March 2012
Volume 53, Issue 14
ARVO Annual Meeting Abstract  |   March 2012
Vision-Related Symptoms And Functional Impairments In Patients With Geographic Atrophy (GA): Findings From A Qualitative Study
Author Affiliations & Notes
  • Fang Wang
    GlaxoSmithKline, King of Prussia, Pennsylvania
  • Asha Hareendran
    United Biosource Corporation, London, United Kingdom
  • Janet S. Sunness
    Hoover Low Vision Rehab Services, Greater Baltimore Medical Center, Baltimore, Maryland
  • Donald C. Fletcher
    Ophthalmology, California Pacific Medical Center, San Francisco, California
    Smith-Kettlewell Eye Research Institute, San Francisco, California
  • Footnotes
    Commercial Relationships  Fang Wang, Current employee of GlaxoSmithKline (E); Asha Hareendran, Current employee of United Biosource Corporation who was contracted to conduct this study (F); Janet S. Sunness, consulted for a number of companies regarding designing GA trials (C); Donald C. Fletcher, Clinical consultant for design of this study (C)
  • Footnotes
    Support  The study is funded by GlaxoSmithKline
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 5445. doi:
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      Fang Wang, Asha Hareendran, Janet S. Sunness, Donald C. Fletcher; Vision-Related Symptoms And Functional Impairments In Patients With Geographic Atrophy (GA): Findings From A Qualitative Study. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5445.

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      © ARVO (1962-2015); The Authors (2016-present)

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To gain insight directly from patients about key symptoms, functional limitations and quality of life impacts associated with geographic atrophy (GA).


Qualitative research was conducted in subjects enrolled from a clinical site in the US who met specific inclusion/exclusion criteria. Three focus groups and 6 interviews were conducted by trained moderators using IRB approved discussion guides. To facilitate concept elicitation, discussions were initiated with open-ended questions, followed by more specific queries based on facts identified from the literature as well as interviews with clinicians. All discussions were recorded and audio-data was transcribed for analyses. Atlas.TI software was used to analyze and organize responses into themes and concepts.


Twenty two subjects with bilateral GA participated in either a focus group or a telephone interview. Mean age was 81 years; 89% were female; 91% were Caucasian; and 41% were living alone. Visual acuity ranged from 20/40 or better (N=5), 20/50-20/190 (N=9), to 20/200 or worse (N=8). Participants reported a range of symptoms including distorted vision (e.g. blurred vision, wavy appearance, shadow and floaters, color vision disturbances, and depth perception) and luminance adaptation issues. Difficulties in many aspects of activities of daily living (ADLs) were also reported including 1) hobbies, social and family life; 2) basic and instrumental ADLs (self-care, walking, shopping, banking, using telephone, paying bills, etc); and 3) psychological well-being (feeling sad, angry, frustrated or anxious etc). The most bothersome problems, as reported by participants, were difficulties in reading, driving, and recognizing people. A variety of adaptation strategies (e.g. task avoidance, device support, and life style modification) were applied to limit impairments resulting from GA symptoms.


GA patients experience many vision-related symptoms that result in a broad range of difficulties in activities of daily living. They appear to use various strategies to adapt to their visual deficits to maintain functional capacity. The results of this study have implications for evaluating outcomes of treatments for GA.

Keywords: quality of life • age-related macular degeneration 

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