Purpose:
To assess the impact of age-related macular degeneration (AMD) and maculopathies on vision specific health-related quality of life (HRQOL) in a population-based sample of Latinos.
Methods:
Participants, aged 40 or older, from The Los Angeles Latino Eye Study (LALES) underwent standardized comprehensive ophthalmological examinations at baseline. AMD was detected by grading 30° stereoscopic fundus photographs using the modified Wisconsin Age-Related Maculopathy Grading System. AMD was defined as the presence of early or advanced AMD. Early AMD was defined as the absence of signs of advanced AMD and the presence of soft indistinct drusen or hard distinct or soft distinct drusen with pigmentary abnormalities. Advanced AMD was defined as the presence of either geographic atrophy or exudative AMD. Self-reported vision-related HRQOL was assessed by the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25). Analysis of covariance (ANCOVA) was used to calculate mean scores for QOL subscales after adjusting for age, gender, comorbidities, other ocular disease and health insurance.
Results:
Of the 6357 participants who completed an ophthalmic examination, 4876 (77%) were included in this analysis, as they had a gradable fundus photograph and completed the HRQOL questionnaires. All vision-specific subscale QOL scores (except general health, color vision, ocular pain, and peripheral vision) were significantly lower for those with any AMD (P <0.001 to <0.05). Scores were even lower for the same subscales in participants with advanced AMD compared to early or no AMD (P<0.003 for all). Participants with soft indistinct drusen, increased or decreased pigmentary changes had significantly lower mean scores for vision specific dependency, near vision, distant vision, driving difficulty, vision related role function, vision related social function and composite QOL, compared to those without the lesion (P <0.001 to <0.05).
Conclusions:
Our results reinforce that any and advance AMD result in measurable impacts on visual functioning and self-reported quality of life.
Keywords: age-related macular degeneration • clinical (human) or epidemiologic studies: biostatistics/epidemiology methodology • clinical (human) or epidemiologic studies: outcomes/complications