (MD)：-5.63；95% CI -9.37，-1.88；P < .01）和身体部分摘要 (PCS)（MD：-4.99；95% CI -11.71，1.73；P < .01）部分的得分明显较低。总体而言，这些研究的质量为中上等：结论：从身体健康、心理健康、日常功能和护理角度来看，NIU 对患者的 QoL 有重大影响。NIU患者的QoL显著下降，尤其是那些合并症和全身性疾病的患者，这突出了验证葡萄膜炎特异性患者报告结果测量（PROMs）的必要性。未来的研究应制定干预措施，并探讨QoL对不同地区的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Ophthalmology 医学-眼科学

CiteScore

9.20

自引率

7.10%

发文量

406

审稿时长

36 days

期刊介绍： The American Journal of Ophthalmology is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and visual science specialists describing clinical investigations, clinical observations, and clinically relevant laboratory investigations. Published monthly since 1884, the full text of the American Journal of Ophthalmology and supplementary material are also presented online at www.AJO.com and on ScienceDirect. The American Journal of Ophthalmology publishes Full-Length Articles, Perspectives, Editorials, Correspondences, Books Reports and Announcements. Brief Reports and Case Reports are no longer published. We recommend submitting Brief Reports and Case Reports to our companion publication, the American Journal of Ophthalmology Case Reports. Manuscripts are accepted with the understanding that they have not been and will not be published elsewhere substantially in any format, and that there are no ethical problems with the content or data collection. Authors may be requested to produce the data upon which the manuscript is based and to answer expeditiously any questions about the manuscript or its authors.