Artikel
Quality of life in patients with age-related macular degeneration compared with visual function and morphological changes
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Autoren
Veröffentlicht: | 22. September 2004 |
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Gliederung
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Objective
Health-related quality of life (HR-QOL) analysis offers a method of incorporating clinical outcomes measurement into patient care, quality management, and clinical studies. We evaluate the National Eye Institute Visual Function Questionnaire (NEI-VFQ) to assess self-reported visual quality of life in correlation with grade of AMD changes and visual acuity (VA) in patients with age-related macular degeneration (AMD).
Methods
A cross sectional study of patients with all stages of AMD was conducted. Examinations included ETDRS visual acuity, binocular ophthalmoscopy, fluorescein angiography, digital colour fundus photography and the German versions of NEI-VFQ. For subgroup analysis we divided the patients into three groups (VG) according to their visual acuity: VG1: both eyes VA ≥ 20/32, VG2: VA ≥ 20/32 and fellow eye ≤ 20/63; VG3 both eyes ≤ 20/63. The AMD lesions were graded as following. Mild (both eyes drusen), moderate (drusen and fellow eye with lesion ≤ four DA [disk area]), severe (one eye late AMD ≥ 4 DA or both eyes late AMD ≤ 4 DA), and very severe (both eyes late AMD, even one ≥ 4 DA).
Results
Two hundred and sixty patients (mean age: 72.6±7.8; 162 female, 98 male) were included into a cross sectional study. VA of study group ranged from hand motions up to 20/12,5. Out of all patients 232 matched into vision groups 1-3. We found 35 patients with mild, 52 with moderate, 98 with severe and 75 patients with very severe changes. Overall NEI-VFQ score was 73.5±16.1 compared with 88,4 in control group with no signs of AMD (n=360). We found a significant correlation not only between VA and HR-QOL but also between grade of AMD changes and HR-QOL. NEI-VFQ mean scores in special scales are lower, especially within VGs 1 and 3, with increasing AMD changes.
Conclusions
Health-related quality of life in patients with AMD is significantly associated with not only ETDRS vision but also grade of AMD changes. HR-QOL measurement should be part of a comprehensive assessment of visual function in future AMD clinical trials.