小児の皮質または脳性視覚障害における視覚関連QOL

Cortical or cerebral visual impairment (CVI) is a leading cause of pediatric visual impairment. However, there are limited data using validated assessments of vision-specific quality of life (VS-QOL) in these patients. The purpose of this study was to assess VS-QOL in children with CVI using the Children's Visual Function Questionnaire (CVFQ).

Children with CVI (ages 12 months to 12 years) were prospectively recruited from a single pediatric neuro-ophthalmology clinic at a children's hospital, where a complete ophthalmologic examination was performed. Age-matched typically developing controls were recruited from a web-based recruitment service. Parents of participants completed the CVFQ. Overall and subscale CVFQ scores were compared between children with CVI and controls. Additionally, CVFQ scores were correlated with clinical findings in children with CVI.

Forty-three children with CVI and 20 controls were included in this study. CVFQ overall and all subscale scores were significantly lower in children with CVI (p < .0001). Among CVI participants, there was a borderline association between visual acuity and CVFQ overall and competence subscale (both p = .07) scores. CVI patients with strabismus had significantly worse scores on the family impact subscale than those without strabismus (p = .04).

CVI profoundly affects VS-QOL in individuals with CVI. Strabismus and CVI may have an additive impact on families. Additional studies are needed to determine whether measures of functional vision correlate with VS-QOL in children with CVI, and also to develop VS-QOL scales that are specific to concerns of families and children with CVI.

All members of the multidisciplinary care team for individuals with CVI should be aware of the effect of this diagnosis on VS-QOL in both the child and family. Ultimately, practitioners and researchers should strive to identify interventions to improve VS-QOL in individuals with CVI.