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D. C. Shield, G. Abedi, R. A. Adelman; Quality of Life In Age-Related Macular Degeneration Comparing Ranibizumab, Bevacizumab, and Photodynamic Therapy. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4527.
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© ARVO (1962-2015); The Authors (2016-present)
To examine quality of life (QOL) in age related macular degeneration (AMD), particularly across photodynamic therapy (PDT), ranibizumab, and bevacizumab treatments.
Patients with both exudative and non-exudative AMD completed a modified version of the Visual Function Questionnaire (VFQ-25). Subgroup analysis was performed per NEI algorithms and additional analyses on treatment side effects were performed. Two-tailed student t-test and means were calculated. Correlations between subgroup outcomes were calculated and linear regression modeling was used to estimate the association between overall QOL and scaled visual acuity, age, gender, and treatment history.
120 patients participated in the study. Of these, 45 had been treated with PDT; 27 with pegaptanib; 45 with ranibizumab; 5 with bevacizumab; and 33 patients had not received any of these treatments (i.e., those patients without choroidal neovascular membranes). Several patients received more than one treatment; these patients were excluded from analysis. Mean age was 81.3±9.6 years. Mean overall QOL scores were 72.9 for the non-exudative AMD group, 81.0 for bevacizumab, 65.9 for ranibizumab, and 56.3 for PDT (p=0.017). No significant QOL subscore differences were found between the ranibizumab and PDT groups. The bevacizumab group had higher QOL related to social functioning, driving, and vision change after treatment (all p<0.02), but this may have been due to small sample size of bevacizumab group. There was no significant difference between treatment groups for ocular pain, mental health or independence scores related to treatment. Step-wise linear regression produced a model in which squared visual acuity was associated with higher QOL and treatment with PDT was associated with lower QOL (r2=0.509, p<0.001).
Patients receiving anti-VEGF medications had QOL similar to patients with non-exudative AMD, while patients receiving PDT had worse QOL. Ocular pain and stress regarding treatment was not statistically different between PDT, ranibizumab, and bevacizumab groups. Visual acuity predicted higher QOL and treatment with PDT predicted lower QOL with linear regression models.
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