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J.E. Keeffe, J.B. Hassell, E.L. Lamoureux; Impact of Age–related Macular Degeneration on Quality of Life . Invest. Ophthalmol. Vis. Sci. 2004;45(13):1378.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To describe the impact of vision loss from age–related macular degeneration (AMD) and explore the association of vision–related quality of life with vision impairment, health and demographic variables. Methods: Adult participants with impaired vision (VA <20/40 in the better eye) were recruited from hospital clinics and vision rehabilitation agencies in urban and rural areas. All had AMD diagnosed by an ophthalmologist and had no previous vision rehabilitation. Quality of life was assessed with the Impact of Vision Impairment (IVI), a 32 item questionnaire where participants rate the extent that vision restricts participation in relevant activities. Participants completed the Short Form General Health Survey (SF–12) and a questionnaire. Distance and near visual acuity were measured. IVI items were ranked by difficulty in categories of vision impairment. Results: The average age of the 106 participants was 83.6 years (range 66 – 101) with 66% female. The median age of onset of AMD was 76 years (range 64 – 98) and median duration 2 years (range <1 – 30). One–quarter had mild vision impairment, (VA<20/40 to 20/60), 60% moderate impairment (VA<20/60 to 20/200) and 15% severe impairment (VA <20/200). Areas of most concern to people with AMD were activities that involved near and distance reading, recreation, shopping, feelings of frustration, and vision stopping them doing what they wanted to do. Vision also interfered with travel and mobility for people with mild, moderate and severe vision loss. Univariate analysis showed that distance visual acuity, physical and mental health (SF–12) were associated with vision related quality of life as measured by the IVI (all p <0.05) while near vision, age, gender and duration of loss were not significantly associated with IVI scores (all p > 0.05). When controlling for general health, multivariate analysis showed an increased risk of restriction to participation and thus quality of life for people with moderate or severe vision impairment compared to those with mild impairment, OR 4.7, CL 1.5, 14.6. Conclusions: The impact of vision loss in AMD goes beyond central vision functions such as reading and recognizing faces but affects participation in recreation and causes concerns for safe mobility and emotional well–being. The effects on quality of life are associated with vision and not other possible effects of ageing investigated in this study.
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