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M. I. van der Reis, E. C. La Heij, F. Hendrikse, J. S. A. G. Schouten; A New Method to Assess the Burden of Disease in Patients With Exudative Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4526.
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The real life time burden of disease can only be assessed in patients who have died and not be based on the multiplication of prevalent disease severity from one study with disease duration from another study. Aim of the present study was to assess the burden of disease in patients with exudative age-related macular degeneration (AMD).
From our AMD database we selected 98 patients diagnosed between January 1992 and December 1997. Patients were selected if exudative AMD was confirmed by fluorescence angiogram according to the classification of the Macular Photocoagulation Study group and if they had a follow-up of at least 6 months. In October 2009 the Dutch mortality registration was used to assess whether patients had died. Mortality rates were compared with a Dutch control group matched for age and sex during a period of 10 years. Visual acuity (VA) was retrospectively assessed from patient files. Univariate analysis was performed with the Kaplan-Meier method and log-rank test.
The mean age was 76.6 (range 56-91) at the time of diagnosis. The mean follow-up was 9.1 years (range 0.7-26.8, median follow-up 8.1). By 1 October 2009, 68.7 % (68 of 98) patients had died. There was no statistically significant difference with the age and sex matched mortality in the Dutch population. The median survival of patients with exudative AMD was 11 years. A complete follow-up until death was registered for 68 patients. These patients had a mean survival of 8.5 years after being diagnosed with exudative AMD. Mean VA in the affected eye at time of diagnoses and at the last visit were 0.84 and 1.39 logarithm of the minimum angle of resolution (logMAR) respectively. The mean VA for patients best eye was 0.41 at time of diagnosis and 1.00 logMAR at the final measured VA.
Patients with exudative AMD have a mean life time disease duration of 8.5 years and a reduced visual acuity level starting at 0.41 logMAR and ultimately reaching 1.00 logMAR in the best eye before death. This older population experiences a great burden of their disease, due to a considerable decrease in VA.
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