Purchase this article with an account.
Robert P. Finger, Jennifer B. Hassell, Farshad Abedi, Mark C. Gillies, Jill E. Keeffe, Robyn H. Guymer; The Impact Of Anti-vegf Treatment On Vision-related Quality Of Life In Age-related Macular Degeneration Outside Clinical Trials. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6521.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To assess vision-related quality of life (VRQoL) in patients with neovascular age-related macular degeneration (nvAMD) undergoing anti-VEGF treatment in routine clinical practice outside phase III clinical trials.
All patients undergoing anti-VEGF treatment for nvAMD at a public tertiary referral centre were eligible. 137 patients with newly diagnosed nvAMD were assessed prior to anti-VEGF treatment then 6 and 12 months later. At the time of this analysis, 89 patients had completed 6 months and 62 patients 12 months follow-up. VRQoL was documented using the Impact of Vision Impairment (IVI) questionnaire. Rasch analysis was performed using Winsteps. Descriptive statistics and regression modeling were performed using SPSS 19.
Rasch analysis demonstrated good measurement properties of the IVI for its three subscales: reading and accessing information, mobility and emotional well-being. Visual acuity in the treated eye improved at 6 (by 10 letters, p<0.001) and at 12 months (by 8 letters, p<0.001) compared with baseline (mean 44 letters, standard deviation 19 letters), and remained stable in the fellow eye (p>0.7). Rasch adjusted scores for mobility, accessing information and reading, and emotional well-being improved to six months for persons who were vision impaired (< 20/63) at baseline (by 1.6 - 1.9 logits, all p<0.01) or whose better eye was treated (by 2.1-2.3 logits, all p<0.007), and remained stable for the overall sample. By 12 months only mobility and emotional well-being in persons whose better eye was treated showed a statistically significant improvement (by 2.0 - 2.3 logits, both p<0.02) while other patients had stable VRQoL scores.
We observed an improvement of VRQoL with anti-VEGF treatment in persons treated in routine clinical practice who were either vision impaired or whose better eye was treated. Other patients maintained VRQoL. Ongoing follow-up of this cohort is required to determine whether the weaker effect seen at 12 compared with 6 months is due to fewer numbers at the later time point, or whether there are other factors, such as chronicity of treatment, progression of dry degeneration or second eye involvement, that affect patient reported outcomes over time.
This PDF is available to Subscribers Only