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Change in vision-related quality of life and influencing factors in Asians receiving treatment for neovascular age-related macular degeneration
  1. Eva K Fenwick1,2,
  2. Gemmy Chui Ming Cheung1,3,
  3. Alfred TL Gan1,
  4. Gavin Tan1,3,
  5. Shu Yen Lee1,3,
  6. Doric Wong1,3,
  7. Ian Yeo1,3,
  8. Ranjana Mathur1,3,
  9. Tien Y Wong1,2,3,
  10. Ecosse L Lamoureux1,2,3
  1. 1 Population Health, Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
  2. 2 Office of Clinical Sciences, Duke-NUS Medical School, Singapore, Singapore
  3. 3 Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
  1. Correspondence to Dr Gemmy Chui Ming Cheung; gemmy.cheung.c.m{at}


Aim To assess the change in vision-related quality of life (VRQoL) after treatment for neovascular age-related macular degeneration (nAMD) and factors influencing this change in an Asian population.

Methods In this longitudinal study, 116 patients (mean age±SD=66.5±9.9 years; 59.5% male) who underwent treatment for nAMD were recruited from a tertiary eye centre in Singapore. Best-corrected visual acuity (BCVA) and the Impact of Vision Impairment (IVI) questionnaire were evaluated at baseline and month 12. We defined three categories of BCVA change in the treated eye: BCVA gain ≥2 lines; no change in BCVA; BCVA loss ≥2 lines. The main outcome measures were the Rasch-derived IVI Reading, Mobility, and Emotional Scores. Multivariable linear regression analyses assessed the influence of sociodemographic, clinical and treatment-related factors on change in VRQoL.

Results Following treatment, mean treated-eye BCVA improved by almost 2 lines (−0.22±0.40 logMAR, p<0.001) and 43% (n=50) patients reported a gain in BCVA of ≥2 lines. Mean±SD scores for Reading, Mobility and Emotional demonstrated positive changes of 0.43±1.73, 0.45±1.54 and 0.66±1.6, respectively (p<0.001 for all). In multivariable models, a ≥2 line improvement in BCVA was independently associated with a 47% (β=0.20; CI 0.01 to 0.39) increase in Reading Scores, but was not independently associated with Mobility or Emotional Scores.

Conclusion Nearly half of patients undergoing treatment for nAMD reported a 2-line improvement in vision which was, in turn, associated with substantial positive increases in Reading Scores. Improvements in Mobility and Emotional Scores appear to be driven by factors other than visual acuity.

  • age-related macular degeneration
  • vision-related quality of life
  • treatment
  • visual acuity
  • change

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  • Contributors EKF and CMGC contributed to the conception of the work, interpretation of the data and drafting of the manuscript; ATLG conducted the data analysis, assisted with interpretation of results and drafted sections of the paper; GT, SYL, DW, IY, RM and TYW revised the manuscript critically for important intellectual content; ELL contributed to the conception of the work, interpretation of the data and revised the manuscript critically for important intellectual content.

  • Funding This study was supported by grants from the National Medical Research Council (STaR/0003/2008 and NIG/1003/2009), National Medical Research Council grant NMRC/NIG/1003/2009; the Singapore Bio Imaging Consortium (C-011/2006) and the Biomedical Research Council (08/1/35/19/550).

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Ethics approval was obtained from SingHealth Centralised Institutional Review Board (#R697/47/2009).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Requests for additional unpublished data from the study can be directed to the joint first author, GCMC, via email:

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