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Vision-related Quality of Life in Malaysian Children with Threshold and Prethreshold Retinopathy of Prematurity
Chong Wern-Yih1,2,3, Qamarruddin Fazilawati3, Jamalia Rahmat4
1Department of Ophthalmology and Visual Science, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia.
Insights
Retinopathy of prematurity (ROP) significantly lowers vision-related quality of life (VRQoL) in Malaysian children, especially those with threshold ROP. General vision and health are most impacted, influenced by factors like gestational age and family income.
Area of Science:
- Ophthalmology
- Pediatrics
- Public Health
Background:
- Retinopathy of prematurity (ROP) presents a higher prevalence in developing nations.
- Limited data exists on vision-related quality of life (VRQoL) for children with severe ROP in these regions.
- This study addresses the ROP burden on VRQoL in Malaysian children.
Purpose of the Study:
- To evaluate the impact of threshold and prethreshold ROP on VRQoL in Malaysian children.
- To identify specific ROP stages affecting VRQoL.
- To explore factors influencing VRQoL in this population.
Main Methods:
- A multicenter prospective cross-sectional study was conducted in three Malaysian tertiary hospitals.
- Children under 7 with prior ROP diagnosis were recruited, excluding those with vision-affecting comorbidities.
- The Children's Visual Function Questionnaire (CVFQ) assessed VRQoL through parent/guardian completion.
Main Results:
- Children with ROP showed significantly lower total CVFQ scores compared to controls (p < 0.001).
- The threshold ROP subgroup reported the lowest scores, particularly in general vision and health domains.
- Gestational age, better eye visual acuity, and family income were significantly associated with VRQoL (p < 0.05).
Conclusions:
- ROP is linked to diminished VRQoL in Malaysian children.
- Threshold ROP poses the most significant challenge to VRQoL.
- Gestational age, visual acuity, and socioeconomic status are key determinants of VRQoL in children with ROP.
Purpose:
The prevalence of retinopathy of prematurity (ROP) is higher in developing countries compared to developed countries. There is limited data on vision-related quality of life (VRQoL) among children with severe type of ROP in developing countries. This study evaluated the influence of threshold and prethreshold ROP on VRQoL in Malaysian children.
Methods:
Multicenter prospective cross-sectional study conducted in three tertiary hospitals in 2018 to 2019. Children less than 7 years old with previous ROP diagnosis were recruited. Patients with systemic comorbidities that affected vision or daily activities were excluded. A parent or guardian completed the Children's Visual Function Questionnaire (CVFQ) for the assessment of child's general health, general vision, competence, personality, family impact, and treatment difficulty.
Results:
Eight were categorized with threshold ROP, 16 with high-risk prethreshold ROP, and 26 with low-risk prethreshold ROP. Fifty age-matched controls were also included. Mean visual acuity in logarithm of the minimum angle of resolution was 0.46 in the threshold, 0.08 in high-risk prethreshold, and 0.01 in low-risk prethreshold subgroups. Threshold ROP was associated with myopia and strabismus, and associated with poor visual acuity compared to prethreshold ROP. Mean total CVFQ score was significantly lower in the ROP group (p < 0.001) compared to the control group. Mean score and all mean subscale scores were significantly lower in the threshold subgroup compared to high-risk and low-risk prethreshold subgroups, with lowest subscale scores on general vision and general health. There was significant association between gestational age, visual acuity of the better eye, family income, and VRQoL (p < 0.05).
Conclusions:
ROP was associated with lower VRQoL in children born prematurely in Malaysia. The threshold ROP group is the most affected. General vision and health domains are their main difficulties encountered. Gestational age, visual acuity of the better eye, and family income affects the VRQoL.
