March 2012
Volume 53, Issue 14
Free
ARVO Annual Meeting Abstract  |   March 2012
The Impact Of Anti-vegf Treatment On Vision-related Quality Of Life In Age-related Macular Degeneration Outside Clinical Trials
Author Affiliations & Notes
  • Robert P. Finger
    Centre for Eye Research Australia, Melbourne, Australia
  • Jennifer B. Hassell
    Centre for Eye Research Australia, Melbourne, Australia
  • Farshad Abedi
    Centre for Eye Research Australia, Melbourne, Australia
  • Mark C. Gillies
    Save Sight Institute, Sydney, Australia
  • Jill E. Keeffe
    Centre for Eye Research Australia, Melbourne, Australia
  • Robyn H. Guymer
    Centre for Eye Research Australia, Melbourne, Australia
  • Footnotes
    Commercial Relationships  Robert P. Finger, Novartis (F, C); Jennifer B. Hassell, None; Farshad Abedi, None; Mark C. Gillies, None; Jill E. Keeffe, Novartis (F); Robyn H. Guymer, Novartis (F)
  • Footnotes
    Support  This study was in part supported by the National Health and Medical Research Council grant #590205 and funding from Novartis Australia. German Research Council grant to RPF (DFG FI-1540/5-5).
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 6521. doi:
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      Robert P. Finger, Jennifer B. Hassell, Farshad Abedi, Mark C. Gillies, Jill E. Keeffe, Robyn H. Guymer; The Impact Of Anti-vegf Treatment On Vision-related Quality Of Life In Age-related Macular Degeneration Outside Clinical Trials. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6521.

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

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Abstract

Purpose: : To assess vision-related quality of life (VRQoL) in patients with neovascular age-related macular degeneration (nvAMD) undergoing anti-VEGF treatment in routine clinical practice outside phase III clinical trials.

Methods: : All patients undergoing anti-VEGF treatment for nvAMD at a public tertiary referral centre were eligible. 137 patients with newly diagnosed nvAMD were assessed prior to anti-VEGF treatment then 6 and 12 months later. At the time of this analysis, 89 patients had completed 6 months and 62 patients 12 months follow-up. VRQoL was documented using the Impact of Vision Impairment (IVI) questionnaire. Rasch analysis was performed using Winsteps. Descriptive statistics and regression modeling were performed using SPSS 19.

Results: : Rasch analysis demonstrated good measurement properties of the IVI for its three subscales: reading and accessing information, mobility and emotional well-being. Visual acuity in the treated eye improved at 6 (by 10 letters, p<0.001) and at 12 months (by 8 letters, p<0.001) compared with baseline (mean 44 letters, standard deviation 19 letters), and remained stable in the fellow eye (p>0.7). Rasch adjusted scores for mobility, accessing information and reading, and emotional well-being improved to six months for persons who were vision impaired (< 20/63) at baseline (by 1.6 - 1.9 logits, all p<0.01) or whose better eye was treated (by 2.1-2.3 logits, all p<0.007), and remained stable for the overall sample. By 12 months only mobility and emotional well-being in persons whose better eye was treated showed a statistically significant improvement (by 2.0 - 2.3 logits, both p<0.02) while other patients had stable VRQoL scores.

Conclusions: : We observed an improvement of VRQoL with anti-VEGF treatment in persons treated in routine clinical practice who were either vision impaired or whose better eye was treated. Other patients maintained VRQoL. Ongoing follow-up of this cohort is required to determine whether the weaker effect seen at 12 compared with 6 months is due to fewer numbers at the later time point, or whether there are other factors, such as chronicity of treatment, progression of dry degeneration or second eye involvement, that affect patient reported outcomes over time.

Keywords: age-related macular degeneration • quality of life • vascular endothelial growth factor 
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