Elsevier

Ophthalmology

Volume 112, Issue 1, January 2005, Pages 152-158
Ophthalmology

Original article
Vision-related quality of life in patients with bilateral severe age-related macular degeneration

https://doi.org/10.1016/j.ophtha.2004.06.036Get rights and content

Purpose

To determine the quality of life (QOL) of patients with bilateral severe age-related macular degeneration (AMD) before macular translocation with 360° peripheral retinectomy.

Design

Prospective, consecutive, noncomparative case series.

Methods

An observational study assessed vision-related and general health QOL using the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) and the Medical Outcomes Study 12-item short form (SF-12) surveys, respectively. Mean QOL scores were correlated with patient age, duration of vision loss, and visual function. Mean QOL scores in study patients were compared with mean QOL scores in groups of patients with low vision, patients with AMD of varying severity, and reference populations.

Main outcome measures

National Eye Institute VFQ-25 and SF-12 QOL scores.

Results

Seventy patients with a mean age of 76.4 years were studied. Mean distance visual acuity (VA) was 62.4 (Early Treatment Diabetic Retinopathy Study letters), mean near VA was 0.81 (logarithm of the minimum angle of resolution), and mean reading speed was 74.9 words per minute. Important NEI VFQ-25 quality of vision subscales (general vision, difficulty with distance tasks, difficulty with near tasks) and vision-specific subscales (dependency, role difficulties, mental health, social function limitations) tended to correlate negatively with increasing patient age and duration of vision loss, but correlated positively with better VA and reading speed. The mean QOL scores for these important quality of vision and vision-specific subscales were significantly worse than or similar to mean scores in patients with low vision, and significantly worse than scores in patients with AMD of varying severity and a reference population. The mean SF-12 physical composite score in study patients was similar to that seen in patients with AMD of varying severity, but significantly higher than that in patients with low vision and a reference population. The SF-12 mental composite score in study patients was similar to those of all 3 comparison groups.

Conclusions

Patients with bilateral severe AMD have vision-related QOL similar to that of patients with low vision but significantly worse than those of patients with AMD of varying severity and persons without eye disease. This inability to perform vision-related daily tasks is not related to general health problems.

Section snippets

Materials and methods

All patients with bilateral severe neovascular AMD scheduled to undergo MT360 at Duke University Eye Center from February 1999 through August 2002 who met eligibility criteria, as outlined in Table 1, were invited to participate in the institutional review board–approved study.21, 22 Data recorded at the initial interview included patient age, patient gender, and duration of central vision loss in the second affected eye, which was calculated from patients' reports of when they could no longer

Results

Seventy patients, of whom 27 (38.6%) were male, were enrolled in the study. The mean age of the patients was 76.4 years (standard deviation [SD], 5.65). Patients had had vision loss in their second eye for an average of 13.5 weeks (SD, 11.2) before presentation. The mean lesion size in the most recently affected eye was 10.0 MPS disc areas (SD, 5.5), and all lesions were ≥3 MPS disc areas in size. The mean distance VA was 62.4 letters (SD, 16.7), mean near VA was 0.81 logMAR (SD, 0.37), and

Discussion

Patients in this study tended to have NEI VFQ-25 QOL scores similar to those of patients with low vision, but worse scores than patients with AMD of varying severity and a reference group without ocular disease.18 However, some quality of vision and vision-specific NEI VFQ-25 subscales seemed to be better descriptors than others of the problems patients with bilateral severe AMD face when performing normal vision-related daily activities. The correlation between visual function and most NEI

Acknowledgments

The authors acknowledge the help provided by William Smiddy and William Feuer in reanalyzing data from a previous study to generate SF-36 composite scores used in the low-vision comparison group in this study.

References (25)

  • E.P. Steinberg et al.

    The VF-14An index of functional impairment in patients with cataract

    Arch Ophthalmol

    (1994)
  • C.M. Mangione et al.

    Development of the “Activities of Daily Vision Scale.” A measure of visual function status

    Med Care

    (1992)
  • Cited by (0)

    Manuscript no. 230648.

    Financial support: National Eye Institute (Bethesda, Maryland) Clinical Vision Research Development Award (grant no.: EY11725) (SSS) and D. Euan Baird, Angelica H. Baird, and the Andrew Family Foundation, Boston, Massachusetts (CAT).

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