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Laura Hall, Shabnam Pakneshan, Ron A Adelman; Quality of Life in Age-Related Macular Degeneration Comparing Aflibercept, Photodynamic Therapy and Pegaptanib Sodium Treatment Groups. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3950.
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To examine quality of life (QOL) in age-related macular degeneration (AMD), particularly across those receiving aflibercept (Eylea®), photodynamic therapy (PDT), pegaptanib sodium (Macugen®), and no treatment.
The Visual Function Questionnaire (VFQ-25) was administered to AMD patients. Subgroup analysis was performed per NEI algorithms and correlations between visual acuity (VA) and subgroup outcomes were calculated. Additional analyses regarding questions on treatment side effects were performed on patients recently switched to aflibercept from bevacizumab (Avastin®) and/or ranibizumab (Lucentis®).
The study included 93 patients: 18 treated with PDT, 9 with pegaptanib, 12 with aflibercept, 25 with aflibercept after being switched from ranibizumab and/or bevacizumab, and 29 with no treatment (14 of those received AREDS). The no treatment group had better mean VA acuity and less severe disease. Mean age was 88 years. Values reported are on a scale of 0-100: higher values indicate better functioning. The overall QOL score yielded a mean of 71.2 for all patients, 60.3 PDT, 63.9 pegaptanib, 80.2 all aflibercept, 81.6 aflibercept after switch, and 71.2 no treatment (p=0.02). There is a strong correlation between visual acuity and QOL (r=0.63). The two lowest subgroup scores were perception of general vision (51.0 all patients, 37.8 PDT, 35.6 pegaptanib, 69.5 all aflibercept, 71.2 aflibercept after switch, and 47.9 no treatment, p<0.01) and driving (p=0.18). The highest scores were in the ocular pain, color vision, and social functioning subgroups. Other significant analyses included the following subgroups: dependency (p<0.01), mental health (p<0.01), peripheral vision (p=0.01) and social functioning (p=0.04). Visual acuity also strongly correlated to near vision and driving and moderately correlated to distant activities, peripheral vision, color vision and role difficulties. Of the 25 patients who were switched to aflibercept, 44% felt that their change in vision was better versus worse (4%) or no change (52%); and 56% felt that the switch was a positive experience versus negative (4%) or no change (40%).
There has been a significant improvement in quality of life for AMD patients since the introduction of anti-VEGF agents. Patients experience markedly less dependence with increased social functioning and mental health.
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