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G. Abedi, S. M. Nayeem, R. A. Adelman; Quality of Life in Age-Related Macular Degeneration Comparing Ranibizimab, Photodynamic Therapy and Pegaptanib Sodium Treatment Groups. Invest. Ophthalmol. Vis. Sci. 2007;48(13):4581.
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© ARVO (1962-2015); The Authors (2016-present)
To examine quality of life (QOL) in age related macular degeneration (AMD), particularly across photodynamic therapy (PDT), pegaptanib sodium, and ranibizumab treatment.
Patients with AMD were invited to fill out a modified version of the Visual Function Questionnaire (VFQ-25). Subgroup analysis of the VFQ-25 was performed per NEI algorithms and additional analyses regarding questions on treatment side effects were also performed. A two-tailed student t-test and mean were calculated. Correlations between the subgroup and treatment-related subgroup outcomes were also calculated to determine which QOL deficits might occur together. Multiple linear regression models were used to estimate the association between the overall QOL score and scaled visual acuity, age, gender, and treatment history.
81 patients participated in the study. Of these, 37 had been treated with PDT; 16 with pegaptanib; 10 with ranibizumab, and 25 had not been treated with any of these treatments. The mean age was 80 years. The overall QOL score yielded a mean score of 67.3 for PDT group, 64.7 for pegaptanib group and 69.6 for ranibizumab group (p = 0.73) Patients’ lowest subgroup scores were in perception of general vision (43.8) and in driving (51.1). The ocular pain subgroup yielded a mean score of 82.9 for the PDT group, 87.5 for the pegaptanib group, and 85 for ranibizumab group. (p = 0.48). The average vision change score following treatment was 87.5 for PDT group, 77.8 for the pegaptanib group and 95.5 for the ranibizumab group (p = 0.02). The average mental health score for concerns related to treatment was 78.2 for PDT group, 73.6 for the pegaptanib group and 92.5 for the ranibizumab group (p = 0.56) while the average independence score related to treatment appointment was 86.1 for the PDT group, 87.5 for the pegaptanib group and 75.8 for the ranibizumab group (p = 0.79 ). A nonlinear relationship was seen between QOL and visual acuity.
Stress regarding treatment and ocular pain was not statistically different between PDT, pegaptanib and ranibizumab groups. However improvement in visual acuity was significantly better in ranibizumab group. Decreasing visual acuity was associated strongly with decreases in ability to perform near vision and distance vision, overall QOL, driving and independence. Scales denoting worry and frustration about treatment did not demonstrate a strong relationship to visual function, implying patient concern about treatment across the visual acuity spectrum
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