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A. M. Pleil, R. Buggage, L. Chen, A. I. Barsdorf, G. Zlateva, Perspectives Study Group; Vision-Related Quality of Life in Subjects With Neovascular Age-Related Macular Degeneration (NV-AMD): A Comparison of Early and Established CNV Lesions. Invest. Ophthalmol. Vis. Sci. 2008;49(13):572.
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To examine relationships among baseline clinical and demographic characteristics and patient self-reported vision-related functioning and quality of life in NV-AMD subjects with early versus established CNV lesions.
Data from 113 subjects who completed 30 weeks of follow-up in the PERSPECTIVES study, a multi-center, multi-national 102 week clinical trial for the treatment of NV-AMD, were included in this analysis. Assessments of visual function at baseline included distance visual acuity, near visual acuity, reading speed, and contrast sensitivity. Vision-related functioning and quality of life information was collected using the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) via a telephone interview administered by trained interviewers. CNV lesions were categorized as early or established by study investigators based on a combination of visual acuity, fundus photos, fluorescein and/or indocyanine green angiography.
Participants mean age was 74.0 years (±8.0). Sixty-seven (59%) patients were female, and 109 (97%) were white. No significant differences in demographic characteristics were found between subjects with early (n=35) or established (n=78) lesions. NV-AMD subjects with early lesions had significantly higher baseline assessments of reading speed (57.2 vs. 43.9; p=0.0064), mean distance visual acuity (68.29 vs. 57.0; p<.0001), contrast sensitivity (1.3 vs. 1.13; p=0.0127), and significantly better near visual acuity (0.46 vs. 0.66; p=0.0005) compared to patients with established lesions. Patients with early lesions had significantly higher NEI-VFQ mean scores for social functioning (85.98 vs. 74.08; p=.02), mental health (60.61 vs. 50.18; p=.048), and color vision (92.97 vs. 82.46; p=.02), and higher mean scores for composite (71.35 vs. 64.64), distance activities (67.05 vs. 60.60), role difficulties (65.15 vs. 58.46), and dependency (76.52 vs. 70.10) compared to patients with established lesions.
Visual impairment and its impact on vision-related quality of life are evident in the early stages of NV-AMD and decline significantly as the disease progresses as defined by lesion state.
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