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S.M. Nayeem, R.A. Adelman; A Study of Quality of Life in Age–Related Macular Degeneration Comparing Photodynamic Therapy and Pegaptanib Sodium Treatment Groups . Invest. Ophthalmol. Vis. Sci. 2006;47(13):2142.
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To study quality of life (QOL) in age–related macular degeneration (AMD), particularly across photodynamic therapy (PDT) and pegaptanib sodium injection (PS) treatment groups.
Patients with AMD were either mailed or administered in person a modified version of the Visual Function Questionnaire (VFQ–25). A two–tailed student t–test and mean were calculated for each treatment group, and subgroup analysis of the VFQ–25 was performed per NEI prescribed algorithms. Additional analyses regarding treatment side effects and correlations between visual acuity (VA) and subgroup outcomes were also performed.
17 patients were interviewed and four patients returned the survey by mail. Of these, seven had been treated with PDT (two had also received intravitreal triamcinolone acetate (IVTA) injections); four had been treated with PS; three had been treated with both PS and PDT (one had also received IVTA); and seven had not been treated with any of these treatments. The average ocular pain score for the first two weeks following treatment was 75.0 for patients treated with PDT and 87.5 for patients treated with PS (100 signifies no pain; p = 0.54). The ocular pain subgroup, as denoted by NEI, yielded a mean score of 87.5 for both subgroups. No patients reported experiencing back pain following treatment. The average mental health score for concerns related to treatments was 77.5 for the PDT group and 78.1 for the PS group (p = 0.97), while the average independence score related to treatment appointments was 90.0 for the PDT group and 100.0 for the PS group (p = 0.37). The overall QOL was 53.7 for the PDT group and 70.4 for the PS group (p = 0.23). Given the correlation between VA and QOL, a score denoting (QOL^2) / scaled VA in best eye was calculated, with scores of 48.8 and 54.9 for the PDT and PS groups, respectively (p = 0.71). Over all patients, VA was strongly correlated to overall QOL (average score 64.9; correlation 0.70) as well as the dependency subgroup (average score 71.8; correlation 0.69), peripheral vision subgroup (average score 71.3; correlation 0.68), and the near activities subgroup (average score 60.8; correlation 0.68). Patients’ lowest subgroup scores were in perception of general vision (39.0) and in driving (41.1).
QOL, stress due to treatment, and ocular pain did not differ between treatment groups. Decreasing VA was associated most strongly with decreases in overall quality of life, independence, and ability to perform near activities. Overall, the group scored poorly on driving functionality.
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