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M.A. Chang, H.F. Fine, E. Bass, S.B. Bressler, A.P. Schachat, S.D. Solomon, N.M. Bressler; Patients' Preferences in Choosing Therapy for Retinal Vein Occlusions . Invest. Ophthalmol. Vis. Sci. 2006;47(13):5200.
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The Vision Preference Value Scale (VPVS) is a validated method to determine the impact of eye disease on quality of life. The purpose of this study was to assess preference values for both branch (BVO) and central vein occlusions (CVO) with macular edema and to determine how preference values may affect patient perceptions of potential treatments.
Patients seen in the Retina Division of the Wilmer Eye Institute with recent onset retinal vein occlusion were identified using ICD–9 coding criteria. The VPVS was administered to a total of 153 patients over the telephone. Additional questions regarding patient enthusiasm for potential treatments were also administered. Charts then were reviewed for demographic and clinical information. Univariate analyses were performed using Pearson’s correlations and Student’s t–tests to identify potentially significant predictors of preference values. Multivariate linear regression then was used to adjust for potential confounders. Relationships between preference values and enthusiasm for potential treatments were assessed using one–way ANOVA.
For patients with BVO, the average preference value was 0.65, with a standard deviation of + 0.20; for CVO the average and standard deviation of the preference value was 0.65 + 0.19. In univariate analyses, duration of vein occlusion greater than 2 years (p=0.01) and worse last–recorded visual acuity in the affected eye (p=0.005) had the greatest association with lower preference values. In multivariate analyses adjusting for age, race, and gender, duration of vein occlusion greater than 2 years (p=0.03) and last–recorded visual acuity of the affected eye (p=0.02) had the strongest association with lower preference value. Approximately half of patients were moderately or very enthusiastic about undergoing intravitreal injection. Seventy percent of BVO patients were moderately or very enthusiastic about the standard of care, laser photocoagulation, whereas only a third of CVO patients were moderately or very enthusiastic about standard observation.
These data suggest that retinal vein occlusion with macular edema is a significant cause of visual morbidity and has a significant impact on patient quality of life. A majority of patients were willing to undergo potentially invasive treatment.
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